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Learning from the care system response to COVID-19

22 October 2020 | Sophie Bulmer
On 9 October we held the third in our “Doing Things Differently” series of virtual learning sessions, this time on a topic that was brought into sharp focus in recent months, care homes.

The COVID-19 pandemic hit our care homes particularly hard. Initial figures show that there were almost 20,000 COVID-related deaths in the sector, accounting for a third of all care home deaths between March and June 2020, with stark lessons learned about hospital discharges and equipment shortages.

However, this period also helped us to see the resilience and ingenuity of care home workers, who responded to the crisis by adopting innovative and collaborative approaches.

Our panel was chaired by John Craig, the Chief Executive of Care City, with representation from academia, clinical practice, and technology and innovation and the conversation focused on building on these deeper changes and opportunities that emerged as part of the COVID-19 response. As John said in his introduction, care homes have been too far down the political priority list for too long and it is vital that we now talk about the changes we want to keep and build on.

I wanted to share some of my own reflections on some of those themes that emerged in the discussion.

Multi-partnership working is essential and needs to be equal

Collaboration between the NHS and care homes has historically been patchy. Professor Claire Goodman, whose research at the University of Hertfordshire has been looking at how data is used between health and social care, talked about how the pandemic laid bare the shortcomings of a system which had allowed care homes to be ‘othered’, used as a repository for patients the NHS could no longer manage. What we saw in response to COVID was a rapid shift towards multidisciplinary and multi-partnership working, with primary care, acute care and care homes collaborating to provide the support that patients needed.

Geraldine Rogers, Deputy Chief Nurse and Fellow for Older People, Basildon & Bentwood CCG, talked about the clinical hubs that they established which allowed them to streamline calls and meet specific needs. What Geraldine saw was a comradeship develop between health and social care and, as was reflected in the conversation happening in the webinar chatbox, there is a real recognition that we need to move away from thinking about these two parts of the sector as different systems if we want to establish lasting change.

Building genuine and lasting partnerships is going to take time and will need NHS staff to work with care home staff, listening to them and, as Geraldine says, hearing what they need, rather than prescribing what they think should happen. Lasting changes can only happen if they are done together, not if they are ‘done to’.

The opportunities of digital health solutions

The advances in digital tools and platforms provide huge opportunities for care homes to improve patient monitoring and outcomes, but only if the focus is on supporting staff in their decisions rather than simply collecting measurements and data.

Our panellist Elina Naydenova, the CEO and Founder of Feebris, a remote monitoring tool, talked about technology moving from something that was ‘nice to have’ to an essential element of delivering care during the pandemic. Elina spoke of the rapid mobilisation and openness to innovation that she saw when working with care home staff, which was also reflected in the chat comments, where we heard experiences of using tools such as Restore 2, Whzan and tools for remote monitoring of wound care.

As highlighted by a question from one of the webinar attendees, there is a challenge around how these digital solutions will be funded in a system that is already under significant financial strain. Our panel’s view was that by re-orientating the health and care system as one, it should become the norm to invest in care homes, not just around them. There is also an opportunity for care homes to develop skills in building the evidence and business case for funding, with Geraldine talking about needing ‘Change Agents’ to work with care homes to make digital changes a reality.

Capacity building and skills development

This brings me to the final theme I wanted to reflect on, which is around the need to invest in building the capacity and skills in care home staff to truly embed improvement.

Geraldine talked about her experience of introducing Whzan, a digital tool which collects blood pressure, temperature, and other readings to monitor for signs of deterioration, which they used alongside Significant 7 to spot the softer signs. There is evidence that those care homes trained in spotting signs of deterioration sooner were better equipped and stood better in their COVID journeys than those that were not trained.

Similarly, Elina talked about the need for any technology being introduced to be supported by capacity building and upskilling of staff, otherwise it will not be used. A recent announcement by the government is that a new post of Chief Nurse for Social Care is to be appointed, and with this comes real opportunity to look at the care workforce as a whole, developing new career pathways and recognising the skills already in place.

Read more about the work we are doing to support care homes.