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Children managed by GP could be removed from shielding list, suggests college

The Royal College of Paediatrics and Child Health has recommended that children and young people whose condition is being managed in primary care can probably be removed from the Covid-19 shielding patient list.

The college has submitted its recommendations as evidence to the Government’s ongoing review into which patients should be shielding from coronavirus via more stringent social distancing.

But the the Department of Health and Social Care (DHSC) stressed that its guidance on shielding, including for children, has yet to change.

The RCPCH review concluded that ‘children and young people who are cared for just in primary care are very unlikely to need to continue to shield’.

‘The majority of children with conditions including asthma, diabetes, epilepsy, and kidney disease do not need to continue to shield and can, for example, return to school as it reopens,’ the report said.

‘This includes many children with conditions such as cerebral palsy and scoliosis, for whom the benefits of school – in terms of access to therapies and developmental support – far outweigh the risk of infection.’

But it added that a ‘small group of children who are clinically extremely vulnerable due to their pre-existing condition will need to continue to shield; while a ‘further larger group of children exists who due to their underlying condition may need to shield and the decision to continue to shield would normally result from a discussion between the clinician, the child and their family’.

Its recommendations also include lists of conditions which should be considered by clinicians as automatically extremely vulnerable, who should continue to shield, or whose condition warrants a discussions between ‘the clinician, the child and their family’ regarding their continued shielding status.

The DHSC said it would take the recommendations into account as part of its work to create a better risk algorithm for who should be shielding from Covid-19 – which the deputy CMO has said could remove 90,000 children from the list – but stressed no changes have been made as yet.

A spokesperson said: ‘We understand how challenging this period is, especially for those who are shielding, and we are doing everything we can to support people, led at all times by clinical and scientific advice.

‘We will continue to engage extensively with partners and the healthcare system throughout this process and welcome the review by the Royal College of Paediatrics and Child Health.

‘However, our guidance on those who have been advised to shield has not changed at this time. We will take into account all available evidence as part of our wider review into shielding.’