The ongoing outbreaks of Covid-19 have had an enormous impact on those who use and provide long-term care in England, with substantial excess mortality for people who use home care and those who live in care homes. They have also had far-reaching implications for the mental and physical health of those in contact with the system, and have piled yet more financial pressure on care providers.
As England continues to grapple with Covid-19, and begins to look towards recovery, we believe it is important to learn from the relevant experiences of other countries in preventing, mitigating and recovering from waves of infection. There is also an opportunity to identify the underlying factors and pre-existing faultlines which made the system so fragile as it went into the pandemic, and to learn from elsewhere about how to put it on a more sustainable and resilient footing in the long term.
Social Care Resilience & Recovery is a project funded by the National Institute for Health Research (NIHR) in collaboration with colleagues from the Care Policy Evaluation Centre (CPEC) at the London School of Economics & Political Science (LSE). The project will draw together learning from scientific evidence and from the experiences during Covid of other countries and their responses to the pandemic in social care. The aim is to inform policy and practice as the sector grapples with, and recovers, from Covid-19, and to put the sector on a more resilient footing for the longer-term.
What are we planning to do?
Our primary research question is: What can we learn from international evidence and experiences in order to support the recovery of the social care sector, and to inform the development of policies to prevent and manage future outbreaks in social care settings in England?
The project aims to:
- Co-develop a framework to provide strategic direction for how the whole social care sector (not just care homes) in England can recover from, be better prepared for, and be more resilient to ongoing and future pandemics;
- Synthesise international evidence on Covid-19 and lessons relevant to the English social care sector;
- Draw together learning to support the sector’s recovery and to inform the development of policies to improve the resilience of the sector in the long-term.
The project is split into four workstreams:
- Workstream 1: Situational analysis and development of analytical framework. This phase will seek to understand the impact of the Covid-19 pandemic on people who use and provide social care in England; of the policy and practice responses to mitigate those impacts; and the factors that supported or hindered the implementation of policies in England. We will use this situational analysis and a Theory of Change workshop to establish a framework from which to assess the relevance of international experiences and evidence to the social care system in England. In parallel, a report on international experiences will be created and regularly updated as the global situation changes. This will enable timely identification of lessons pertinent to the English context;
- Workstream 2: Scoping reviews of existing evidence. Evidence reviews to map and synthesise empirical evidence of key policy and practice measures to prevent and mitigate the impact of the pandemic, and barriers and facilitators of implementation of those measures;
- Workstream 3: International case studies. We intend to identify four case study countries whose experiences during covid-19 offer relevant learning for the English social care system. In-depth learning will be drawn together about the resilience of the system as it entered the pandemic; the policies and processes adopted to mitigate the impact of Covid-19; factors that helped and hindered; and what measures are being taken to support recovery.
- Workstream 4: Synthesis. Lastly, findings across all these workstreams will be synthesised, using the framework developed in workstream 1, and recommendations developed for policy and practice.
The research team will be supported by a Public Involvement and Engagement Group and an advisory group of experienced academics and representatives of key stakeholder organisations. These groups will act as critical friends, will help ensure that the project is relevant and of high quality and will provide links with other groups carrying out relevant research or with other stakeholders with an interest in this area.
Given the constantly-evolving situation and the importance of timely learning, we will seek to ensure relevant emerging findings are available to national and local decision-makers as quickly as possible. Throughout the lifetime of the project, we will seek to publish a range of outputs such as:
- An international report, hosted at www.ltccovid.org, will provide an overview of long-term care systems around the world; how they have been affected by the covid-19 pandemic; how they have responded and what lessons have been learnt. This will be updated regularly to enable timely learning for England;
- Research evidence summaries/blogs, highlighting policy-relevant findings;
- Timely briefings for key stakeholders;
- Journal articles.
The first substantial output will be published in early Summer 2021, which will reflect on the English experience during the first and subsequent waves of infection and what lessons could be learnt. A final output will bring together what we have learnt across the project and summarise the main lessons and recommendations for the recovery from, and future prevention and management of, Covid-19 in the English social care sector, as well as lessons emerging to inform the longer-term future of social care.
More on the project will be available at www.ltccovid.org
The project started in January 2021 and aims to complete by Summer 2022.
The project is being undertaken jointly between the Nuffield Trust and the Care Policy and Evaluation Centre at the LSE.
Adelina Comas-Herrera (PI)1, Natasha Curry (co-lead)2, Erica Breuer1, William Byrd1, Margaret Dangoor1, Nigel Edwards2, Stefanie Ettelt1, Jose-Luis Fernandez1, Nina Hemmings2, Martin Knapp1, Margrieta Langins1, Shoshana Lauter1, Klara Lorenz-Dant1, Camille Oung2, Maximilian Salcher-Konrad1, Sian Smith1 and Jessica J. Yu1, in collaboration with the National Care Forum.
1 Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science
National Institute for Health Research (NIHR), Policy Research Programme (PRP) - Recovery, Renewal, Reset: Research to inform policy responses to COVID-19 in the health and social care systems. Grant number: NIHR202333