COVID-19 resources on infection control

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Digital health and Covid-19: a PRSB consultation

Professional Record Standards Body

Findings of a consultation exploring the role of digital in responding to the pandemic; the opportunities and challenges encountered and the lessons for the future; and views on ways in which PRSB and its members can influence this agenda. The report reveals that the experience of a shift to digitally enabled working was, on balance, seen as positive by both professionals and people using services; the benefits from remote consultation went beyond convenience and a reduced risk of infection, particularly for people who have found traditional consultations a challenge; almost universally, there was a sense that many of the changed ways of working, with adjustment where necessary, should be retained; however, poor infrastructure, multiple platforms, and lack of interoperability across many health and social care settings prevented optimal service delivery; remote and self-monitoring tools have great potential, but they need standardising, integration, quality control and risk management; data requirements, for practice, governance and for research, need much better planning and coordination and reducing burden is essential; the pace of change in practice has not been matched by updated and responsive protocols for information sharing, leading to suboptimal care and frustration; the care sector, and social care, despite welcome developments such as access to NHSMail during the crisis, experience challenges in the timely access to information that could improve outcomes and experience for people. The report sets out a comprehensive set of recommendations addressing each of the priorities for action identified in the consultation.

Last updated on hub: 24 November 2020

COVID-19 and health inequality

Independent Scientific Advisory Group for Emergencies

This report examines Covid-19 mortality rates in the most deprived neighbourhoods in England and in the lowest income households – contextualising them within the wider issue of health inequalities. Firstly, the report provides an overview of socio-economic health inequalities in the UK. It then summarises epidemiological evidence of socio-economic inequalities in relation to Covid-19 (both in the UK and internationally) and examines the pathways linking Covid-19 and inequality. In part three, it examines inequalities and the impact of the emergency policy response to Covid-19, including the lockdown, the emerging parallel pandemic of restricting non-COVID NHS services, mental health impacts, rising homelessness and school closures. Part four examines the emerging evidence of an unequal Covid-19 economic crisis and the impact that it could have on future health inequalities. The report concludes by outlining some key recommendations whereby local government and devolved authorities, the NHS and national government can act to reduce these inequalities. Key messages include: Covid-19 has magnified and exacerbated health inequalities with higher rates of illness and death from Covid-19 in more deprived communities; Covid-19 has highlighted the importance of the social determinants of health namely – housing, income, nutrition, employment sickness benefits and financial support, social security and social care and health care; people in lower paid jobs or living in more deprived neighbourhoods are more likely to experience adverse outcomes from the virus because of co-morbidities and reduced immune response associated with poverty and stress, occupational exposures and inability to shield at home, overcrowding and homelessness, lack of sickness benefits and lack of access to and adequacy of health and social care services. While the UK government has taken steps to mitigate some of the distributional impacts of Covid-19, there is an urgent need for additional action to reinvest and rebuild capacity in all public services linked to a strategy for full employment and resource redistribution.

Last updated on hub: 24 November 2020

Learning Disability Mortality Review (LeDeR) programme: action from learning: deaths of people with a learning disability from COVID-19

NHS England

This document describes how the NHS is working with partners and stakeholders to embed the learning from the University of Bristol’s report into the deaths of 206 people with a learning disability at the start of the COVID-19 pandemic. The report highlighted some good practice in the care of people with a learning disability, but it also highlighted concerns about the care that some people received. This document explains how the required changes to the services are being implemented so that action is taken. Specifically, it outlines the actions to improve the detection of deterioration in the health of people in community and home settings including people with a learning disability; actions to address the issue of ‘Do not attempt cardiopulmonary resuscitation’ (DNACPR) and learning disability as a cause of death; actions relating to diagnostic overshadowing, when the symptoms of physical ill health are incorrectly either attributed to a mental health/behavioural problem or considered inherent to the person’s learning disability or autism diagnosis; and actions relating to the reasonable adjustments that healthcare providers need to put in place to ensure that people with a learning disability have equal access to health services.

Last updated on hub: 24 November 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

Mitigation of risks of COVID-19 in occupational settings with a focus on ethnic minority groups – consensus statement from PHE, HSE and FOM

Public Health England

Consensus statement from Public Health England (PHE), Health and Safety Executive (HSE ) and the Faculty of Occupational Medicine (FOM) on the mitigation of risks of COVID-19 in occupational settings with a focus on ethnic minority groups.

Last updated on hub: 24 November 2020

Enabling safe and effective volunteering during coronavirus (COVID-19)

Department for Digital, Culture, Media and Sport

This guidance aims to help organisations and groups understand how to safely and effectively involve volunteers during the pandemic.

Last updated on hub: 23 November 2020

Adult secure service user, family and carer feedback survey during the Coronavirus (COVID-19) pandemic

Rethink Mental Illness

Findings from a survey to gather the views and experiences of people in adult secure services, in all service categories including mental illness, personality disorder, learning disability and autism (both in the hospital and the community), and their families and carers, to find out the impact of COVID-19 on them from March to June 2020. The most striking finding was the considerable variation in responses – both between services and within the same service. This report sets out 9 key areas where people identified examples of what is working well, as well as where lessons could be learnt and improvements made, not only for a potential second wave of the pandemic but also to ensure long lasting improvements for services as a consequence of this experience. The key areas are: activities; outdoor access; leave and progress; communication; digital access; family and friends contact; infection control; physical health; and staff. Leave was the most common theme in all of the responses to the survey and overwhelmingly people found the restrictions difficult. People cited a range of reasons for this – not being able to continue with community activities, feeling ‘cooped up’ and the impact on seeing friends and family. Some people linked these restrictions to the effect this was having on their progress and were frustrated that this was holding them up. There was also frustration for people that lockdown easing in the community was not always reflected in the lifting of restrictions in their hospital. Overall, people said they were very understanding of the measures that needed to be in place to limit the impact of COVID-19 and keep them safe.

Last updated on hub: 19 November 2020

Recasting social workers as frontline in a socially accountable COVID-19 response

International Social Work

The COVID-19 pandemic has seen the engagement of a wide range of professionals in responding to clinical, social and economic issues. While the clinical expression of the pandemic has generated strong media portrayal of physicians and nurses as frontline workers, social workers – who play a key role in helping individuals and families in crisis – have not been similarly highlighted. The pandemic within a social accountability framework highlights important roles of both public officials and civic society in containment efforts. This article recognizes social workers as important actors in their representative and supportive role for civil society during COVID-19.

Last updated on hub: 19 November 2020

Social work and COVID-19 pandemic: an action call

International Social Work

The social work profession, more than any other, is most hurt by the rampaging coronavirus (aka, COVID-19) pandemic given the scourge’s pernicious impact on society’s underserved and undervalued populations. More so, the pandemic has undermined the profession’s historical value commitment to social justice and human rights while overturning our insistence on the importance of human relationships. The purpose of this essay is to explicate the nexus between social work and COVID-19 pandemic. While noting the deafening silence of the profession in the global discourse of the pandemic, it advocates for the urgency of our response if our profession is to attain significant public value amid the current loss of lives and threats to human rights. Strategies for our professional action, in flattening the curve of the contagion, are laid out.

Last updated on hub: 19 November 2020

A rapid systematic review of measures to protect older people in long term care facilities from COVID-19

medRxiv

The global COVID-19 pandemic produced large-scale health and economic complications. Older people and those with comorbidities are particularly vulnerable to this virus, with nursing homes and long term care facilities experiencing significant morbidity and mortality associated with COVID-19 outbreaks. The aim of this rapid systematic review was to investigate measures implemented in long term care facilities to reduce transmission of COVID-19 and their effect on morbidity and mortality of residents, staff, and visitors. Databases (including MedRXiv pre-published repository) were systematically searched to identify studies reporting assessment of interventions to reduce transmission of COVID-19 in nursing homes among residents, staff, or visitors. Outcome measures include facility characteristics, morbidity data, case fatalities, and transmission rates. Due to study quality and heterogeneity, no meta-analysis was conducted. The search yielded 1414 articles, with 38 studies included. Reported interventions include mass testing, use of personal protective equipment, symptom screening, visitor restrictions, hand hygiene and droplet/contact precautions, and resident cohorting. Prevalence rates ranged from 1.2-85.4% in residents and 0.6-62.6% in staff. Mortality rates ranged from 5.3-55.3% in residents. Novel evidence in this review details the impact of facility size, availability of staff and practices of operating between multiple facilities, and for-profit status of facilities as factors contributing to the size and number of COVID-19 outbreaks. No causative relationships can be determined; however, this review provides evidence of interventions that reduce transmission of COVID-19 in long term care facilities.

Last updated on hub: 17 November 2020

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