Project Summary
The Social Care COVID Resilience & Recovery project will draw together learning from scientific evidence and from international experiences of long-term care systems. The aim is to inform policy and practice as the social care sector in England grapples with, and recovers, from Covid-19, and to put the sector on a more resilient footing for the longer-term.
The project is funded by the National Institute for Health Research (NIHR) and is a collaboration between the Care Policy Evaluation Centre (CPEC) at the London School of Economics & Political Science (LSE) and the Nuffield Trust, with support from the National Care Forum.
Why is this work important?
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 both for people who use home care and who live in care homes. It has also had far-reaching implications for the mental and physical health of those in contact with the system and has put major financial pressure on care providers.
As England continues to grapple with Covid-19, and begins to look towards the post-covid recovery process, there is an opportunity to learn from international experiences in preventing, mitigating and recovering from waves of infection. There is also an opportunity to identify the underlying factors and pre-existing faultlines within the system that meant the sector was in a fragile state as it went into the pandemic, and to learn from elsewhere about how to put the system on a more sustainable and resilient footing in the long-term.
Project Aims
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 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, and be better prepared and 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.
Project Methods
The project is split into four work packages, comprising:
- 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, we will start a living report on international experiences in order to identify opportunities for lesson learning;
- 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 is supported by a Public Involvement and Engagement Group and an advisory group of experienced academics and representatives of key stakeholder organisations. These groups act as critical friends, ensuring 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.
Outputs
Workstream 1.
Theory of Change
Recording of public webinar:
The social care sector in England and Covid-19, mapping the way towards recovery and increased resilience. Available at: https://ltccovid.org/2021/05/26/video-and-slides-of-the-webinar-on-the-social-care-sector-in-england-and-covid-19-mapping-the-way-towards-recovery-and-increased-resilience-24th-may/
This webinar shared and gathered feedback on, research to identify areas in which international evidence can inform policy and practice in the Social Care sector in England. In this webinar the research team presented initial findings from the first part of the project and gathered views from participants on the map towards social care recovery and increased resilience, on the key topics that the project should focus on, and on other projects that are working towards similar aims.
Situational analysis:
Report
Published 5 May 2023, citation:
Curry N, Oung C, Hemmings N, Comas-Herrera A and Byrd W (2023) Building a resilient social care system in England: What lessons can be learnt from Covid-19? Research report, Nuffield Trust and Care Policy and Evaluation Centre.
The full report, accessible summary, easy read summary and press release are available here: https://www.nuffieldtrust.org.uk/research/building-a-resilient-social-care-system-in-england-what-lessons-can-be-learnt-from-covid-19
Workstream 2.
Part one: Mapping of scientific evidence on Covid-19 and Long-Term Care
Published journal articles:
Byrd, W., Salcher-Konrad, M., Smith, S. and Comas-Herrera, A., 2021. What Long-Term Care Interventions and Policy Measures Have Been Studied During the Covid-19 Pandemic? Findings from a Rapid Mapping Review of the Scientific Evidence Published During 2020. Journal of Long Term Care, 0(2021), p.423–437.DOI: https://doi.org/10.31389/jltc.97
Salcher-Konrad M, Smith S, Comas-Herrera A. (2021) Emerging Evidence on Effectiveness of COVID-19 Vaccines Among Residents of Long-Term Care Facilities. Journal of the American Medical Directors Association Aug;22(8):1602-1603. https://doi.org/10.1016/j.jamda.2021.05.017
Published Open Science Framework Protocol:
Byrd W., Salcher-Konrad M., Patel D. and Comas-Herrera A. (2022). What long-term care interventions and policy measures have been studied during the COVID-19 pandemic? A systematic mapping review of the scientific evidence published during 2021. https://osf.io/7e5jf
Evidence summaries:
Byrd W, Salcher-Konrad M (2021) Evidence summary: What research is there linking hospital discharges to Covid-19 outbreaks in long-term care facilities? LTCcovid.org, International Long-Term Care Policy Network, CPEC-LSE, 22 October 2021. https://ltccovid.org/2021/11/15/evidence-summary-what-research-is-there-linking-hospital-discharges-to-covid-19-outbreaks-in-long-term-care-facilities/
Hemmings, N., Oung, C., Ettelt, S., Salcher-Konrad, M., Curry N. and Comas-Herrera, A. (2021) Evidence summary: Strategies to support uptake of Covid-19 vaccination among staff working in social care settings. LTCcovid.org evidence summary. https://ltccovid.org/2021/05/25/evidence-summary-strategies-to-support-uptake-of-covid-19-vaccinations-among-staff-working-in-social-care-settings/
Smith S., Salcher-Konrad M. and Comas-Herrera A. (2021) COVID-19 outbreaks during or shortly after vaccination of care home residents: summary of three studies from the US and Germany. LTCcovid.org, International Long-Term Care Policy Network, CPEC-LSE, 4th May 2021. https://ltccovid.org/2021/05/05/covid-19-outbreaks-during-or-shortly-after-vaccination-of-care-home-residents-summary-of-three-studies-from-the-us-and-germany/
Smith S, Salcher-Konrad M and Comas-Herrera (2021) Evidence summary: emerging evidence on the protective effect of vaccines from COVID-19 infections among care home populations. LTCcovid.org, International Long-Term Care Policy Network, CPEC-LSE, 15 April 2021. https://ltccovid.org/2021/04/15/evidence-summary-newly-emerging-evidence-from-three-studies-on-the-protective-effect-of-covid-19-from-infections/
Byrd W, Smith S, Salcher-Konrad M and Comas-Herrera (2021) Evidence summary: The use of Information and Communications Technology and Data Sharing in Long-Term Care settings. LTCcovid.org, International Long-Term Care Policy Network, CPEC-LSE, 12 April 2021. https://ltccovid.org/2021/04/12/evidence-summary-the-use-of-information-and-communications-technology-and-data-sharing-in-long-term-care-settings/
Yu J. and Comas-Herrera A. (2021) Developing a map of international research on Covid-19 and Long-Term Care, 21st March 2021. https://ltccovid.org/2021/03/22/developing-a-map-of-international-research-on-covid-19-and-long-term-care-21st-march-update/
Smith S, Salcher-Konrad M, Comas-Herrera A (2021) Article summary: Vaccine effectiveness after 1st and 2nd dose of the BNT162b2 mRNA (Pfizer/BioNTech) Covid-19 vaccine in long-term care facility residents and healthcare workers – a Danish cohort study (pre-print), 12 March 2021. https://ltccovid.org/2021/03/12/article-summary-vaccine-effectiveness-after-1st-and-2nd-dose-of-the-bnt162b2-mrna-pfizer-biontech-covid-19-vaccine-in-long-term-care-facility-residents-and-healthcare-workers-a-danish-coh/
Part 2. Scoping review on evaluations of interventions to support unpaid carers during the Covid-19 pandemic
Protocol for the initial (wider) scoping review:
Comas-Herrera A., Byrd W., Fry A, Marczak J., Rajagopalan J. and Lorenz-Dant K. (2023) Impacts experienced by unpaid or other family/informal carers who provided longterm care during the Covid-19 pandemic: A protocol for a scoping review of the scientific evidence published 2020-2022 OSF | (Protocol) Unpaid Carers in Long-Term Care.pdf
Revised protocol to focus on evaluations of interventions:
Comas-Herrera A., Byrd W., Fry A, Marczak J., Rajagopalan J. and Lorenz-Dant K. (2024) Interventions implemented to mitigate impacts experienced by unpaid or other family/informal carers who provided long- term care during the Covid-19 pandemic, and their effectiveness: An updated protocol for a scoping review of scientific evidence published 2020-2022. OSF | [Interventions] (Protocol) Unpaid Carers in Long-Term Care.pdf
Workstream 3. Case studies
Part 1. Mapping of international experiences with Covid-19 in Long-Term Care systems
LTCcovid International living report on COVID-19 and Long-Term Care
Full report:
This report was developed to collect information on the structure of the Long-Term Care systems, impacts of the Covid-19 pandemic among people who used and provided LTC, measures adopted to mitigate the impacts of the pandemic and new reforms countries were adopting to strengthen their LTC systems and improve preparedness. It was formed of 68 questions that could be answered by any country in the world. This report was “crowd sourced” over 2021 and mid-2022 (some questions were updated for the case study countries until end of 2023, see below). International Long-Term Care experts who were part of the LTCcovid.org initiative were invited to contribute information about the developments in their countries as they happened, and also in response for information requests when the team were preparing evidence summaries on particular questions (see the evidence summaries).
Comas-Herrera A, Marczak J, Byrd W, Lorenz-Dant K, Patel D, Pharoah D (eds.) and LTCcovid contributors. (2022) LTCcovid International living report on COVID-19 and Long-Term Care. LTCcovid, Care Policy & Evaluation Centre, London School of Economics and Political Science. https://doi.org/10.21953/lse.mlre15e0u6s6
The full report can be accessed here: https://ltccovid.org/international-living-report-covid-ltc/
LTCcovid country reports:
The International living report described above could be read “by question”, as in the version provided above, or by country, generating reports for specific countries from the questions that had been answered. The reports below are from the countries that are most complete, which are also the countries that were considered as part of the “long list” for the case studies.
The reports for Denmark, France, Japan and the Netherlands are the most complete and recent, as these were used as part of the development of the case studies.
Australia, Austria, British Columbia (Canada), Denmark, England, France, Israel, Italy, Germany, Japan, Netherlands and Sweden
International overviews of Long-Term Care policies and practices in relation to Covid-19:
We “crowd-sourced” reports from international experts in Long-Term Care on specific topics, sending out specific questions to international experts.
National discussions on mandatory vaccination for long-term care staff in 24 countries. LTCcovid international overviews of long-term care policies and practices in relation to Covid-19 (No. 1, May 2021). https://ltccovid.org/2021/05/25/national-discussions-on-mandatory-vaccination-among-long-term-care-staff-in-23-countries-ltccovid-international-overviews-of-long-term-care-policies-and-practices-in-relation-to-covid-19-no-1-may/
Current situation in relation to “visiting” in care homes and outings for residents in 23 countries as of July/August 2021. LTCcovid international overviews of long-term care policies and practices in relation to Covid-19 (Issue 2, August 2021). https://ltccovid.org/2021/08/05/current-situation-in-relation-to-visiting-in-care-homes-and-outings-for-residents-ltccovid-international-overviews-of-long-term-care-policies-and-practices-in-relation-to-covid-19/
Long-Term Care and COVID-19 vaccination, prioritization and data, 26th January 2021 update. https://ltccovid.org/2021/01/26/new-international-living-report-long-term-care-and-covid-19-vaccination-prioritization-and-data/
Videos of: International Workshop on Covid-19 and Long-Term Care, What have we learnt and what policies do we need to strengthen LTC systems?
We hosted a 2-day even over the 6 and 7 December where contributors of LTCcovid.org, researchers, international organisations such as the World Health Organization, the OECD, International Development Bank and the European Centre for Disease Prevention and Control. The presentations covered 18 countries. The recordings and slides are available here: https://ltccovid.org/international-workshop-on-covid-19-and-long-term-care-systems-what-have-we-learnt-and-what-policies-do-we-need-to-strengthen-ltc-systems/
Part 2. Case studies: lessons from Denmark, France, Japan and the Netherlands
Videos:
These are video recordings from a series of four webinars reflecting on what England should learn from the experiences of the Long-Term Care (LTC) systems in Japan, France, Denmark and the Netherlands during COVID-19, as part of the Social Care COVID Resilience and Recovery project. The webinars were used to test the initial lessons identified as part of the case studies.
Video: What can the English social care sector learn from France to recover from the COVID pandemic and become more resilient? – https://ltccovid.org/2023/05/15/video-what-can-the-english-social-care-sector-learn-from-france-to-recover-from-the-covid-pandemic-and-become-more-resilient/
Video: What can the English social care sector learn from the Netherlands to recover from the COVID pandemic and become more resilient? https://ltccovid.org/2023/03/20/video-what-can-the-english-social-care-sector-learn-from-the-netherlands-to-recover-from-the-covid-pandemic-and-become-more-resilient/
Video: What can the English social care sector learn from Japan to recover from the COVID pandemic and become more resilient? https://ltccovid.org/2023/05/12/video-what-can-the-english-social-care-sector-learn-from-japan-to-recover-from-the-covid-pandemic-and-become-more-resilient/
Video: What can the English social care sector learn from Denmark to recover from the COVID pandemic and become more resilient? https://ltccovid.org/2023/03/27/video-what-can-the-english-social-care-sector-learn-from-denmark-to-recover-from-the-covid-pandemic-and-become-more-resilient/