Table 1

Impact of COVID-19 on C&YP and summary of mitigating actions/policy recommendations

Topic areaSummary of impactSummary of mitigating actions/policy recommendations
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.

  • C&YP, children and young people; NHS, National Health Service.