The project

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.

What are 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 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.

Our approach

The project is split into four work packages, comprising:

1. 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;

2. 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;

3. 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.

4. 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.

Timescale

The project started in January 2021 and aims to complete by Summer 2022.

Planned project outputs

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:

• A “living” international report providing an overview of how Long-Term Care systems around the world have been affected by the COVID-19 pandemic, how they have responded and what lessons have been learnt, as well as brief descriptions of long-term care systems;
• Research evidence summaries/blogs, highlighting policy-relevant findings (see below);
• 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.

Project outputs so far:

Evidence summaries:

COVID-19 outbreaks during or shortly after vaccination of care home residents: summary of three studies from the US and Germany

Evidence summary: emerging evidence on the protective effect of vaccines from COVID-19 infections among care home populations

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)

Evidence summary: The use of Information and Communications Technology and Data Sharing in Long-Term Care settings