Exploring published literature of emerging practice as a response to challenges due to COVID-19
18 May 2020
The summaries below are of articles that might help thinking about what has been learned from the COVID-19 experience so far, along with suggestions on how this might be used to support improvement in future.
This week, featured articles include those regarding:
Reflections
As we are passing the initial 'crisis response' phase, there are a lot of reflective pieces being published that give an overview of the response to COVID-19. Ian Bruce of Glasgow Council for the Voluntary Sector (GCVS) reflects on how the voluntary sector has responded and changed, including an increase of digital services, a rethinking of risk on the part of funders and the importance of small community groups that were able to respond immediately. Cormac Russell delves a little more into how the challenge of COVID-19 has challenged conventional thinking and reinforced the case for asset based approaches to community development. He warns professionals and politicians of over-engineering a system response to new demands and needs in a way that might suffocate community initiative.
Expansions
A common emerging practice as a response to COVID-19 remains the expansion of services already provided by the third sector. This reflects the fact that in many cases the pandemic has created new needs but rather enhanced or amplified current needs. For example, Marie Curie have expanded their bereavement helpline. Similarly, there has been an increase in funding for organisations supporting people with autism, struggling with COVID-19 related restrictions on travel. An interesting characteristic of this type of funding is that it comes directly from Scottish Government to provider organisations, bypassing HSCP processes. Community groups are also expanding as the national profile of community activity is increased, more local organisations are getting involved and communities feel more galvanised. Castlemilk Together is a group that has been functioning for a number of years but has seen a spike in activity in order to respond to increased need, with support from the local football team, parish church and an increased number of volunteers.
Continuations
Organisations are beginning to looking at how programmes or projects that were emerging before the pandemic can be used within a new context. Glasgow Centre for Population Health have been developing a programme for food sustainability in partnership with a range of community organisations and the Glasgow Food Policy Partnership. The distribution and campaigning networks of this initiative are being reoriented to support those facing food insecurity as a result of social isolation or reduced income.
Summaries
COVID-19: the challenge of patient rehabilitation after intensive care
As people who have required intensive care are beginning to be discharged, there is a new focus on how to support their recovery at home. Unlike conditions such as heart attack and stroke, there are no established pathways for support post-discharge for people who have required intensive care. COVID-19 has brought into focus the need for such pathways. Furthermore, there is discussion on the likely psychological impact and need for people discharged from intensive care, along with the need for GPs to engage with this process as they are likely to see a lot more people who have experienced intensive care.
This article outlines some current practice from across the UK in relation to this.
Royal Berkshire Hospital
Offers 'intensive aftercare' for people who have been in intensive care for four days or more. They are first seen at an outpatient clinic two months after discharge and then again at six months and a year. At each stage they are assessed and may be further referred for physiotherapy, psychological help, memory help, ENT treatment, or post-traumatic stress counselling.
The success of this service is such that it is accepting people from other hospitals and also GPs.
"GPs are slowly coming on board. At first, they didn’t feel it was necessary. Now they actually refer patients that have not had follow-up at other hospitals to our hospital."
COVID-19 supercharges existing inequalities faced by Glasgow’s 150,000 disabled people
A survey carried out by the Glasgow Disability Alliance has shown the impact of COVID-19 on its members. The report from the survey highlights reveals two key issues:
- The COVID-19 pandemic is supercharging inequalities already faced by disabled people: existing issues such as food poverty, isolation and digital exclusion are becoming more intense and more prevalent.
- The COVID-19 response risks leaving disabled people behind: as COVID-19 becomes the priority, lifeline services are removed at a time when they are even more vital to disabled people. Survey responses highlight a fear that ‘resource rationing’ guidelines are stripping them of their rights to equal access to potentially life-saving treatment.
In response to these concerns, the Glasgow Disability Alliance is meeting remotely to offer peer support and share experiences, they are advocating for members who want to challenge decisions around treatment at this time and have established a helpline for those who have fallen through the cracks.
This approach highlights the importance of civil society groups in amplifying concerns and working at an individual level to support change.
Strengthening social care analytics during the pandemic and beyond
The COVID-19 pandemic has revealed a need for access to accurate, usable data and analytics in social care. The Health Foundation are exploring what data analytics can do to support social care commissioners, providers, and service users and their carers during the pandemic and beyond.
Building on their Advanced Applied Analytics programme (that develops resources to support social care capacity for analytics), the Health Foundation are partnering with Future Care Capital (FCC), a health and care charity that has championed greater use of data and technology to improve outcomes from both formal and informal social care provision. Together they are working to support social care systems to develop an analytics framework that will enable them to develop insights based on current, real time data.
The immediate response from the Health Foundation is to help spread and implement the learning from existing projects such as the Learning Care Home project. This centres on an app that allows staff to provide a structured referral and resident observations, and then transmits the data instantly to the community NHS team who also see the resident’s GP record, allowing them to make an informed action plan.
Supporting the Roma community in a pandemic
The Govanhill Development Trust, a part of Govanhill Housing association has been working closely with the Roma community in dealing with the impact of COVID-19. Challenges have been in the growing unemployment and lack of access to reliable information. The Development Trust has been working with the Roma community for around six years, and has built strong connections to it. A lot of new activity for them has been in producing translated information, supporting benefits applications.
An emerging need has been support in arranging repatriation of people who have died from COVID-19. While this happened previously, it was not as common and wasn’t done remotely, in such difficult circumstances. The Development Trust has been supporting people going through this process
Castlemilk Together
Housing associations in Castlemilk are part of Castlemilk Together, a community organisation that provides support to those who need it.
In response to COVID-19 there has been an increase in people, businesses and organisations wanting to provide support to the community, in this context Castlemilk Together is a nucleus around which a community response has grown. Through Castlemilk Together, people are able to access a range of supports offered by groups locally such as Community Food Action, the Castlemilk Relaxation Centre and the LD Let’s Talk service.
Taking stock in a time of change
A useful tool to support people to take a moment and reflect on their work. This could be something to share with people in the system that we are talking with and contribute to our offer of supporting people through changes in our bespoke work.
Strengthening social care analytics during the pandemic and beyond
The COVID-19 pandemic has revealed a need for access to accurate, usable data and analytics in social care. The Health Foundation are exploring what data analytics can do to support social care commissioners, providers, and service users and their carers during the pandemic and beyond.
Building on their Advanced Applied Analytics programme (that develops resources to support social care capacity for analytics), the Health Foundation are partnering with Future Care Capital (FCC), a health and care charity that has championed greater use of data and technology to improve outcomes from both formal and informal social care provision. Together they are working to support social care systems to develop an analytics framework that will enable them to develop insights based on current, real time data.
The immediate response from the Health Foundation is to help spread and implement the learning from existing projects such as the Learning Care Home project. This centres on an app that allows staff to provide a structured referral and resident observations, and then transmits the data instantly to the community NHS team who also see the resident’s GP record, allowing them to make an informed action plan.
Self-managed neighbourhood care in a global pandemic: how is Buurtzorg doing?
The underlying principles of the Buurtzorg model is to rely on the professional ability of its teams to work with people and communities to create their own solutions, while providing those teams quickly and responsively with the support they need to do so effectively.
In essence, this is a balancing act between centralised and autonomous functions. Facing a challenge as large and complex as supporting people in the context of COVID-19, there is a tendency towards increasing centralisation of decision making. This is something that has been resisted by Buurtzorg who have focussed on learning what is needed from professionals and then providing support.
Key challenges people faced have been the rapidly changing clinical advice. In response to this the crisis team was set up to keep track of and interpret regulatory changes, gather and disseminate the latest clinical evidence. The team is made up of experienced nurses and an epidemiologist, meets for an hour at the same time every day and is available to the teams whenever they need it. The key role is to listen to the concerns and fears of the teams, review the information and requirements coming from them and from the government, doctors, other health and care providers, and so on, and respond in practical ways.
As in Buurtzorg's neighbourhood teams, although there is no hierarchy in the crisis team, "different people have different qualities and they just ‘pop up’ as needed." One of its members said:
"For example, someone who is good with academic articles and summarising their key points; or someone particularly good at handling phone inquiries."
Social work on Orkney
A short blog blog from a social worker on Orkney discussing the changes in their work as a result of COVID-19, outlining the challenges facing people living in rural areas and how they are being supported.