COVID-19 resources on Infection control

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Testing service for extra care and supported living settings

Department of Health and Social Care

Guidance on regular retesting for extra care and supported living settings that meet the eligibility criteria. NHS Test and Trace is making regular COVID-19 testing available to eligible extra care and supported living settings in England. In order to be eligible for testing, extra care and supported living settings must meet both of the following criteria: a closed community with substantial facilities shared between multiple people; where most residents receive the kind of personal care that is CQC regulated (rather than help with cooking, cleaning and shopping). This guidance covers: why testing is important; what to do if you have an outbreak; the end-to-end testing process; unique organisation number; preparing your setting; registering completed tests; returning test kits; results; where to go for support; step-by-step guide for registering a test kit after completing a test.[Published 7 December 2020; Last updated 1 July 2021]

Last updated on hub: 08 December 2020

The 12-month stretch: where the Government has delivered – and where it has failed – during the Covid-19 crisis

Resolution Foundation

This note explores the past 12 months of the pandemic through the health crisis, the economic crisis, and their impact on households’ ability to cope financially. It takes a step back, considering the big picture of what policy makers have done, how well they have done it, and where it’s left people, both in terms of health and economic outcomes. We find that the past year has been marked by big successes on income support and vaccines, but repeated failures on lockdown that have cost lives and deepened the economic crisis, and left a legacy of inequality that needs to be addressed in the recovery. Key findings: the UK was the first country to start a clinically-approved vaccination programme, and is delivering jabs three times faster than Europe; over £186 billion in emergency Covid-19 support has directly supported households and firms – via the furlough scheme, benefits uplift and grants for companies and the self-employed; delaying the start of the latest lockdown until January, despite evidence of fast rising cases, is estimated to have led to around an extra 27,000 Covid-related deaths compared to a situation in which restrictions were put in place quickly enough to prevent the death rate rising from early December levels; poorer households have borne the brunt of the health and economic crises – recent mortality rates in the most deprived parts of England have been almost twice those in the least deprived areas; although aggregate savings have surged during the crisis, the poorest fifth of households are 50 per cent more likely to have seen their savings deteriorate rather than rise during the crisis; the poorest fifth of households are also twice as likely to have seen their debts rise rather than fall during the crisis.

Last updated on hub: 22 March 2021

The challenge of controlling COVID-19: public health and social care policy in England during the first wave

Policy Press

Providing an account of the policy response to COVID-19 in England, this book analyses the political and long-term systemic factors associated with the failures to control the first wave of the pandemic during 2020. It explores the part played by key policy actors, particularly politicians and scientists, and focuses on two difficult policy issues during the first wave: the establishment of a ‘test, trace and isolate’ system and responses to the high death rate in care homes for older people. Drawing on a wide range of documentary evidence, including parliamentary papers and SAGE minutes, the book draws attention to the importance of longstanding structural problems in public health and the care sector, especially the impact of outsourcing and privatisation.

Last updated on hub: 25 May 2021

The challenge of controlling COVID-19: public health and social care policy in England during the first wave

Policy Press

Providing an account of the policy response to COVID-19 in England, this book analyses the political and long-term systemic factors associated with the failures to control the first wave of the pandemic during 2020. It explores the part played by key policy actors, particularly politicians and scientists, and focuses on two difficult policy issues during the first wave: the establishment of a ‘test, trace and isolate’ system and responses to the high death rate in care homes for older people. Drawing on a wide range of documentary evidence, including parliamentary papers and SAGE minutes, this book draws attention to the importance of longstanding structural problems in public health and the care sector, especially the impact of outsourcing and privatisation.

Last updated on hub: 23 June 2021

The Coronavirus and the risks to the elderly in long-term care

Journal of Aging and Social Policy

The elderly in long-term care (LTC) and their caregiving staff are at elevated risk from COVID-19. Outbreaks in LTC facilities can threaten the health care system. COVID-19 suppression should focus on testing and infection control at LTC facilities. Policies should also be developed to ensure that LTC facilities remain adequately staffed and that infection control protocols are closely followed. Family will not be able to visit LTC facilities, increasing isolation and vulnerability to abuse and neglect. To protect residents and staff, supervision of LTC facilities should remain a priority during the pandemic.

Last updated on hub: 31 August 2020

The courage to be kind: reflecting on the role of kindness in the healthcare response to COVID-19

Carnegie UK Trust

Findings from reflective conversations of a cluster of doctors in leadership programmes on the experience and new ways of working as a result of the pandemic. The five participants in the project were able to reflect on the COVID response from roles within Scottish Government, local health board management, hospital medicine, emergency department and general practice. This report presents a thematic analysis of what was heard across these reflective conversations. It is structured chronologically and, in doing so, it tells a story of people’s experiences of change across the NHS through three distinct phases: lockdown (April-May), lifting lockdown (June-July), and remobilising (August-September). Each phase is broken down into key themes, with the voice of participants woven between. The report finishes with a discussion that summarises what has been learnt about kindness and relationships in the first six months of COVID, and considers what this might mean for the future. Although they reflected shifting dynamics, pressures and emotions, the three phases of conversations present a clear focus on what is important, and an indication of what should be valued and prioritised in health and social care renewal, in order to build a system that looks after the wellbeing of patients and staff: a meaningful conversation about staff wellbeing – too often the individual can be overlooked in conversations about the system; sustaining a common purpose – the clear focus on COVID-19 demanded and enabled a more relational approach and, more widely, kindness became a feature of interactions among staff and leadership; shifting the emphasis on targets – the experience of COVID-19 may open up a much wider conversation about how best to fit targets to a system in a way that delivers the best for both patients and staff.

Last updated on hub: 10 December 2020

The COVID-19 long-term care situation in England

International Long-term Care Policy Network

This report provides an overview of the impact of COVID-19 so far on people who use and provide long-term care in England and of the policy and practice measures adopted to mitigate its impact. The report finds that the impact of the COVID-19 pandemic has been severe in England and has affected disproportionally people who use and provide long-term care. Since the beginning of the pandemic and until the 6th November, 15,659 people had died in the care home and their deaths were linked to COVID-19 in the death register. An estimate of the deaths of care home residents (including those who died in hospital) suggests that, until the 13th November, 20.799 care home residents died whose deaths were attributed to COVID-19. An estimate of excess deaths in care homes suggests that 22,948 more people died until the 30th October, compared to the previous 5 years. This would represent around 5% all care home residents. With the initial response almost entirely focused on the NHS, too little consideration was given to the fragmented social care system, which was already in a fragile state prior to the pandemic, and into which many people were being discharged from hospital. Since the first wave, there has been improvement in terms of availability of guidance, access to Personal Protection Equipment and testing. In the second wave, care providers continue to face challenges with testing capacity (and speed), visiting policies and the financial implications of the additional costs of the pandemic and decreases in revenue. The pandemic has laid bare long-standing problems in the long-term care system in England, such as the fragmentation of responsibilities, funding and workforce pressures, as well as the unequal relationship between the health and social care systems and the invisibility of groups such as working age adults with disabilities and unpaid carers in social care planning.

Last updated on hub: 24 November 2020

The COVID-19 pandemic and long-term care: what can we learn from the first wave about how to protect care homes?

Eurohealth

The COVID-19 pandemic has highlighted and exacerbated pre-existing problems in the long-term care sector. Based on examples collected from the COVID-19 Health System Response Monitor (HSRM) and the International Long-term care Policy Network (LTCcovid), this article aims to take stock of what countries have done to support care homes in response to COVID-19. By learning from the measures taken during the first wave, governments and the sector itself have an opportunity to put the sector on a stronger footing from which to strengthen long-term care systems.

Last updated on hub: 15 January 2021

The difficult balance between ensuring the right of nursing home residents to communication and their safety

International Journal of Environmental Research and Public Health

The COVID-19 epidemic has had a profound impact on healthcare systems worldwide. The number of infections in nursing homes for the elderly particularly is significantly high, with a high mortality rate as a result. In order to contain infection risks for both residents and employees of such facilities, the Italian government passed emergency legislation during the initial stages of the pandemic to restrict outside visitor access. On 30 November 2020, the Italian President of the Council of Ministers issued a new decree recognizing the social and emotional value of visits to patients from family and friends. In addition, it indicated prevention measures for the purposes of containing the infection risk within nursing homes for the elderly. This article comments on these new legislative provisions from the medicolegal perspective, providing indications that can be used in clinical practice.

Last updated on hub: 15 June 2021

The doctor will Zoom you now: getting the most out of the virtual health and care experience: insight report

National Voices

Findings of a rapid, qualitative research study designed to understand the patient experience of remote and virtual consultations. The study engaged 49 people using an online platform, with 20 additional one to one telephone interviews. Participants were also invited to attend an online workshop on the final day of the study. All participants had experienced a remote consultation during the lockdown period of the COVID-19 pandemic. The report suggests that remote consultations and the use of technology offer some great opportunities to make significant improvements to general practice, hospital outpatient and mental health appointments, but making the most of this opportunity means understanding the patient experience. For many people, remote consultations can offer a convenient option for speaking to their health care professional. They appreciate quicker and more efficient access, not having to travel, less time taken out of their day and an ability to fit the appointment in around their lives. Most people felt they received adequate care and more people than not said they would be happy with consultations being held remotely in future. However, there is no one size that fits all solution. Key to a successful shift to remote consultations will be understanding which approach is the right one based on individual need and circumstance. The report argues that a blended offer, including text, phone, video, email and in-person would provide the best solution and an opportunity to improve the quality of care. By focusing on the needs of people receiving care and using a combination of communication tools a more equal space for health care providers and patients to interact can be created.

Last updated on hub: 30 July 2020

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