Delivery of healthcare | Cancelled outpatient and inpatient health services Backlog of pent up demand for paediatric health services. Late presentation of acute need. Disruption in provision of universal health visiting, dental health and school delivered immunisation programmes.
| Ensure universal early years public health services are prioritised and supported financially, with targeted help for children and families in poverty. Robust business continuity planning. Prioritise essential services including healthcare, social care, emergency services, utilities and the food chain. Guidance, online consultations and outreach, for conditions other than COVID-19. Build on the reset, restore and recover model promoted by the Royal College of Paediatrics and Child Health. Innovation in new delivery models of services for children.
|
Interruption of schooling and early years provision | Widening gap in attainment between children from the poorest and most wealthy families. Families with children with special educational needs and /or disabilities have been under additional pressure during this period. Encouraging and sustaining infection prevention control measures is likely to be particularly difficult within children.
| Provide support for young people in critical transitions, and low-income or at-risk C&YP who lack IT and good home study environments. Targeted support for disadvantaged pupils to catch up, including funding tutors and extra classes. Universities to consider lowering admission offers to disadvantaged applicants to address the current awards process. A focus on holistic care, and supporting children’s emotional needs and mental health and well-being on return to school. Reform childcare/early years education to improve the quality, affordability and availability of childcare. Introduce age-specific and evidence-based handwashing interventions such as eBug.
|
Increased health impact of lockdown – domestic abuse and safeguarding | Challenging behaviour, parental drug and alcohol abuse, and mental health issues all exacerbated. Lack of face-to-face contact means reduced opportunities for intervention and support in domestic abuse or other safeguarding issues – for both perpetrators and victims. Children becoming aware of, and witnessing, existing domestic abuse due to stay at home measures. Stay-at-home measures and fears about COVID-19 have made it more difficult for victims to leave and speak out about domestic abuse. Lack of oversight and safeguarding mechanisms for families where ‘hidden harm’ exists. Chronic underfunding of adult and child abuse services. Disruption to multiagency risk assessment conference (MARAC) functioning and reduction in MARAC referrals – particularly concerning given the level of risk.
| Helping volunteers and the wider community to be alert and watch out for signs of abuse and what they can do to help. Support community organisations responding to local needs. Ring-fenced funding for specialist services for Black, Asian and minority ethnic women and other marginalised groups. Provide safety advice and support services for women at risk of domestic abuse. Involvement of domestic abuse professionals in wider contingency planning. Planning for the surge in demand in services (domestic abuse, adult and children’s social care). Greater cross-departmental working and shared funding (justice, police, housing, the domestic abuse sector and wider agencies). Identify how Safeguarding Adult Boards can provide support and help to facilitate robust partnership efforts. National ‘code word’ campaign as a route to emergency support, via supermarkets/pharmacies. Increased provision of specialist domestic abuse specialists such as Independent Domestic Violence Advocates in hospitals. Ensure regular updates about safe accommodation options available for domestic abuse victims and which support services and perpetrator programmes are still available. Set up virtual MARAC meetings while face-to-face meetings are not possible.
|
Increased health impact of lockdown - Emotional well-being and mental health | C&YP coping with significant changes to their routine. Impact of parental stress and coping on children. Increased anxiety levels reported for C&YP. Some reduction in mental health referrals for early years. Double burden on services as social distancing measures begin to be lifted – backlog from the last few months and emerging issues requiring treatment and support. Limited professional and informal support in the early postnatal period leading to poorer perinatal mental health.
| Encourage and support other forms of social contact. Restrict duration of isolation Encourage daily physical activity Capacity building and planning for surge in demand following the lifting of social distancing measures. Maximising the use of technology, in a way that includes those who are digitally excluded. Restarting services and delivering them in ways that mitigate and reduce inequalities, such as targeting areas of lower socio-economic status.
|
Increased health impact of lockdown - Young carers | Restricted personal contact, schooling and travel may exacerbate inequalities already experienced by young carers. The impact on carers of ‘shielding’ parents is likely to be long term. Increased physical caring responsibilities and emotional dependence from prolonged time at home. Reduced capacity to home school due to lack of physical space or IT equipment. Increased risk of infection from undertaking shopping for food and medication. Coronavirus Act 2020 temporarily removing local authority statutory duties to assess young carers could further isolate this group.
| Councils to actively ‘check’ on known young carers and ensure they are not providing excessive or inappropriate care. Schools to reassess their approach to and provision of ongoing support, including identification of previously unknown carers and encouragement to attend school. Where non-attendance, schools should make regular contact with young carers. Information resources developed for social workers, carers and parents to help young carers understand the situation and stay safe.. Supermarkets to include young carers in dedicated shopping times for vulnerable groups. The Government to advise pharmacies to ensure that young carers continue to access required medication. The NHS to consider the support for young carers, for example, within hospital discharge and in maintaining digital contact.
|
Child poverty and social inequalities | Existing inequalities exacerbated by the COVID-19 pandemic and lockdown. The predicted recession is likely to disproportionately affect children and families, in the context of existing levels of child poverty in the UK prior to the pandemic.
| Provide immediate emergency support for children to ensure all parents can cover the basic costs of raising their children in the face of reduced income as a result of the pandemic. More generous payments to families with children through child benefit and universal credit should be a policy priority, and the two-child limit should be scrapped. Prioritise families with children when developing policies around housing, early years childcare, public transport and digital access to education.
|