BAPEN & PINNT Statement

23/11/2020

Join statement on recent advice for people on HPN previously advised to shield
 
In March 2020 the Government advised that all people classified as ‘clinically extremely vulnerable’ should shield to help protect them from the risks of Covid-19 infection. This was very restrictive and although it kept many people safe it also had a significant impact on people lives and mental health.
 
The shielding guidance was relaxed over the summer and the national shielding programme was paused across all UK nations. As the number of Covid-19 cases has started to surge again, each nation has issued updated advice for people who were initially advised to shield at the start of the pandemic.
 
People receiving Home Parenteral Nutrition (HPN) are not formally included in the Government’s list of ‘clinically extremely vulnerable’ groups, although they are included in the NHS England list. The updated Government guidance now includes “other people” who have been classed as ‘clinically extremely vulnerable’ based on clinical judgement. This should include adults receiving Home Parenteral Nutrition.
 
General guidance for keeping safe during Covid-19:
 

Socialising:
  1. All people should stay at home, except for specific purposes.
  2. People receiving HPN can go outdoors for exercise or to attend essential health appointments in line with the current guidance. It is important to attend healthcare appointments when advised to do so.
  3. Where it is permitted to meet up with other people from outside your household or support bubble we strongly suggest you follow this guidance.
  4. Try to keep contact with others to a minimum and avoid busy areas. Maintaining social distancing and hand washing is very important, especially when people in your household have symptoms.
 Work:
  1. People receiving HPN are strongly advised to work from home. If this is not possible then people on HPN should not attend work for the period of any restrictions.
  2. Other people you live with who are not clinically extremely vulnerable themselves can still attend work if they cannot work from home.
 Education:
  1. Evidence has shown that there is a very low risk of children becoming very unwell from Covid-19, even for children with existing health conditions, including those on Home Parenteral Nutrition. Therefore children receiving HPN are no longer advised to shield. It is advisable to discuss individual circumstances with their nutrition team but in most cases, children are advised to attend school normally.
  2. Children who live with someone who is clinical extremely vulnerable, but who are not clinically extremely vulnerable themselves, should continue to attend school.
  3. Should a school or authority issue specific information about children with special needs or HPN, we suggest you discuss this with your child’s nutrition team or healthcare professionals.
Travel:
  1. People receiving Home Parenteral Nutrition should follow the advice given to the general public and avoid all non-essential travel by private or public transport. Travel to hospital and GP appoints is strongly encouraged unless told otherwise by a healthcare professional.
  2. Overseas travel – people receiving HPN should follow the general advice on travelling abroad but should also seek personal advice from their usual healthcare professionals or nutrition team members. If a homecare company is asked to arrange an overseas trip they will seek advice from the HPN centre. 
 Shopping and Medicines: 
  1. People receiving Home Parenteral Nutrition are advised not to go to the shops or a pharmacy.
  2. If you need help with accessing medicines and have no support then the NHS volunteer responders may be able to help (www.nhsvolunteerresponders.org.uk; telephone 0808 196 3646 between 8am and 8pm).
  3. You can also contact your local council who may have a community support network to assist with accessing food, household supplies, social contact and any other support you may need.
 Registering for support: 
  1. It is possible to register for additional help at www.gov.uk/coronovirus-shielding-support. You will need your NHS number. 
We strongly suggest you stay informed about the advice given by your nation’s Government. Links provided below: 
  • Guidance on shielding and protecting people who are clinically extremely vulnerable from COVID-19 England: Read here  
  • Guidance for ‘clinically extremely vulnerable’ and ‘vulnerable’ people in Northern Ireland: Read here  
  • Guidance for coronavirus (COVID-19): shielding advice and support in Scotland: Read here  
  • Guidance on protecting people defined on medical grounds as extremely vulnerable from coronavirus (COVID-19) – previously known as ‘shielding’ in Wales: Read here  
There may be individual cases where advice needs to be given based on additional health condition(s). In these circumstances people will be given bespoke advice.
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