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The needs of children and young people (CYP) were overlooked in the first wave of the coronavirus pandemic, the chief nurse at Public Health England has warned.
Viv Bennett said action was needed to “reverse the harm” caused to CYP due to Covid-19 going forward and called on every nurse to play a part.
“We have young people who are really traumatised and terrified actually”
Speaking at the Queen’s Nursing Institute annual conference last week, Ms Bennett said most of the impacts on CYP were “indirect” and related to lockdown and social distancing measures.
She said “conflict” in the home had increased since the pandemic and that the number of safeguarding concerns raised with authorities had risen.
Obesity among children had worsened while CYP with long-term conditions and special educational needs had faced problems accessing services.
Significantly, Ms Bennett said CYP were experiencing a level of anxiety about Covid-19 that was “disproportionate to their risk” and that social isolation was having a traumatic effect on them.
“We have young people who are really traumatised and terrified actually,” she warned the conference.
It comes as new NHS Digital survey released at the end of last week showed a rise in mental health problems in CYP during the pandemic.
According to the data, one in six young people had a probable mental health disorder in July during the first wave, compared with one in nine in 2017.
Ms Bennett told the conference the only time CYP had felt included in conversations about Covid-19 was when they were being blamed for transmission of the virus.
“Children tell us that they feel invisible and young people told us particularly that they feel that they have been ignored through this pandemic until such times as for example universities have gone back when they have been blamed,” said Ms Bennett.
It was acknowledged that the “specific and different needs of Covid weren’t understood in the first wave”.
Ms Bennett said this had led to children either being “overlooked” or “bundled together with adults” when advice was given, noting as an example that not as many children needed to shield as were told to in the peak.
“It was an invisible frontline in the first surge and we must work together to ensure it is not in the second surge”
Looking ahead, she said: “We absolutely have to make sure that we don’t do the same again because we do know now how Covid is affecting children and we need to think very carefully about how we manage the second surge.”
As part of this, Ms Bennett said it was crucial that public health nurses who looked after children and families including health visitors and school nurses were not redeployed again during the second wave.
She recently urged this point to directors of nursing in a joint letter with English chief nursing officer Ruth May and Local Government Association community wellbeing spokesperson Ian Hudspeth.
“Services for children are a frontline – it was an invisible frontline in the first surge and we must work together to ensure it is not in the second surge because this is so important for our children,” Ms Bennett told the conference.
She added that it was important that public health nurses were allowed to use their clinical judgement alongside national guidance to decide whether a face-to-face to digital appointment was most appropriate for an individual child or young person.
“I think some of that autonomy was not helped by some of our guidance last time and we need to get the balance right this time, so people have a good framework to work in but clinical judgement is understood and respected,” Ms Bennett told the conference.
More widely, Ms Bennett said all nurses whether they worked directly with children and families or not could make a difference in the second wave.
“I think every nurse understanding what the risks are to young people, what their concerns about protecting themselves and protecting other people, is really, really important,” she said.
She added that she would “love” to see all nurses gaining a better understanding of the different forms of vulnerability experienced by CYP.
One finding that had come out of the first wave was there was “no common language” around vulnerability, said Ms Bennett.
To address this, a new vulnerability framework had been developed by the Children and Young People Transformation Board.
She said one of the most important changes that could be made was ensuring CYP were listened to.
“We have to really listen to CYP and we have to move from a place where they feel ignored or blamed to a place where they feel included and supported to manage through this pandemic and beyond into our recovery,” Ms Bennett told the conference.
She added: “So, I think really listening, raising awareness, offering reassurance where appropriate and then being very mindful of vulnerable children who may come into your sphere of work even if you are not primarily a children’s or families nurse, would be incredibly supportive through the second surge.”