New guidance sets out which children can be removed from shielding list

Most of the children on the shielding list who are managed in primary care can be removed from the list and GPs will be expected to do this following discussions with patients, according to new guidance.

Most children with asthma will not need to shield, the guidance says (Photo: Peter Dazeley/Getty Images)
Most children with asthma will not need to shield, the guidance says (Photo: Peter Dazeley/Getty Images)

The new guidance from the Royal College of Paediatrics and Child Health (RCPCH) divides children on the shielding list into two groups - group A and group B.

Children in group A, which includes those with risk of severe infection due to primary or drug-induced immunodeficiency, those with specific immunosuppression as part of their cancer therapy and those with severe lung disease or who have an impairment in ability to cough and clear airway secretions, should continue to shield.

However, those in group B, which includes the majority of children that are being managed in primary care, could come off the list following a 'case-by-case discussion to decide whether, on the balance of risks, a child should be advised to continue to shield'.

Children should only be removed from the list by a GP or consultant following a consultation with the child and their family and other clinicians where appropriate, the RCPCH said.

'Children and young people who are cared for just in primary care are very unlikely to need to continue to shield,' the guidance adds.

Developing evidence-base

The guidance explains that evidence relating to the impact of COVID-19 on children and young people with comorbidities has developed during the pandemic and allowed the college to update its advice on shielding.

'This has indicated that not all those children and young people who are currently advised to shield need to continue to do so. 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 guidance says.

'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.'

The college said that it had developed the new guidance to help support clinicians as they discuss the risks of COVID-19 with individual patients.

GPonline reported last week that the majority of children would be removed from the shielding list. Dr Jenny Harries, a deputy CMO for England, revealed the plans during NHS England's regular primary care webinar. She also said that the government was working on a developing a new algorithm to better assess risk from COVID-19 in all patients to help inform which people should remain on the shielded list going forwards.

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