BackgroundDuring the COVID‐19 pandemic, the first UK lockdown (March to May 2020) witnessed a dramatic reduction in children presenting to primary/emergency care, creating concern that fear of the virus was resulting in children presenting late.MethodsAn online survey was co‐developed with UK parents to understand the impact of the lockdown on parents' help‐seeking for, and care of, their sick/injured child(ren). The survey was advertised through social media and snowballing to parents whose children had been ill/injured during the lockdown. Analysis used descriptive statistics, SPSSv25 and thematic analysis.ResultsThe survey was fully completed by 198 UK parents. The majority asked for help (144/198): from their family doctor (78), national helplines (48) or an Emergency Department (23). Most reported that their decision‐making had not changed, although how they sought help had changed. A few parents reported that the severity and duration of illness had increased because of uncertainty about and/or difficulty accessing services. Parents did not always report seeking help for symptoms rated red or amber by the Royal College of Paediatrics and Child Health. Parents reported accessing information through the internet or using information that they already had.Parent ContributionThis was a collaboration with parents from survey development to dissemination, with two parents being integral members of our research team.ConclusionsOur questionnaire was completed by parents who were not deterred from seeking help for their sick or injured children. Even for these parents, the lockdown changes to services created uncertainty about, and barriers to, accessing medical help for their children.

An increasing number of holiday clubs provide free meals to alleviate children's hunger during the school holidays. Holiday clubs are well-placed to promote healthy eating among children from disadvantaged communities who may be at risk of experiencing food insecurity, but currently little is known about the feeding practices used by staff and whether these are conducive to maximising opportunities to promote healthy eating. Unlike previous research which has predominantly studied feeding practices in parent-child dyads and childcare settings, this qualitative study explored staff perspectives on the feeding practices they use to promote healthy eating within nine UK holiday clubs working with children from disadvantaged communities. Nine individual interviews and four focus groups were completed with 27 holiday club staff during the 2019 summer holidays. Thematic analysis revealed seven feeding practice themes, including teaching about nutrition; encouraging balance and variety; modelling; involvement; non-food rewards; restriction; and reoffering foods. The results revealed that some staff implement various positive feeding practices which align with the existing evidence-base of feeding practices in other contexts, which is a promising finding given the current lack of information and guidance from which to draw on. However, staff also sometimes reported using maladaptive feeding practices, including overt restriction and punishment. These results emphasise the need for guidance on effective ways to implement feeding practices with children in holiday clubs. Indeed, staff demonstrated their receptivity to engaging with training resources to maximise their opportunities to promote healthy eating behaviours among children.

Holiday clubs play a pivotal role in providing food and vital enrichment opportunities to alleviate food insecurity among children during the school holidays (holiday hunger). The need for these opportunities increased substantially for families throughout 2020, as food insecurity quadrupled in the UK during the Covid-19 pandemic. In this qualitative study, holiday club staff from England and Wales reflected on the adaptations they implemented in order to maintain food supplies and food-related enrichment activities for families during the first UK national Covid-19 lockdown and subsequently throughout the summer of 2020. Staff also reflected on the opportunities and challenges related to implementing these adaptations during this period. Twenty-five holiday club staff engaged in video-based interviews during August and September 2020. The findings revealed a range of innovative changes to holiday club food provision, and the challenges and opportunities faced varied across holiday clubs. Challenges during the pandemic in some clubs included staff shortages (typically due to furloughing and/or increased working demands) and difficulties sourcing adequate funding. However, staff identified that the opportunities for holiday clubs included enhanced partnership working during the pandemic, increased engagement with digital technology to communicate with families and deliver their online cooking sessions, and their ability to continue providing food and much needed creative opportunities for children unable to attend school and/or the holiday club. The ability of clubs to adapt their models of working when faced with adversity was essential in protecting their organisational resilience and delivering their vital services. The findings emphasise the important role that holiday clubs play in their communities and highlight their willingness to adapt and expand their role in response to the pandemic to continue to tackle food insecurity and provide vital food and food-related enrichment opportunities to families. The findings also identify lessons that can be applied to practise in the future.

BackgroundChildren’s use of urgent care services continues to increase. If families are to access the right services at the right time they need access to information to inform their decision making. Providing a safety net of information has the potential to reduce morbidity and avoidable mortality and has been shown to reduce re-consultation safely.AimOur research programme aims to provide parents with information they can use to help them determine when to seek help for an acutely ill child.MethodOur programme includes: ASK SARA, a systematic review of existing interventions; ASK PIP, qualitative exploration of safety netting information used by parents and professionals; ASK SID, development of the content and delivery modes for the intervention; ASK ViC, video capture of children with acute illness; and ASK Petra, safety netting tool development using consensus methodology.ResultsThe ASK SNIFF programme findings demonstrate the need for professionally endorsed and co-produced safety netting resources focussing on symptoms of acute childhood illness. We now have consensus on the scripted content for a safety netting tool supported by video materials to enable parents to see symptoms for real.ConclusionSafety netting tools are a valuable aid to general practice enabling GPs to show parents what to look out for when their child is sick so that they know when to (re)consult. Recent reports of failure to recognise and appropriately safety net children with sepsis highlights the importance of such tools.

The Professional Nurse Advocate (PNA) programme is a clinical and professional leadership programme delivered by Higher Education Institutions (HEI) which equips nurses with the skills to deliver restorative clinical supervision to colleagues in England. The programme has been gradually rolled out across England during 2021/22 with the aim of ensuring there will be PNAs in place to support colleagues in the following specialties: Critical care, Mental Health (Adult Acute & Children and Young Peoples inpatient settings) Community, Learning Disabilities (Adult), Children and Young People, Safeguarding, Health & Criminal Justice settings (HCJ), and International Nurses. In February 2022, NHSE sought an evaluation of the PNA programme. A research team from Coventry University was commissioned to undertake this work. This Executive Summary Report sets out the methods, activities, findings, and recommendations as requested by commissioners.