Words from the Chair
A focus on measles
In this Newsletter I feel compelled to discuss the current outbreak of measles. I am sure that none of us expected to see an outbreak of measles of this size in our careers. We have recently been warned by the UKHSA, that the current outbreaks in the West Midlands and Birmingham will spread to our other towns and cities unless urgent action is taken.
As of 18th January, there have been 216 confirmed cases in the West Midlands since 1 October 2023, 80% of those were in Birmingham, 10% in Coventry with the majority of cases being in children under the age of 10 years (UKHSA data). Numbers of babies and children presenting in Wales doubled last year from 735 to 1,603.
Vaccination rates are the lowest they have ever been for ten years, MMR1 coverage at 5 years decreased to 92.5% and MMR2 coverage at 5 years decreased to 84.5%. The percentages are more alarming in inner city areas with some parts of London being quoted to be as low as 60%. No vaccines met the 95% WHO target.
Evidence shows us that factors such as being a member of a new community or of lower socioeconomic status is associated with lower vaccine coverage. This is added to the vaccines that were missed during the COVID-19 pandemic and not caught up with.
The decision to not vaccinate is complex as we learnt during the pandemic. It involves health beliefs, the knowledge base of individuals and misconceptions within families, communities, and previous messages in the press. Access to vaccines is important with families telling us that making it easier for them to access vaccines would help them.
The NHS Vaccination Strategy was published in December 2023 and includes proposals to help people to understand why vaccines are needed.
The strategy also explains how the NHS App makes booking vaccination appointments more convenient, makes vaccine history accessible, simplifies the booking process.
The strategy proposes that, where possible, seasonal vaccines should be co-administered. It also aims to help people understand where to go to and widen the places where vaccines can be given.
There is much to do to limit the outbreak; we know that we must learn the lessons about vaccination from the pandemic. As nurses caring for babies, children and young people and Association members, we must support our colleagues in primary care with the MMR vaccination effort. Simple measures such as always checking the vaccination status, giving vaccines when we can, signposting to where families can access vaccines and promoting the effectiveness of the MMR vaccine are within our gift to do.
Caron Eyre caroneyre0@gmail.com
Updates from the ABPN
Notification of the 85th Annual General Meeting of the ABPN
Notice is hereby given that the 85th Annual General Meeting of the ABPN will be held at 12md on 26th March 2024 in person at The Studio (The Studio, 7 Cannon St, Birmingham B2 5EF) or virtually via MS Teams.
- Agenda
- President’s welcome and introductions
- Apologies received.
- Minutes of the 84th Annual General Meeting and matters arising
- Officers' reports
- a. Chair
- b. Honorary Secretary
- c. Membership Services Co-ordinator
- d. Finance Officer
- e. Journal Editor
- f. Communications - Newsletter and Website
- Approval of Fellows
- Confirmation of Annual Subscription Fee
- Officer Elections: Chair
- Governance and Development Group Membership
- Member’s Items: Please notify the Honorary Secretary robin.hyde@northumbria.ac.uk of any items to be included by 19th March 2024.
- Date of next AGM: to be agreed.
Update on our Oral History Project
Recordings for the Oral History Project continue, if you would like to add your own history to the project, please do get in touch with katrina.mcnamara@icloud.com.
We are looking forward to launching the work and to sharing the career pathways, hopes, motivation and pride on 26 March 2024, providing a resource for others in the years ahead.
Social media news
After a winter break we’re back and we’ve been uploading on YouTube and TikTok! We’ve also been posting on our Facebook and Twitter! We post updates relating to the ABPN to our Facebook, and on our Twitter we post all sorts, from research to new developments in child health news and lots more!
If you’d like to get involved with our social media, if there’s something you’d like to share or if you would be interested in doing a video for our TikTok please send an email to georgina.fg@sky.com
You can check out our social media channels below.
Keeping our policies up to date
As a charity the Association is required to have policies in place to guide our working practices. These are updated regularly and are available on our website.
We have just uploaded our Terms of Reference for the ABPN fellowships.
The Blue Book
Our Blue Book contains key moments from the history of the Association reaching back to its first meeting in 1938.
As always, we are interested in any new content for the Blue Book, especially material that will help us fill in details from our early history.
We now maintain the Blue Book as a live document and update it regularly. You can find a copy of the Blue Book on our website.
If you have any information you think we should add, then please do let us know. You can contact Robin (robin.hyde@northumbria.ac.uk) or Bernie (bernie.carter@edgehill.ac.uk).
New membership platform
We are in final stages of our transfer over to the new membership platform.
Our members will be receiving more detailed information over the coming month regarding the transfer and for those with a valid email address a unique link to sign up to the platform.
Members of our Governance Team will be receiving some training in the use of the platform which will be our last part of the handover and go live date.
Members without access to email or the internet will continue to be supported manually by our membership team.
If you have any questions regarding your membership please reach out. Simon looks forward to joining you all soon on our new platform.
- Membership Secretary: membersabpn@yahoo.co.uk
Newsletter
We hope you like the style and content of our Newsletter.
If you have any ideas for content or have any feedback, please do contact Bernie.
bernie.carter@edgehill.ac.uk
Charity Focus
Introducing a new section that focuses on the work of a charity.
This issue features the charity Designability and their Wizzybug wheelchairs.
Designability and their Wizzybug powered wheelchairs
Moving independently through space is a basic right of children. The Wizzybug powered wheelchair enables young disabled children to do just that and it is loaned to families across the UK completely free of charge.
The charity Designability developed Wizzybug specifically for young disabled children from the age of 14months to facilitate independence, choice and self-initiated movement at a key development stage. It enables young children to have better social interaction, develop a sense of self and have lots of fun whilst unlocking the potential for child development.
Wizzybug is suitable for children with reduced mobility with good head control, who are able to maintain a sitting position with the use of the pelvic belt, harness, headrest and lateral supports it is supplied with. Wizzybug is suitable for indoor/outdoor and off-road use and grows with the child. It is intended for short periods of supervised use.
Appointments are held in Bath and Leeds and families are loaned Wizzybug for as long as it is suitable for their child. Funding is available to assist with the cost of attending the appointment including overnight accommodation if required.
Families can self-refer to the scheme by completing the application form on the website.
[Image used with permission of Designability].
Training and Education
We welcome ideas and contributions to our training and education pages.
So, if you’d like to share any training or education resources and updates, please use our contact form on our website.
ABPN Honorary Fellow Webinar Series: Global, regional and local issues: opportunities for children's nurses
We’re delighted to announce the first in our series of Honorary Fellow webinars.
- Title: Global, regional and local issues: opportunities for children's nurses
- Date and time: We’re aiming for a date in March; to be announced.
- Presenter: Fiona Smith, RN,C, RN,A, Dip in Nursing Studies, BA Health Studies, Masters in Business Admin (Health)
- Summary of webinar: Fiona will be talking about some of the global, European and UK perspectives of the issues facing children and young people today. She will address some of the opportunities that children’s nurses, either individually or collectively can take to tackle and influence services and outcomes for children, young people and their families.
- Joining the webinar: The link for joining the webinar will be on our website.
About Fiona: Fiona was awarded Honorary Fellowship of the ABPN in 2023. She retired from her role as Professional Lead for Children and Young People’s Nursing at the RCN in 2021. She is currently volunteering locally, acting as adviser for professional nursing associations overseas, and presents at conferences internationally. Fiona is an Honorary Fellow Association of British Paediatric Nurses, Honorary Fellow Royal College of Paediatrics & Child Health, and Honorary Fellow of Hong Kong Academy of Nursing.
You can contact Fiona by email on fiona.smith15@yahoo.com or follow her on Twitter @FionaSmithMMO
Launch of 2nd edition of Essentials of Nursing Children and Young People
The ‘Essentials of Nursing Children and Young People’ (2nd edition) is edited by Jayne Price, Orla McAlinden and Zoe Veal. This substantial textbook, published in 2024, builds on the first edition published in 2018.
This textbook is aimed primarily at undergraduate children’s nursing students, and the contents and activities in this textbook focus on preparing students to address the changing health care needs of children, young people and their families.
The editors agree that this textbook will not be the only resource needed by undergraduate children’s nurses, but they have created a comprehensive resource reflecting their shared passion for nursing children and young people and their commitment to aspiration of elevate the art and science of nursing children and young people.
Core to this second edition is a critical consideration of pedagogy and an emphasis on the voice of stakeholders. The chapters will help students to meet future standards for practice and be valued as a core text by practitioners well as being recognisable to practitioners, and relevant to our collective aspiration of elevating the art and science of nursing children and young people.
Writing chapters and editing a book are connected but very different processes, each with its own challenges and opportunities. Jayne, Orla and Zoe were delighted to have contributions from so many similarly passionate clinicians and academics and they thank everyone involved.
Orla, quoting John Steinbeck (1902-1968), says that you should “write what should not be forgotten”. The ‘Essentials of Nursing Children and Young People’ is a text that is beautifully written and contains information that should not be forgotten.
Journal of Child Health Care Resources
Apart from high quality peer reviewed papers and great editorials, the Journal of Child Health Care produces fantastic JCHC podcasts, hosted by Associate Editor, Liz King. These podcasts focus on authors talking about their research and the papers published in the journal.
In the most recent edition of the journal, our very own Robin Hyde has co-authored an editorial on the importance of retaining undergraduate burse education programmes for children’s nurses. The full details of the editorial are Tatterton, M.J.; Carey, M.C.; Hyde, R.; Hewitt, C. Don’t throw the baby out with the bathwater: Preserving children’s undergraduate nurse education in the move towards genericism in nursing. Journal of Child Health Care 0, 13674935241231112, doi:10.1177/13674935241231112
HCUK Events
A series of great events and conferences events are run by HCUK and by following the link to our page on the ABPN website, you can get up to 20% off.
Update on policies, guidelines & reports
British National Formulary for Children (BNFC)
The BNFC provides key information on the selection, prescribing, dispensing and administration of medicines used for children.
You can keep up to date with changes such as dose changes, adverse reactions, safety information and much more on their website.
For example, read about updated guidance on general principles of vaccination during pregnancy and breast feeding
Valuing care: using data to improve children and young people’s lives
'Valuing care' is a detailed report that says data-driven approaches that focus on the needs of children and young people need to be embedded into children’s social care reforms in order to improve commissioning, practice, and outcomes.
The report identifies the current costs of care, finding a “limited correlation between the needs of young people, the costs of their care, and the type of care they receive.”
Key findings note that:
- “10% of the cohort of children in care account for 51% of the spend.
- Reducing the charges of 7% of the highest cost placements in this study to £5k per week would yield an annual saving of £34.7m. Over time this could potentially equate to nationally reduced costs of £800m.
- 80% relationships of children and young people in care need support with their emotional health and in understanding their life story.
- Children with disabilities are three times more likely to be placed in residential placements, regardless of whether their needs are severe or complex.”
Listening to patients and organisations to update NICE’s quality standard on Transition from children’s to adults’ services (NICE standard update)
In December 2023 the NICE quality standard – ‘Transition from children’s to adults’ services’ - was updated in response to listening to stakeholders (patients and organisations).
The key changes are:
- “A new statement (statement 2) has been included about the need to have a co-ordinated transition plan in place to ensure there is a consistent response, particularly when several different services are supporting a young person with complex needs.
- Statement 6 that addresses missed appointments after transfer to adults’ services, now focusses on initial appointments (e.g., those in the first year following transfer) rather than just the first appointment. This is to ensure young people are not discharged from adult services for not attending appointments.
- Statement 5 about meeting a practitioner in adults’ services has been amended to clarify who is included.”
The state of children and young people’s advocacy services in England, Children's Commissioner for England
In this report, published in December 2023, the Children’s Commissioner states that the report shows “just how far the current system of advocacy is from a model where children get proactive advocacy wherever they need it…..and that even when children get a referral to an advocate, and most children do not, many referrals do not result in children getting direct support from an advocate.”
She further notes the “inconsistencies in how advocates are trained and the qualifications they are required to have to advise children on their rights and entitlements…and whether they are genuinely independent.”
She concludes that changes need to be made “to the way that advocacy is commissioned, how the quality of advocacy is assessed, and a national effort to increase the number of well trained and skilled advocates.” Effective implementation will require adequate resourcing.
Public Health Wales: refreshed indicators for the Public Health Outcomes Framework
In December 2023, indicators in the Public Health Outcomes Framework reporting tool were refreshed. This framework aims to “help understand the impact which individual behaviours, public services, programmes and policies are having on health and wellbeing in Wales”.
Key findings include:
- “Update on breastfeeding, low birth weight, teenage conceptions and mortality indicators for the National Survey for Wales.
- Suicide remains significantly higher in males, and higher rates can also be found in more deprived areas of Wales.
- Smoking is almost three times higher in deprived areas than the least deprived.
- The rate of loneliness is almost four times higher amongst those limited a lot by a disability, compared to those not limited."
Mental Health of Children and Young People in England, 2023 - wave 4 follow up to the 2017 survey.
This report presents findings from 2,370 children and young people who took part in the fourth wave of the 2017 Mental Health of Children and Young People (MHCYP) survey.
The report focused on the mental health of children and young people (aged 8-25 yrs) living in England. It also looks at their household circumstances, and their experiences of education and services and of life in their families and communities.
Key facts for 2023 include:
- “About 1 in 5 children and young people aged 8 to 25 years had a probable mental disorder.
- After a rise in prevalence between 2017 and 2020, rates of probable mental disorder remained stable in all age groups between 2022 and 2023.
- Among children aged 8-16yrs, rates of probable mental disorder were similar for boys and girls, while young people aged 17-25 years, rates were twice as high for young women than young men.
- More than 1 in 4 children (8-16yrs) with a probable mental disorder had a parent who could not afford for their child to take part in activities outside school or college, compared with 1 in 10 of those unlikely to have a mental disorder.
- Children (11-16 years) with a probable mental disorder were 5 times more likely than those unlikely to have a mental disorder to have been bullied in person.”
Children in Need
This annual release of statistics focusses on children in need. Children in need are legally defined under the Children Act (1989) as a group of children “assessed as needing help and protection as a result of risks to their development or health.” This group includes children on child in need plans, children on child protection plans, children looked after by local authorities, care leavers and disabled children.
Key facts for 2023 include:
- “403,090 children were classed as in need (down 0.3% or 1200 since 2022).
- 50,780 children were on protection plans (down 0.3% or 100 since 2022).”
The report notes that the “latest annual decreases follow the increase in 2022, in which there was a rise in all the headline measures, likely linked to school attendance restrictions due to COVID-19 no longer in place.”
Working together to safeguard children, 2023
In December 2023, the Department for Education (DfE) published a new edition of its statutory guidance Working together to safeguard children. This latest guidance outlines what organisations and agencies must and should do to help, protect and promote the welfare of all children and young people (< 18 years) in England. This is essential reading.
The NSPCC Learning, CASPAR Briefing highlights the key provisions introduced in the new guidance and includes updates on:
- "multi-agency expectations for all practitioners
- working with parents and families
- clarifying the roles and responsibilities of safeguarding partners
- the role of education and childcare providers
- multi-agency practice standards
- support for disabled children
- tackling harm that occurs outside the home".
Roundup of Reviews
Cochrane review: Positioning for lumbar puncture in newborn infants
This review was published in December 2023. The objective was to assess the benefits and harms of the lateral decubitus, sitting, and prone positions for lumbar puncture in newborn infants. Five studies with 1476 participants were included.
Key conclusions include:
- “When compared to sitting position, lateral decubitus position probably results in little to no difference in successful lumbar puncture procedure at first attempt.
- Infants in a sitting position likely experience less episodes of bradycardia and oxygen desaturation than in the lateral decubitus, and there may be little to no difference in episodes of apnoea.
- Lateral decubitus position results in little to no difference in time to perform the lumbar puncture compared to sitting position.
- When compared to prone position, lateral decubitus position may reduce successful lumbar puncture procedure at first attempt.”
Cochrane review: Topical and oral steroids for otitis media with effusion in children
Published in December 2033 this Cochrane review aimed to assess the effects (benefits and harms) of topical and oral steroids for otitis media with effusion (OME) in children.
Key conclusions include:
- “Overall, oral steroids may have little effect in the treatment of OME, with little improvement in the number of children with normal hearing and no effect on quality of life.
- The evidence for nasal steroids was all low‐ or very low‐certainty.
- OME is likely to resolve spontaneously for most children.
- The potential benefit of treatment may therefore be small and should be balanced with the risk of adverse effects.”
Leveraging multisectoral approach to understand the determinants of childhood stunting in Rwanda: a systematic review and meta-analysis
This review study used the UNICEF framework on maternal and child nutrition to systematically evaluate the determinants of child stunting in Rwanda and identified available gaps.
Key results include:
- “Most (75%) of the overall inequality in stunting was due to the difference in the social determinants of stunting between poor and non-poor households.
- Maternal education (17%) and intergenerational transfer (31%) accounted for most of the inequalities in stunting.
- An increase in gross domestic product per capita contributed to a reduction in its prevalence.”
A systematic meta-review of systematic reviews on attention deficit hyperactivity disorder
This meta review included 231 systematic reviews and meta-analyses on any topic on ADHD that met their eligibility criteria.
Key results include:
- “Prevalence of ADHD was 7.2% for children and adolescents and 2.5% for adults, though with major uncertainty due to methodological variation in the existing literature.
- Evidence exists for biological and social risk factors for ADHD.
- Strong evidence exists for the efficacy of pharmacological treatment on symptom reduction in the short-term, particularly for stimulants.
- Limited evidence exists for the efficacy of pharmacotherapy in mitigating adverse life trajectories.
- Pharmacotherapy is linked with side effects like disturbed sleep, reduced appetite, and increased blood pressure, but less is known about potential adverse effects after long-term use.
- Evidence of the efficacy of non-pharmacological treatments is mixed.”
Global prevalence of developmental disabilities in children and adolescents: A systematic umbrella review
This systematic umbrella review aimed to systematically summarize the prevalence estimates of developmental disabilities in children and adolescents reported in systematic reviews and meta-analyses. Ten systematic reviews were included.
Key results and conclusions include:
- “Sensory impairments were the most prevalent disabilities (approximately 13%) and cerebral palsy was the least prevalent disability (approximately 0.2-0.3%).
- Pooled estimates for geographical regions were available for vision loss and developmental dyslexia.
- Global burden of disease prevalence estimates were lower for all disabilities except cerebral palsy and intellectual disability.
- Available estimates from systematic reviews and meta-analyses do not provide representative evidence on the global and regional prevalence of developmental disabilities among children and adolescents due to limited geographical coverage and substantial heterogeneity in methodology across studies.”
Skin assessments and interventions for maintaining skin integrity in nursing practice: An umbrella review
The aim of this review was to summarise the overall evidence regarding 1) risk factors associated with xerosis cutis, incontinence-associated dermatitis/diaper dermatitis, intertrigo, skin tears, 2) the performance of diagnostic tests and/or classifications addressing the severity and/or signs and symptoms of xerosis cutis, incontinence-associated dermatitis/diaper dermatitis, intertrigo, skin tears, 3) the effects of skin cleansing/care interventions for the maintenance and promotion of skin integrity in all age groups, 4) effects of skin cleansing/care interventions for the prevention of xerosis cutis, incontinence-associated dermatitis/diaper dermatitis, intertrigo, skin tears in all age groups. Twelve systematic reviews were included.
Key results and conclusions include:
- “The validity and reliability of the International Skin Tear Advisory Panel classification is supported by moderate quality evidence.
- The reliability and criterion validity for Skin Tear Audit Research were rated insufficient.
- Results indicate that structured skin care programs are preferable to unstructured skin care with classic soap and water for maintaining skin integrity in general, preventing skin tears, and to prevent and treat xerosis cutis and incontinence-associated dermatitis.
- All reviews focusing on leave-on products for the prevention and treatment of incontinence-associated dermatitis and diaper dermatitis indicate the effectiveness of barrier films or lipophilic leave-on products in adults, elderly people and paediatric care, but could not establish the superiority of any product.
- The majority of systematic reviews in the field of skin care are at high risk of bias and should not be used for evidence-based practice.”
School bullying in children and adolescents with neurodevelopmental and psychiatric conditions: a systematic review and meta-analysis
This systematic review and meta-analysis aimed to assess the odds of bullying involvement and its association with mental health measures in children and adolescents (aged 4–17 years) with a diagnosis of a neurodevelopmental or psychiatric condition provided by a health professional. Two hundred and twelve studies were included in the meta-analysis.
Key results and conclusions include:
- “For traditional bullying, pooled prevalence was 42·2% (95% CI 39·6–44·9) for victimisation, 24·4% (22·6–26·3) for perpetration, and 14·0% (11·4–17·1) for perpetration–victimisation.
- For cyberbullying, prevalence was 21·8% (16·0–28·9) for victimisation, 19·6% (13·4–27·7) for perpetration, and 20·7% (8·4–42·6) for perpetration–victimisation.
- Compared with controls, young people with neurodevelopmental or psychiatric conditions were more likely to be involved in traditional and cyberbullying as a victim (OR 2·85 [95% CI 2·62–3·09] and 2·07 [1·63–2·61]), perpetrator (2·42 [2·20–2·66] and 1·91 [1·60–2·28]), and perpetrator–victim (3·66 [2·83–4·74] and 1·85 [1·05–3·28]).
- Bullying involvement was associated with higher scores in mental health measures in young people with neurodevelopmental or psychiatric conditions, particularly internalising symptoms and externalising symptoms.”
Transgender and gender diverse youths’ experiences of healthcare: A systematic review of qualitative studies
This systematic review aimed to review qualitative studies addressing the healthcare experiences of transgender and gender diverse youths under 18 years. Sixteen studies were included.
Key findings and conclusions included:
- “Four narratives were identified including experiences of: accessing care, healthcare settings and services, healthcare providers, and healthcare interventions.
- Long waiting times, lack of competent providers, and fear were reported as challenges to accessing gender-affirming care.
- Negative experiences occurred in mental health services and primary care, while school counseling and gender clinics were affirming.
- Puberty blockers and hormone-replacement therapy were identified as protective factors.
- TGD youths are at risk of negative health outcomes due to an under resourced healthcare system.”
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