North Thames multi-centre service evaluation: Ethical considerations during COVID-19

Area of Science:

• Paediatric Healthcare
• Public Health Policy
• Pandemic Response

Background:

• COVID-19 pandemic led to diversion of healthcare resources from paediatric services.
• Hospital visiting restrictions and reduced face-to-face paediatric care were implemented.
• Impact on children and young people (CYP) required investigation for future pandemic planning.

Purpose of the Study:

• To investigate the impact of COVID-19 service changes on children and young people.
• To inform recommendations for maintaining paediatric care during future pandemics.

Main Methods:

• Multi-centre service evaluation using a survey.
• Consultant paediatricians across the North Thames Paediatric Network participated.
• Investigated redeployment, visiting restrictions, patient safety, vulnerable children, virtual care, and ethical issues.

Main Results:

• 81% of paediatricians believed children's right to health was compromised.
• Sub-optimal care due to staff redeployment (61%) and mental health impacts from visiting restrictions (79%) were reported.
• Reduced face-to-face care disproportionately affected vulnerable children with complex needs, disabilities, and safeguarding concerns.

Conclusions:

• Paediatric care was perceived as compromised, leading to harm to children during the pandemic.
• Harm to children must be minimized in subsequent pandemics.
• Recommendations include prioritizing face-to-face care for vulnerable children.