COVID-19 resources

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Covid-19 and the nation’s mental health: forecasting needs and risks in the UK: July 2020

Centre for Mental Health

This briefing draws on international evidence to provide an assessment of the economic impacts of Covid-19 and their implications for public mental health. It also reviews evidence relating to the criminal justice system and to young adults and the potential longer-term psychological impacts of rising youth unemployment. Research has identified specific groups of people facing higher risks to their mental health at this time, including the families of people treated in intensive care, people with existing mental or physical health conditions, and pregnant women. There is also evidence that people with existing mental health difficulties have been experiencing a worsening of their mental health during the pandemic. The impact of the pandemic on children and young people’s mental health is greater in areas and communities hardest hit by the virus and by lockdowns. Children from low income families, from Black, Asian and minority ethnic communities and young carers are all more likely to experience poor mental health as a result of the pandemic. Children’s mental health has been affected by disruptions to their education, compounded by reduced access to support for their mental health. The paper makes a number of recommendations for action to protect the nation’s mental health, including: targeting mental health resources where they are most needed; proactively protecting the mental health of children and young people; facilitating a psychologically informed return to school; providing additional mental health support for groups facing further risks; improving safety in the criminal justice system; and supporting young people seeking employment.

Last updated on hub: 27 August 2020

How has COVID-19 changed the landscape of digital inclusion?

Centre for Ageing Better

This briefing looks at how COVID-19 has impacted older people's internet use and sets out recommendations to help ensure fewer people are digitally excluded. The paper identifies multiple and complex barriers that individuals in later life face in getting online, including self-efficacy or lack of confidence; awareness of benefits; awareness of risks; employment history; perception of cognitive ability; influence of family; perceived value and relevance; and access and affordability of equipment. The paper suggests that there are some consistent principles of good practice that can be applied to the support offered to older people. They include: flexibility and relevance – helping people to do the things they need and want to do online; the right pace; repetition and reflection; the right language, avoiding jargon and focusing on the task, not the tech; a strong teacher-student relationship; time to build relationships; ongoing, open-ended support, allowing learners to return with questions and problems; and co-design, involving a wide range of users in the shaping and design of all services, new and existing, to ensure their relevance and effectiveness.

Last updated on hub: 27 August 2020

Community health and care discharge and crisis care model: an investment in reablement

Local Government Association

This paper sets out the view of the Local Government Association (LGA) and Association of Directors of Adult Social Care (ADASS) that the ‘discharge to support recovery and then assess’ approach is a key component of a person-centred community health and care model. The experience of responding to COVID19 has demonstrated the importance of this care being centred on the individual, providing safe, proactive care that maximises independence and wellbeing. The paper argues that people have the best outcomes when they are helped to avoid having to go to hospital or return home from hospital safely and without delay, with support targeted on their needs. Once settled back into their homes, and after a period of reablement or rehabilitation if needed, only then should they have a care and health assessment for any ongoing needs. However, the paper suggests that but there are not enough community-based services to support people at home – the 2020 ADASS Budget Survey highlights that only 4 per cent of directors of adult social services are confident their budgets will enable them to meet statutory duties. The Covid-19 crisis has confirmed the need to reshape health and care, embedding positive developments and preventing a return of fragmented and untimely care and support, especially on discharge from hospital. This will require government and national partners to support local place-based leadership, to continue to shift resources towards community-based services, and to support the recruitment, retention and retraining of the workforce.

Last updated on hub: 27 August 2020

The future of commissioning for social care

Social Care Institute for Excellence

SCIE's latest commissioning guide that focuses on the immediate future of commissioning in light of COVID-19.

Last updated on hub: 26 August 2020

How Covid-19 has magnified some of social care’s key problems

King's Fund

Examines eight key problems facing social care and the extent to which Covid-19 has exacerbated these challenges. These include: means testing – social care is not free at point of use like the NHS; catastrophic costs – some people end up paying large amounts and even selling their homes to pay for care; unmet need – many people go without the care and support they need; quality of care – a wide spectrum of concerns, from 15-minute care visits to neglect and lack of choice and control; workforce pay and conditions – staff are underpaid, leading to high vacancy rates and turnover; market fragility – care providers go out of business or hand back contracts; disjointed care – health and care is not integrated around the individual and causes issues such as delayed transfers of care from hospital; the ‘postcode lottery’ – there is unwarranted variation between places in access to care and its quality. This piece discusses how the emphasis on them has shifted as a result of the pandemic – while the first two issues have barely been mentioned during the past few months, in the remaining six areas, Covid-19 has brought significant change and, if anything, exacerbated these challenges.

Last updated on hub: 26 August 2020

What enables or hinders people in the community to make or update advance care plans in the context of Covid-19, and how can those working in health and social care best support this process?

Centre for Evidence-Based Medicine

An evidence review of the enablers and barriers to advance care planning (ACP) in the context of Covid-19 and best support approaches. The review identified 21 research studies and 10 systematic reviews that met the inclusion criteria and were classed as highly relevant. In addition, it identified 12 guidelines related to ACP in the UK during COVID-19. The analysis shows that in the context of COVID-19 some known barriers to ACP in community settings have worsened, while others have improved. COVID-19 has raised public awareness of ACP, increased the importance of and attention to IT systems, motivated the development of new guidelines and templates, and rapidly shifted ‘business as usual’ processes and protocols. This presents opportunities to improve ACP in the community. However, existing guidelines and resources are to a major extent clinician-focused; there are few video- and web-based ACP resources for the public and those that exist are scattered and piecemeal. This is a concern given good quality evidence that online and video ACP interventions are beneficial, particularly among people with limited English proficiency, poor health literacy and/or from otherwise disadvantaged communities. In the context of COVID-19, and to reduce inequalities in access to ACP, the report recommends national investment in evidence-based, public-facing resources and integrated systems to support ACP, building on existing resources. Alongside this investment, simultaneous, interconnected strategies are needed, underpinned by healthcare policy, including training for those working in health and social care, better coordination of electronic medical record systems, and public education and awareness raising.

Last updated on hub: 25 August 2020

A structured tool for communication and care planning in the era of the COVID-19 pandemic

Journal of the American Medical Directors Association

Residents in long-term care settings are particularly vulnerable to COVID-19 infections and, compared to younger adults, are at higher risk of poor outcomes and death. Given the poor prognosis of resuscitation outcomes for COVID-19 in general, the specter of COVID-19 in long-term care residents should prompt revisiting goals of care. Visitor restriction policies enacted to reduce the risk of transmission of COVID-19 to long-term care residents requires advance care planning discussions to be conducted remotely. A structured approach can help guide discussions regarding the diagnosis, expected course, and care of individuals with COVID-19 in long-term care settings. Information should be shared in a transparent and comprehensive manner to allay the increased anxiety that families may feel during this time. To achieve this, this paper proposes an evidence-based COVID-19 Communication and Care Planning Tool that allows for an informed consent process and shared decision making between the clinician, resident, and their family.

Last updated on hub: 24 August 2020

Editorial: unprecedented times? Social work and society post-COVID-19

British Journal of Social Work

Sets out the key messages from the latest issue of the British Journal of Social Work and emphasises how, in response to the Covid-19 pandemic, social work, along with allied professions, must adapt and change without losing sight of its core ethos and skills and drawing on the lessons from both research and practice.

Last updated on hub: 24 August 2020

COVID-19 and English council funding: how are budgets being hit in 2020-21?

Institute for Fiscal Studies

This report examines the scale and nature of forecast impacts of the Covid-19 pandemic on local authorities spending and income. It explores how impacts may vary across council types, regions and council characteristics; compares the impacts with the financial resources provided to councils by central government and with the resources available to them in the form of reserves; and considers the implications for future funding policy. Councils forecast spending pressures of £4.4 billion and non-tax income pressures of £2.8 billion in 2020–21. Taken together, this equates to a financial hit equal to 13.0% of pre-crisis expenditure. Adult social care accounts for £1.8 billion of the spending pressures, with unspecified unachieved efficiency savings accounting for the next-biggest chunk, at £0.6 billion. Taken together, councils’ forecasts for spending and non-tax income and the baseline scenario for funding imply a funding shortfall of approximately £2 billion this year, although uncertainty about pressures and funding availability means there is scope for the gap to be much bigger or smaller. The report argues that several options are available to the Government. The simplest approach would be to increase the general grant funding it gives councils but targeted support to those councils facing the greatest problems would be more affordable. One option would be to follow the example of Wales, where councils submit claims based on the additional costs they have incurred, subject to some vetting. Temporary powers to borrow to cover day-to-day spending could also be considered, and have been identified by the OECD as a sensible way to give local areas more flexibility and autonomy to respond to the crisis as they see fit.

Last updated on hub: 24 August 2020

Experiences of child and adolescent to parent violence in the Covid-19 pandemic

University of Oxford

This report draws upon the findings of online surveys of 104 parents who have experiences C/APV from their child aged 10-19 years and 47 practitioners who work with families experiencing C/APV. It also draws data provided by all 43 police forces across England and Wales on total numbers of reported C/APV incidents over the one-year period from 1st April 2019 to 31st May 2020. The analysis reveals that 70% of parents reported an increase in violent episodes during lockdown; 69% of practitioners said they had seen an increase in referrals for families experiencing C/APV; 64% of practitioners identified that the severity or incidence of violence had increased; 29% of parents identified a decline in C/APV during the lockdown period which was explained by a reduction in the stresses and triggers for violence in this period. Respondents identified some lockdown-specific reasons for the increase in C/APV, which include spatial confinement and coerced proximity, changes in structure and routine, fear and anxiety and lack of access to formal and informal support. The report makes ten recommendations to services, local authorities, and government in planning a response to C/APV, including ensuring robust safeguarding measures for young people and families experiencing C/APV; planning for a rise in demand for support as lockdown lifts and schools and workplaces reopen; avoiding over-criminalisation of young people using violence; and providing safe spaces for families at crisis point and respite care for young people.

Last updated on hub: 24 August 2020