Update to families from the Cardiac team at Evelina London

27 Mar 2020
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Update to families from the Cardiac team at Evelina London

27 March 2020

Hi everyone,

This has been a time of unprecedented upheaval and change for everyone, and we know from the many calls we have had to our service just how worried all of you have been. We also understand it is difficult to keep up with the constant changes in recommendations.

The purpose of this update is to let you know what is happening here at the Evelina London and what adjustments we have needed to take as part of the wider NHS response to COVID-19.

The focus of the NHS as a whole is to provide the best care to those who need it most, both those affected by COVID-19 and our patients in need of urgent care. This has meant that we, and teams in other hospitals in London, have had to fundamentally change the way we provide care.

At Evelina London, we are focussed on the resilience of our children’s services, supporting our local and specialist paediatric centres from across the region, whilst also considering our adult colleagues and services.

Cardiac investigations, procedures and surgery

Babies and children still need to have their tests and treatments at the right time. At present we are still able to provide emergency and urgent procedures including cardiac catheterisation and cardiac surgery. We are limiting the number of any truly elective or planned procedures at present.

Outpatient services at Evelina London

We have had to change the way we monitor children. Routine outpatient clinics are cancelled to minimise the number of children and their families that come to hospital. This also means that you can adhere to the current government recommendations to stay at home. Instead we are planning to do most of our clinics over the telephone, and plan further tests (ECGs and heart scans) at a later date.

We are making arrangements for our children and young people who can’t wait any longer for their heart tests. We will be in touch directly with families about this.

Outpatient services in the Network

The demands on NHS services are not just in London but are being experienced across the region. This means that at present we are unable to come to all of the hospitals across the network to carry out our outpatient clinics. We are working very closely with paediatricians in each of these hospitals to work out who can be contacted by phone, who should be seen by the local team, and who may need to be seen at Evelina London.

Please be reassured that if your child needs to be seen, they will be seen. If you are concerned please see our contact details below.

Transfer of patients from the Royal Brompton Hospital

We have been working with the team at the Royal Brompton for several years, building a collaborative relationship and planning for how we will work together. The London-wide demand for adult beds means that the Royal Brompton Hospital cannot undertake heart surgery at present.

As a result some patients that would normally be treated at the Royal Brompton, may be treated at Evelina London. This is very much focussed on the management of emergency or urgent cases at this time – just as for our patients. A small number of the staff from the Royal Brompton will be working alongside us to provide care here at Evelina London and this is a positive opportunity for us strengthen to our relationships and share our skills across services. At the moment shared care applies only to inpatient care, there has been no movement of any Royal Brompton outpatient activity.

Where to get guidance

There is so much information out there. Some of it is not the same which causes confusion for professionals, patients and their families. For general advice about self-isolation we are continuing to refer to the NHS website which is constantly being updated.

Our team have worked closely with the British Congenital Cardiac Association (BCCA) to develop specific guidelines for children and adults with congenital heart disease. The BCCA is the national body that supports all professionals who work in the field of managing children and adults with CHD. These guidelines can be found on the BCCA website.

For the majority of children who have minor or operated CHD, they are at no greater risk of being affected by COVID-19 than other children without heart problems. The BCCA have outlined a list of conditions which we as a profession would consider to be potentially more vulnerable than other children. We do not know this for certain, as there is no patient data to support this, but we felt that it was a reasonable approach based on how patients with CHD manage with any respiratory infections.

We strongly recommend that everyone follows the current guidelines to stay in the home and avoid contact with any family or friends that you don’t live with. This is not only protecting you and your family, but it also helping to limit the spread of COVID-19 across the country.

All the latest information can be found at the NHS website and the official UK government website. This includes information about the virus, what to do if you develop symptoms and advice around self-isolation and social distancing.

If you have additional questions then please get in contact with our team on 020 7188 4546 from 9am to 5pm Monday to Friday, and we will do our best to answer them. If you have an urgent query outside these hours then contact Savannah Ward on 020 7188 8849. Please do bear with the team at this time, we are experiencing a high number of calls but will always do our best to get back to you as soon as we can.

Please all keep well, follow the government advice and remember that although the NHS is facing a challenge unlike anything we have seen before, we are still here for you.

Best wishes,

Aaron

Consultant Paediatric Cardiologist

Head of Service, Paediatric Cardiology

Evelina London

Stay up to date & get support from ECHO

You can view ECHO’s e-newsletter (30/03/20) which highlights these key changes: bit.ly/evelinaupdatenewsletter

ECHO update our Coronavirus information page regularly: echo-uk.org/coronavirus

The page covers:

the latest guidance from NHS, government and BCCA (British Congenital Cardiac Association)
An FAQ which we are regularly adding to
links for you and your family to further information including guidance on managing your wellbeing

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