What do delays in social care funding reforms mean for a struggling system?

This position statement from think tank the King’s Fund says the social care system is not fit for purpose and is failing the people who rely on it. Long-term problems, including high levels of unmet need and providers struggling to deliver the quality of care that older and disabled people have a right to expect, are becoming more acute due to rising demand, backlogs caused by Covid-19 and a workforce crisis.  

Adult social care funding and eligibility | The King’s Fund (kingsfund.org.uk)

Covid 19

Current awareness updates

Original Research

Factors influencing self-harm thoughts and behaviours over the first year of the COVID-19 pandemic in the UK: Longitudinal analysis of 49 324 adults.
Paul E. British Journal of Psychiatry 2022;220(1):31-37.
[Conclusions: Findings suggest that a significant portion of UK adults may be at increased risk for self-harm thoughts and behaviours during the pandemic. Given the likelihood that the economic and social consequences of the pandemic will accumulate, policy makers can begin adapting evidence-based suicide prevention strategies and other social policies to help mitigate its consequences.]

COVID-19: stepdown of infection control precautions and discharging patients to home settings.
UK Health Security Agency (UKHSA); 2022.
[17 January 2022: Updated to reflect change in isolation period in hospitals from 14 to 10 days for cases and contacts of cases of COVID-19, as well as clarification of isolation period for severely immunocompromised patients.]

COVID-19: management of staff and exposed patients and residents in health and social care settings.
UK Health Security Agency (UKHSA); 2022.
[17 January 2022: Updated to reflect change in isolation period in hospitals from 14 to 10 days for cases and contacts of cases of COVID-19 and includes new changes to self-isolation periods for staff in health and care settings.]

COVID-19: infection prevention and control (IPC)
UK Health Security Agency (UKHSA); 2022.
[17 January 2022: Updated to reflect change in isolation period in hospitals from 14 to 10 days for cases and contacts of cases of COVID-19.]

Preventing and controlling outbreaks of COVID-19 in prisons and places of detention.
UK Health Security Agency (UKHSA); 2022.
[17 January 2022: Updated information on: ending self-isolation for prisoners/detainees and staff who test positive for COVID-19; testing information for staff and prisoners/detainees who are identified as a contact; return to work criteria for staff who test positive for COVID-19 or who are identified as a contact; visitors to prisons.]

Daily Insight: Vax to the future.
HSJ: Health Service Journal (Daily Insight) 2022;:7031723.
[The expiry date on some batches of the Pfizer covid vaccine supplies has been extended to 45 days, following concerns that large quantities would be wasted. Also: LSE research finds no significant relationship between the number of managers or the amount spent on management and the quality of NHS hospital services. 18 January.]





Public Health

Current awareness updates

Prostate cancer.
National Institute for Health and Care Excellence (NICE); 2021.
[This quality standard covers managing prostate cancer in people referred to secondary care or having follow-up for prostate cancer in primary care. It describes high-quality care in priority areas for improvement. In December 2021, changes were made to align this quality standard with the updated NICE guideline on prostate cancer.]

Combined adult and paediatric respiratory clinical assessment service (RCAS) hubs for acute respiratory infection.
NHS England and NHS Improvement; 2021.
[This document supports systems to plan for a likely rise in respiratory infections (for example, Covid-19, respiratory syncytial virus (RSV), influenza and other infections) this winter.]

Our Vision for the Women’s Health Strategy for England.
Department of Health and Social Care (DHSC); 2021.
[Analysis of call for evidence consultation response has informed development of this document, which is published alongside the consultation response. This document sets out the government’s vision and the publication of the strategy will follow in 2022.]

Children and young people’s mental health:eighth Report of Session 2021–22.
House of Commons Health and Social Care Committee; 2021.
[This report calls for urgent action to prevent mental health services slipping backwards as a result of additional demand created by the pandemic and the scale of unmet need prior to it. MPs found that despite progress in numbers of young people receiving treatment, it was unacceptable that more than half with a diagnosable condition pre-pandemic do not receive the mental health support they need.]

Covid 19

Current awareness updates

COVID-19: infection prevention and control (IPC).
UK Health Security Agency (UKHSA); 2021.
[November 2021 Updates: 1) Guidance broadened to include seasonal respiratory infections; 3 COVID-19 specific pathways removed; section on the hierarchy of controls added; physical distancing advice updated. 2) Updated to clarify text on aerosol generating procedures. 3) Dental appendix broadened to include seasonal respiratory infections; 3 COVID-19 specific pathways removed and replaced with respiratory and non-respiratory pathways.]

COVID-19 rapid guideline: managing COVID-19
National Institute for Health and Care Excellence (NICE); 2021.
[In November, NICE added a new recommendation on ivermectin.]

Daily Insight: Another test for NHS staff.
HSJ: Health Service Journal (Daily Insight) 2021;:7031436.
[A letter sent by Chris Whitty, Ruth May and Susan Hopkins has strengthened expectations on NHS staff who have just returned from abroad. NHS workers returning from any non red-list country must have a negative PCR test before returning to work. Also: New guidance has recommended that trusts relax the segregation of patients according to covid-19 risk. There is likely to be a developing picture on infection control guidance over the next few weeks in light of the Omicron variant. 30 November.]

Frequently asked questions: Demonstrating Covid-19 and vaccination status.
House of Commons Library; 2021.
[This briefing paper provides answers to frequently asked questions about demonstrating Covid-19 status (otherwise called Covid-19 status certification) and use of the NHS Covid Pass in England.]

Covid-19 status certification.
House of Commons Library; 2021.
[Covid-19 status certification (also referred to as a “vaccine passport”) has been proposed as a means of reducing the risk of transmitting the Covid-19 virus in a number of settings. This briefing explores the Government’s policy on certification. It also provides discussion on the scientific evidence and other issues associated with the use of certification.]

Responding to violence against women and children during COVID-19: impact on service provision, strategies and actions in the WHO European Region (2021).
World Health Organization (WHO); 2021.
[A new report published by WHO/Europe shows that helplines providing support to women and children experiencing violence saw a spike in calls during the first 9 months of the COVID-19 pandemic. The data in the new report was collected between January and September 2020, a time in which millions of people in the WHO European Region were confined to their homes because of lockdowns or other restrictive measures.]

UK vaccine response to the Omicron variant: JCVI advice.
Department of Health and Social Care (DHSC); 2021.
[Advice from the Joint Committee on Vaccination and Immunisation (JCVI) in response to the emergence of the Omicron variant. This statement sets out the JCVI’s advice on extending the UK COVID-19 vaccination programme to offer booster doses to adults aged 18 to 39 years, and second doses to children and young people aged 12 to 15 years.]

Covid 19

Current awareness updates

How many care home staff in England have received two Covid-19 vaccine doses? Nuffield Trust chart.
Nuffield Trust; 2021.
[After the deadline passed, care home staff in England now need to have received two Covid-19 jabs to carry on working. Nina Hemmings looks at how many had been vaccinated twice only a few weeks before the deadline.]

Effects of COVID-19 pandemic on mental health outcomes in a cohort of early psychosis patients.[Abstract]
Szmulewicz AG. Early Intervention in Psychiatry 2021;15(6):1799-1802.
[AIM: To evaluate the impact of the COVID-19 pandemic on clinical outcomes, we used data from Electronic Health Records from 128 patients receiving care at a First Episode Psychosis clinic. CONCLUSIONS: We report that patients have avoided accessing higher levels of care, except in extreme cases. We argue that this is not a sustainable trajectory and that public health actions are required.]

Provider collaboration review: Mental health care of children and young people during the COVID-19 pandemic.
Care Quality Commission (CQC); 2021.
[Review of care in 7 areas of England in June and July 2021 found COVID-19 pandemic has had an enormous impact on the mental health of children and young people, and has led to an increased demand on services, particularly eating disorder services.]

Effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality: systematic review and meta-analysis.
BMJ; 2021.
[This systematic review and meta-analysis suggests that several personal protective and social measures, including handwashing, mask wearing, and physical distancing are associated with reductions in the incidence covid-19. Public health efforts to implement public health measures should consider community health and sociocultural needs.]

COVID-19 Young people and vaccines Toolkit.
Cabinet Office; 2021.
[An updated vaccines toolkit for younger people has been launched by the Cabinet Office. The toolkit includes links to assets and videos designed to encourage vaccine uptake among young people aged 18 to 29.]

Public Health

Current awareness updates

Avian influenza: guidance for managing human cases.
UK Health Security Agency (UKHSA); 2021.
[Information to assist with the management of possible and confirmed human cases of avian influenza.]

Heart valve disease presenting in adults: investigation and management.
National Institute for Health and Care Excellence (NICE); 2021.
[This guideline covers investigation and management of heart valve disease presenting in adults. It aims to improve quality of life and survival for people with heart valve disease through timely diagnosis and appropriate intervention.]

Acute heart failure: diagnosis and management.
National Institute for Health and Care Excellence (NICE); 2021.
[This guideline covers diagnosing and managing acute heart failure or possible acute heart failure in people aged 18 and over. Heart failure may indicate acute myocardial injury in patients with COVID-19. See the recommendations in NICE COVID-19 rapid guideline on managing COVID-19. In November 2021, NICE withdrew the recommendations on valvular surgery and percutaneous intervention because they have been replaced by the NICE guideline on heart valve disease.]

Public health commissioning in the NHS: 2021 to 2022.
Department of Health and Social Care (DHSC); 2021.
[Information about NHS England’s objectives and funding arrangements as it commissions public health services in the ongoing context of coronavirus (COVID-19).]

Cause for concern: Australian youth engaged with alcohol and other drug services are falling behind our community progress in reducing tobacco use.[Abstract]
Hallam KT. Early Intervention in Psychiatry 2021;15(6):1789-1792.
[Tobacco use is decreasing in the general youth population yet little evidence is tracking changes in young people who are engaged with youth alcohol and other drug (AOD) services that are often disengaged from school and work settings. Conclusion: The results highlight a need for the adoption of evidence-based tobacco early intervention programs in youth AOD services to address this significant health risk.]

Quality improvement project to decrease unnecessary investigations in infants with bronchiolitis in Cork University Hospital.[Abstract]
Jansen L. BMJ Open Quality 2021;10(4):DOI: 10.1136/bmjoq-2021-001428.
[Conclusion: An evidence-based protocol improved physicians’ ability in diagnosing and managing infants with bronchiolitis. This led to a reduction in unnecessary and potential harmful investigations, thereby improving patient quality of care. This improvement will contribute to decreased healthcare cost and appropriate use of resources during the high-pressured winter period.]

Covid 19

Current awareness updates

COVID-19: letter to patients on end of shielding programme.
UK Health Security Agency (UKHSA); 2021.
[Reference-only version of letter from the government to patients on the end of the shielding programme.]

COVID-19 rapid guideline: managing the long-term effects of COVID-19.
National Institute for Health and Care Excellence (NICE); 2021.
[This guideline covers identifying, assessing and managing the long-term effects of COVID-19, often described as ‘long COVID’. On 11 November, NICE made new recommendations and updated existing recommendations on identification; planning care; multidisciplinary rehabilitation; follow up, monitoring and discharge; and service organisation. NICE also updated the list of common symptoms, emphasising that these may be different for children.]

COVID-19 booster vaccine programme for winter 2021 to 2022: JCVI statement, November 2021.
Department of Health and Social Care (DHSC); 2021.
[This statement sets out further advice from JCVI on extension of the booster programme to revaccinate adults aged 40 to 49 years against COVID-19. The main aim of this booster vaccination programme is to reduce deaths, serious disease and hospitalisations from COVID-19 over the 2021 to 2022 winter period and through 2022.]

Why we think you should say yes to the COVID-19 vaccine.
Leeds Clinical Commissioning Group; 2021.
[An information leaflet about the COVID-19 vaccine where clinicians and faith leaders highlight the importance of having the vaccine. The leaflet has been translated into the following languages: Amharic, Arabic, Bengali, Czech, Farsi, Kurdish Sorani, Polish, Punjabi, Romanian, Slovak, Tigrinya and Urdu. Audio versions of the leaflet are available for each of those languages.]

No one wants to see my baby: challenges to building back better for babies.
Parent-Infant Foundation; 2021.
[This report explores the continued impact of Covid-19 on babies. It consists of a survey of professionals, in-depth studies with 11 families and a review of the literature, conducted with partner organisations Home-Start and Best Beginnings. The report shows that many services across the UK are not operating as they were before the pandemic, and babies and their families are missing out as a result.]

Essential and Invisible: Filipino irregular migrants in the UK’s ongoing COVID-19 crisis.
Kanlungan Filipino Consortium; 2021.
[For many in the United Kingdom, it might feel as if the “crisis” of the COVID-19 pandemic is coming to an end. Yet for irregular migrants, the pandemic has become a protracted struggle to survive. This report is based on interviews with Filipino irregular migrants based in the UK conducted in Spring 2021, compared to the same interviewees’ responses in Spring 2020.]

Coronavirus: support for landlords and tenants.
House of Commons Library; 2021.
[This briefing explains measures during the coronavirus outbreak to help renting households retain their homes. It covers calls for more assistance to prevent evictions and homelessness.]

Covid 19

Current awareness updates

COVID-19 rapid guideline: managing COVID-19.
National Institute for Health and Care Excellence (NICE); 2021.
[In October, NICE added new recommendations on casirivimab and imdevimab. New data on the use of heparins (from the REMAP-CAP trial results) does not change the current recommendations.]

The consequences of COVID-19 lockdown for formal and informal resource utilization among home-dwelling people with dementia: results from the prospective PAN.DEM study.[Abstract]
Vislapuu M. BMC Health Services Research 2021;21(1):1003.
[The care situation for PwD changed dramatically in the early phase of the COVID-19 pandemic, especially for those living alone who received less support from homecare services and visiting caregivers. For future crises and the forthcoming post-pandemic period, health authorities must plan better and identify and prioritize those in greatest need.]

The impact of the COVID-19 pandemic on patterns of attendance at emergency departments in two large London hospitals: an observational study.[Abstract]
Vollmer MAC. BMC Health Services Research 2021;21(1):1008.
[Our study findings reflect broader trends seen across England and give an indication how emergency healthcare seeking has drastically changed. At ICHNT, we find that a larger proportion arrived by ambulance and that hospitalisation outcomes of patients without COVID-19 did not differ from previous years. The extent to which these findings relate to ED avoidance behaviours compared to having sought alternative emergency health services outside of hospital remains unknown.]

Remote schooling through the coronavirus (COVID-19) pandemic, England: April 2020 to June 2021.
Office for National Statistics (ONS); 2021.
[How remote learning has affected the amount of learning materials covered by pupils and the dependence of remote learning on parental input over the course of the coronavirus (COVID-19) pandemic.]

Inequalities in accessing dementia care and support during COVID-19.
The Mental Elf; 2021.
[Catherine Talbot reviews a recent qualitative study on accessing post-diagnostic dementia care before and since COVID-19, which highlights the need to reduce inequalities in dementia care.]

COVID-19: provision of immunisation sessions for outbreaks in schools.
Public Health England (PHE); 2021.
[Guidance for School Age Immunisation Services on the provision of immunisation sessions in schools where there are cases or an outbreak of COVID-19.]

UKHSA review into IPC guidance.
Department of Health and Social Care (DHSC); 2021.
[Recommendations for changes to COVID-19 infection prevention and control (IPC) advice to help ease pressure on the NHS.]

Impacts of the COVID-19 pandemic on youth mental health among youth with physical health challenges.[Abstract]
Hawke LD. Early Intervention in Psychiatry 2021;15(5):1146-1153.
[CONCLUSIONS: Mental health concerns are highly prevalent among youth with physical health concerns, and also appear to be exacerbated by the COVID-19 pandemic. Physical health concerns appear to constitute risk factors for heightened mental health responses to the pandemic situation. System planners striving to adapt mental health services to meet distancing recommendations are urged to consider youth with physical health conditions and ensure that integrated supports are available to them.]

NDNS: Diet and physical activity – a follow-up study during COVID-19.
Public Health England (PHE); 2021.
[This report presents the findings from a follow-up study of National Diet and Nutrition Survey Rolling Programme (NDNS RP) participants which aimed to describe and assess the impact of the COVID-19 pandemic on the diet and physical activity of people in the UK in 2020.]

Vaxzevria (AstraZeneca) Covid-19 vaccine: Recognition of batches manufactured in India.
House of Commons Library; 2021.
[This briefing provides an overview of the regulatory concerns associated with batches of the Vaxzevria (previously called AstraZeneca) vaccine which were manufactured in India.]


Long COVID

MEDBOX issue brief on Long COVID

The MEDBOX team publishes issue briefs on different topics around COVID-19. They have prepared a new issue brief on the long-term effects of coronavirus infection, Long COVID (also known as long-haul COVID, post-acute COVID-19, long-term effects of COVID, or chronic COVID). The issue brief includes many links to relevant reports and guidance about long COVID.

Read the brief here