COVID-19 resources

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Children's social care 2022: recovering from the COVID-19 pandemic

Ofsted

Focusing on the recovery from the COVID-19 pandemic, this briefing draws on evidence from a sample of Ofsted inspections, and from focus groups and interviews with inspectors and policy colleagues, to understand what the children's social care sector has done well, the pressures that remain and the main barriers to managing these pressures. During the COVID-19 restrictions, some children were less visible to professionals, which increased the risk that evidence of harm to them was not being identified. When the restrictions were lifted, and all children returned to school and re-engaged with other services, professionals were able to see these children again. However, some services are either not yet being offered or are running at a lower capacity than pre-pandemic levels. The pandemic compounded a number of existing issues that affect care leavers. We are continuing to hear that greater numbers of care leavers than would have been expected before the pandemic are not in stable employment or education. There is concern that the toll on their well-being will be long-lasting. Some children are having to live in places where their specific needs cannot be met. Recruitment and retention of staff continue to be a problem across children’s social care. A large number of social workers have left the sector or have moved to agency contracts, which offer competitive incentives. Many tasks that do not require direct contact with children and families, and would have previously been carried out in offices, are now being done from home. This minimises the time that social workers spend together in person, reducing opportunities for peer support and learning. There are also concerns around training, as providing this online makes it more difficult for attendees to hold discussions with peers and form strong support networks.

Last updated on hub: 04 August 2022

The impact of the pandemic on population health and health inequalities

British Medical Association

This report looks at the impact of the pandemic on population health and health inequalities in the UK. It discusses how the pandemic has affected the nation's physical and mental health, as well as social determinants of health such as education and employment. A call for evidence survey was conducted to set out the experience of the medical profession during the pandemic and to learn lessons for future pandemics. We found that the pandemic has harmed people's physical and mental health and worsened health inequalities: poor population health and worsening health inequalities before the pandemic made the UK's experience of COVID-19 worse; opportunities had been missed before the pandemic to improve population health and address health inequalities; by July 2022, more than 200,000 people had lost their lives, while millions have seen their quality of life affected by long COVID; many people have also reported poorer mental health because of the pandemic; however, none of this has been felt equally, with ethnicity, age, disability status, and other factors meaning some social groups have been more affected than others; the pandemic also affected the social determinants of health - as workplaces and schools closed, and business stalled, people's financial security and future career prospects were threatened and those already struggling before the pandemic were often worse affected. The report argues that we must learn from the positive developments during the pandemic such as the speedy development, approval, and NHS-led roll out of the COVID-19 vaccines, and the hugely effective schemes to house rough sleepers – although there has been variability as to how well both programmes have been sustained and benefited their target population.

Last updated on hub: 03 August 2022

Support at the end of life: the role of hospice services across the UK

The Nuffield Trust

This report addresses a significant gap in our understanding of the services that the hospice sector provides across the UK, including how the Covid-19 pandemic has impacted services. The pandemic has seen major disruption to services across health and social care, along with a huge shift in where patients are dying, with both significantly impacting on end of life care. However, data from hospices is not routinely collected, and the last reported data are from a survey in 2016/17. In this report, we provide information on hospices' service provision for the years 2018/19, 2019/20 and 2020/21. The data draw on a nationwide survey of hospices, conducted by Hospice UK. The findings from the report illuminate the impact of Covid-19 on services that the hospice sector provides, and the people who hospice services support. The data shows that in 2020/21 hospices supported an estimated 300,000 people in the UK, including people at the end of life, families, carers and bereaved relatives. During the pandemic there has been a shift in where and how services are provided, with much more care delivered at home. In 2020/21, there were almost a million 'hospice at home' contacts. In contrast, day services and hospice outpatient settings saw a decline in the number of contacts and people seen, and fewer people were hospice inpatients. In addition, the complexity of patients' needs may have increased, with patients receiving inpatient care having more contacts each, and contacts per person for bereavement services also increasing. In 2020/21, more than 120,000 community support contacts were delivered virtually, along with virtual welfare, bereavement and therapy services. Hospices switched to providing services remotely, to respond to concern from patients about attending appointments and to reduce the risk of Covid-19 infection. In 2020/21, there was a drop in the number of people who hospices supported but this was small, particularly when compared to the significant falls in activity across other health services during the pandemic.

Last updated on hub: 28 July 2022

From pandemic to cost of living crisis: low-income families in challenging times

Joseph Rowntree Foundation

This report draws on a longitudinal study which followed a set of families on low incomes and their experiences of making ends meet over six years before and during the pandemic. It is based on interviews with parents in 13 families in November and December 2021, focusing on how families managed as the pandemic extended into a second year. It also considers the continuing implications and pressures of managing on a low income in a changing world as the pandemic eases (and state responses to mitigate the financial impact are rolled back), but the cost of living crisis emerges. The Covid crisis added another complication to the lives of those already dealing with multiple stressors. The post-pandemic world will bring ongoing and new challenges, as well as opportunities, in changing times. The uncertainty and instability faced by families with unpredictable income from work and benefits is now being exacerbated by the cost of living crisis which is predicted to have severe consequences for families already struggling to make ends meet. To address this growing crisis, action is required on a wide range of fronts. Families need: a state safety net that provides adequate and reliable financial support, at least rising with inflation; employment laws supporting access to secure, adequately paid employment, allowing people control over hours to fit in with family life; statutory sick pay paid from the first day of sickness, rather than the fourth; public services, including the benefits system, mental health and other GP services that are easier to access with better information and easier channels of communication; measures to help families achieve full digital access; greater efforts by policymakers to connect and engage with people like those in this study who can feel overlooked, with further action to ensure people's concerns are heard and addressed.

Last updated on hub: 27 July 2022

The parallel pandemic: COVID-19 and mental mealth

Northern Health Science Alliance

This report seeks to understand the impact of the COVID-19 pandemic on mental health and productivity in the North and to explore the opportunities for ‘levelling up’ mental health and improve productivity, across the country. It examines: regional trends in mental health during the COVID-19 pandemic; inequalities in mental health during the COVID-19 pandemic by ethnicity, sex, income and age; regional trends in anti-depressant usage during the COVID-19 pandemic; impact of the parallel pandemic on productivity; policy context and recommendations. Before the pandemic, people from ethnic minority backgrounds had similar mental health scores to those from a white British background. However, at the start of the pandemic there was a larger fall in the average mental health score for the ethnic minority group (a fall of 1.63 points on the GHQ-12 scale, compared to 0.87). This fall was greater for those from ethnic minority backgrounds in the North (a fall of 2.34, compared to 1.45 for the rest of England), and these scores remained lower throughout the pandemic. During the pandemic the North East and Yorkshire and the North West experienced the greatest volume of anti-depressant prescriptions at 5.39 and 5.27 per person, respectively. The report conservatively estimates that these reductions in mental health in the North during the two years of the pandemic could cost the UK economy around £2bn in lost economic productivity. The report makes ten recommendations, including increasing NHS and local authority resources and service provision for mental health in the North; and increasing the existing NHS health inequalities weighting within the NHS funding formula.

Last updated on hub: 26 July 2022

A critical juncture for youth justice: learning lessons and future directions for a post-pandemic youth justice system

Alliance for Youth Justice

This is the second of a series of three policy briefings by the Alliance for Youth Justice to explore the challenges and opportunities created by the impact of the COVID-19 pandemic on children and the youth justice system. It draws on a comprehensive literature review; interviews with national stakeholders; consultation sessions with AYJ's members and Young Advocates; and a series of research papers based on extensive research by our project partners at Manchester Metropolitan University (MMU). The briefing considers key challenges for the youth justice system that have been brought about, aggravated or accentuated by the pandemic, highlighting the need for urgent action. It demonstrates how the youth justice system is at a critical juncture, considers future directions for justice for children, and calls for lessons to be learnt from experiences during the pandemic. The briefing finds that there are multiple emerging challenges for youth justice, examining: delayed justice; children's experiences of courts and sentencing; the role of Youth Offending Teams. The briefing recommends that we must build a youth justice system fit for the future, by: addressing injustices emphasised and exacerbated by COVID-19; considering future directions for the youth justice system that are ambitious and learn the lessons from the pandemic.

Last updated on hub: 25 July 2022

Crises and crossroads for the children's secure estate: resisting child imprisonment and rethinking youth custody post-pandemic

Alliance for Youth Justice

This is the third in a series of three policy briefings by the Alliance for Youth Justice to explore the challenges and opportunities created by the impact of the COVID-19 pandemic on children and the youth justice system. It draws on a comprehensive literature review; interviews with national stakeholders; consultation sessions with AYJ’s members and Young Advocates; and a series of research papers based on extensive research by our project partners at Manchester Metropolitan University (MMU). The briefing considers the significant challenges facing the children’s secure estate, outlining the context of existing failures pre-pandemic, the significant risk of harm to children in custody as a result of the pandemic, and the projection that the number of children in custody will steeply rise. The briefing finds that experiences in custody during COVID-19 have been brutal for both children and staff. New practices have been developed and cultural norms have shifted, creating significant risks but also opportunities to rethink regimes and standards. There is no clear central plan or ambition for the children’s secure estate. The pandemic response has demonstrated why this is so critical, and raised questions about leadership, oversight and structure of the estate. Alarm bells are ringing about how an estate already on its knees will be drawn further into deep crisis, should the number of children in custody rapidly increase as projected by the government. The briefing calls for a clear vision for children in custody, urgent action to repair the harms of the pandemic period, rethinking standards of care, and working to prevent the number of children in custody increasing.

Last updated on hub: 25 July 2022

The COVID-19 inquiry: learning the lessons

NHS Confederation

This document sets out core considerations for the forthcoming Covid-19 inquiry, the situation facing the NHS when the pandemic began, and how events unfurled. The NHS went into the pandemic with huge unaddressed workforce shortages, high bed occupancy, systemic inequalities in health outcomes and underfunding of health and social care as well as wider public services, meaning the health system was underprepared when the pandemic hit in March 2020. The COVID-19 inquiry must consider the medium-term impact of austerity and the long-term failure to address the social determinants of health. Moreover, the health and social care response was greatly hindered by a challenging operating environment, characterised by a lack of national preparedness and unclear decision-making, which often came too late and was communicated poorly. The UK lacked the requisite testing and diagnostic capacity in contrast to our counterparts such as Germany. Instead, the NHS had to establish sites, set up systems or procure capacity from scratch when the crisis hit. In addition, PPE was frequently not fit for purpose in terms of quantity or type. A lack of candour about these and other key elements of the response provided the workforce with false assurances. The COVID-19 inquiry should focus on the impact of decisions made at the highest level, by those who set the strategy and guidance. Learning lessons from the pandemic will not wait for the inquiry to conclude. Staff across the health and care system are working hard to now modernise and scale up so that the system is ready for potential new COVID-19 variants, future pandemics and the impact of the climate crisis. This paper highlights some learnings from the pandemic which we believe should be reflected in the NHS Long Term Plan refresh. However, we hope the findings of the statutory inquiry will bolster these efforts. A wealth of innovation and best practice has been shared throughout the system that the COVID-19 inquiry team should look at in their assessment of lessons learned.

Last updated on hub: 20 July 2022

Expanding extra-care

Association of Directors of Adult Social Services

This round-table write-up focuses on the factors currently holding back the wider expansion of housing-based models of care, explores how stakeholders can work together to overcome these. In February, ADASS and housing and care provider Mears jointly hosted a round-table, held under Chatham House rules so as to promote open discussion, exploring these issues. The event sought to draw out the expertise of local authorities and their partners to provide the sector with insights, evidence and approaches for understanding the barriers to delivering on the ambitions for housing-based care, and potential solutions via which to surmount them. Key takeaways include: Covid-19's impact on the numbers of people moving into residential care, and on public perceptions of it, offers an opportunity to increase awareness of other models; in many cases, extra-care schemes have delivered positive experiences for residents during the pandemic; coronavirus pressures have accelerated integration between health, housing and social care; housing-based care models would benefit from being more straightforwardly defined, because terms such as extra-care carry too little meaning for members of the public as well as professionals and politicians; alongside establishing clearer identities, efforts should be made to further potential residents' understanding of the benefits of modern housing-based care models; the adult social care sector must also get better at setting out the broader business case for housing-based care, especially in terms of the savings it offers to the NHS; extra-care development should be tailored to local needs, rather than being delivered on a one-size-fits-all basis, to meet demand in rural areas and towns as well as cities; the needs of Black and ethnic minority communities, and other marginalised groups, should be a key focus when commissioning housing with care; strategic leadership is crucial to bring together partnerships that can create workable solutions.

Last updated on hub: 19 July 2022

Understanding the distinct challenges for nurses in care homes: learning from Covid-19 to support resilience and mental wellbeing

University of East Anglia

This study aimed to understand the distinct challenges faced by registered nurses (RNs) working in the care home sector during the COVID-19 pandemic, how RNs managed these stresses and challenges and to co-produce recommended strategies which would be feasible and acceptable to supporting the future wellbeing of care-home RNs. The study was conducted in two phases and for both phases we recruited NMC-registered nurses – the eighteen interview participants and twelve workshop attendees came mainly from England and Scotland, and most were female with an Adult Nurse registration (three reported a Mental Health Nurse registration). The study identified six activities or practices which can support the wellbeing of RNs working in care homes during the COVID-19 pandemic. These are: a formal, bespoke mental health and wellbeing strategy for nurses and staff working in care homes; debriefing sessions; emotional support networks; improving communication from external agencies to care homes as well as within care homes; providing training and career development opportunities for the whole care-home workforce; improved planning for future pandemics and major unplanned events.

Last updated on hub: 19 July 2022

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