In the UK, the Covid-19 pandemic has affected people in many different ways. We know some people are at particular risk, including older people, those with underlying health conditions or weaker immune systems, people who smoke and the obese. There is also emerging evidence that the disease is having a disproportionate impact on people from black, Asian and minority ethnic backgrounds, those on lower incomes and those living in socially deprived areas. This has highlighted the health and care priorities that drive the ARC’s applied research: the need to improve care for vulnerable and older populations, to support people living with multiple health conditions, and to address wider inequalities in health.
Adapting our research portfolio and wider activities to address Covid-19
The ARC has adapted its existing research portfolio and initiated new research to understand the impact of Covid-19 on individuals, communities and populations in south London, and beyond. We have also rapidly initiated work to inform health and social care policy and professional guidance. In addition, we are working closely with the two other London ARCs, the three London Academic Health Science Networks (AHSNs), and with NHS England and NHS Improvement, with the ambition of creating a ‘learning system’ across health and social care. The aim is to make new learning rapidly available across the health and care system in London to support policy and decision making.
This work is highlighted below and covered elsewhere within this section of the website.
Working with diverse communities to understand the impact of Covid-19
The emerging evidence on the health and social impact of Covid-19 in the UK has highlighted the need to work closely with diverse local communities, people and organisations. To understand the experiences of individuals and communities in south London during the pandemic, we have:
- Initiated an online community event to gather experiences and evidence from people with protected characteristics. Early findings were shared with the UK Parliament Women and Equalities Committee
- Organised two online engagement in research events to engage with local women and community organisations to understand the impact of Covid-19 on maternity and perinatal mental health
- Led a virtual consultation to understand the experiences, concerns and research priorities of people affected by serious illness during the pandemic in relation to palliative and end of life care.
We are also organising an online event in September for patients, service users, carers, community members, and researchers to gather learning and experience from the past year to inform the ARC’s wider patient and public involvement strategy.
Supporting palliative and end of life care services
Although many people survive Covid-19, an estimated 1% to 4% die from this disease. In this context, effective palliative care is vital to improve quality of life and care for patients, and to support family, and friends at the end of life. Our palliative and end of life care theme has:
- Published several rapid Covid-19 research studies, including a systematic review on the role of palliative care and hospice services in pandemics
- Launched a new study to understand how palliative care and hospice services have adapted practices and staffing and used innovations to respond to Covid-19
- Prepared international guidance to help respiratory professionals manage the supportive care needs of those with Covid-19
- Produced a widely shared guide to help people with Covid-19 experiencing breathlessness to manage their symptoms.
You can read more about how the ARC’s palliative and end of life care researchers have responded to the challenges of the pandemic in this feature article.
Supporting social care services and informing policy
Our social care research team, based at the NIHR Health & Social Care Workforce Research Unit, have undertaken a wide range of work to understand the impact of Covid-19 on social care services and to produce resources to support them. This includes:
- A new study of the response of day centres for homeless people in south London during the pandemic. The team expect that the results of this research will enrich their parallel study examining the resilience of day care services.
- Co-producing a resource to assist and support managers or volunteer co-ordinators of day centres to Unlock Lockdown and plan for a ‘new normal’. The resource draws on existing guidance related to Covid-19 for social care, and relevant guidance, advice, action points for other regulated settings, some of which is also relevant to adult day centres.
- The team have also worked with the Social Care Institute for Excellence (SCIE) to develop their guide to support services to open and deliver care safely.
Understanding the impact of Covid-19 on maternity and perinatal mental health
Our maternity and perinatal mental health research staff have:
- Initiated a project to understand how Covid-19 interacts with hypertension and other mental and physical co-morbidities during pregnancy, and to assess whether co-morbidity increases the risks for pregnant women with Covid-19
- Adapted a study to explore the impact of Covid-19 on mental health, domestic abuse, and drug and alcohol use during pregnancy
- Launched a new project to understand the experiences of parents who suffer pregnancy loss and whose babies die during the pandemic
- They are also studying how community-based perinatal mental health services have responded to Covid-19, and reporting on the interpersonal and societal effects of Covid-19 for the wider maternity safety agenda.
Advising on the ethics of how care is prioritised during the pandemic
During the pandemic, experienced clinicians and health managers across the country have had to make difficult decisions about how care is prioritised. Our public health team have provided valuable expertise in this area, establishing a pandemic ethics virtual group designed to offer guidance to NHS England on prioritisation decisions.
- The group advised NHS England on a decision to temporarily close its bowel cancer screening programme to allow laboratory capacity to be directed at Covid-19 testing
- The group provided technical advice and support to the Faculty of Intensive Care Medicine on new guidance for triage to intensive care units (ICUs)
- The public health team is also part of the South East London Ethical Oversight Group. The Group’s remit is to ensure that there is a consistent approach across all health services providers in south-east London in relation to Covid-19. As part of this work, ARC researchers helped to develop a decision support resource for GPs in south-east London.
Using applied informatics to evaluate new models of mental health care in south London
In the early days of the Covid-19 pandemic, mental health services in London went through a period of rapid transformation, including a move towards remote consultations. Our team of applied informatics researchers, in collaboration with the Health Innovation Network, are leading the evaluation of the implementation and impact of remote consultations and other service changes that have taken place across the three mental health trusts in south London: South London and Maudsley, Oxleas and South West London & St George's.
Using implementation science to inform and evaluate service change
The ARC’s specialist team of implementation science researchers have produced an interactive resource to support the rapid implementation and evaluation of health and social care innovations, interventions and services launched during the pandemic. The team also organised an innovative virtual conference bringing together 180 international delegates to discuss implementation science and how to maximise its relevance for practice and policy in the context of Covid-19.