Expanding Video Consultation Services at Pace and Scale in Scotland During the COVID-19 Pandemic: National Mixed Methods Case Study

Expanding Video Consultation Services at Pace and Scale in Scotland During the COVID-19 Pandemic: National Mixed Methods Case Study
J Med Internet Res 2021;23(10):e31374 doi:10.2196/31374

• A national evaluation of the introduction, spread, and scale-up of Scotland’s video consultation services both before and during the pandemic. The research found that the national-level groundwork before the pandemic allowed many services to rapidly extend the use of video consultations during the pandemic, supported by a strong strategic vision, a well-resourced quality improvement model, dependable technology, and multiple opportunities for staff to try out the video option. 
• The bespoke product - Attend Anywhere, had been piloted in 2017 and was scaled up across all health board by February 2020 branded nationally as “Near Me”.

Face coverings during COVID-19

Contents:

• The science
• How to make/use a face mask
• Government policies

COVID-19 Oximetry @Home and Virtual wards

COVID-19 Oximetry @home

• NHS England guidance
• Tools and resources (including FutureNHS workspaces)
• Progress reports
• Key research

COVID virtual wards (secondary care)

• NHS England guidance

Setting up Oximetry @home and Virtual Ward services – Simulation videos
UCL Partners
Simulation videos  designed to support trusts setting up Oximetry @home and Virtual Ward services.

A simple device has been a lifeline during the pandemic – and could change how we provide care for good. [NHS England blog, 22 March 2021]
Dr Matt Inada-Kim National Clinical Director for Infection, Antimicrobial Resistance & Deterioration explains the impact of COVID Oximetry @home and COVID virtual ward services, and how the learning is now being incorporated into the design of other care pathways.

Digital home care for people with coronavirus [NHSX blog 22 March 2021]
NHSX Chief Digital Officer Tara Donnelly reflects on the experience of patients with COVID-19 being cared for remotely using a tech-enabled service.

Development and presentation of an objective risk stratification tool for healthcare workers when dealing with the COVID-19 pandemic in the UK

Development and presentation of an objective risk stratification tool for healthcare workers when dealing with the COVID-19 pandemic in the UK: risk modelling based on hospitalisation and mortality statistics compared with epidemiological data
BMJ Open 2021;11:e042225. doi: 10.1136/bmjopen-2020-042225

• Researchers from UCL, London, have generated a tool that provides a framework for objective risk stratification of doctors and healthcare professionals during the COVID-19 pandemic, without requiring disclosure of information that an individual may not wish to share with their direct line manager during the risk assessment process.
• The tool has been made freely available through the British Medical Association website (https://www.bma.org.uk/media/3820/bma-covid-19-risk-assessment-tool-february-2021.pdf) and is widely used in the National Health Service and other external organisations.

Changes in mortality patterns and place of death during the COVID-19 pandemic: A descriptive analysis of mortality data across the UK

Changes in mortality patterns and place of death during the COVID-19 pandemic: A descriptive analysis of mortality data across four nations.
Palliat Med. 2021 Aug 23:2692163211040981. doi: 10.1177/02692163211040981.

• Analysis of patterns of mortality including place of death in the United Kingdom (UK) during the COVID-19 pandemic to date found that where people died changed, with an increase in deaths at home during and between pandemic waves.

COVID-19 admission risk tools should include multiethnic age structures, multimorbidity and deprivation metrics for air pollution, household overcrowding, housing quality and adult skills

COVID-19 admission risk tools should include multiethnic age structures, multimorbidity and deprivation metrics for air pollution, household overcrowding, housing quality and adult skills
BMJ Open Respiratory Research 2021;8:e000951. doi: 10.1136/bmjresp-2021-000951

• Ethnic minorities exhibit higher multimorbidity despite younger age structures and disproportionate exposure to unscored risk factors including obesity and deprivation. Household overcrowding, air pollution, housing quality and adult skills deprivation are associated with multilobar pneumonia on presentation and ICU admission which are mortality risk factors. Risk tools need to reflect risks predominantly affecting ethnic minorities.

What has been the effect of the coronavirus pandemic on key population health outcome measures?

What has been the effect of the coronavirus pandemic on key population health outcome measures?
The Strategy Unit 9 July 2021

• This report begins by explaining the different sources of information on Covid-19 deaths before comparing approaches to estimating ‘excess deaths’ — a better, more complete measure of the coronavirus pandemic’s overall mortality impact. In the second half of the report, we implement a set of actuarial and public health metrics — standardised death rates, years-of-life-lost and life expectancy — that offer a different perspective on the pandemic’s effect on population health.

Unlocking the digital front door - keys to inclusive healthcare

Unlocking the digital front door - keys to inclusive healthcare
National Voices, May 2021

• This report explores how the move to remote service models impacted people and how the Voluntary, Community and Social Enterprise sector (VCSE) has led innovative ways to deliver healthcare and support people during the COVID 19 pandemic. Also available is a literature review and insight data, personal narratives and recommendations for better practice, better policy, and better innovations.

QCOVID Coronavirus (COVID-19) risk assessment and validation

Coronavirus (COVID-19) risk assessment
NHS Digital

• QCovid® is a coronavirus risk prediction model, created by the University of Oxford, which is being used to support the NHS coronavirus response. QCovid® is an evidence-based risk prediction model that estimates a person's combined risk of:
• catching coronavirus and being admitted to hospital
• catching coronavirus and dying
• There are online tools for clinicians and patients, and a population risk tool. 

An external validation of the QCovid risk prediction algorithm for risk of mortality from COVID-19 in adults: a national validation cohort study in England
The Lancet Digital Health May 25, 2021DOI:https://doi.org/10.1016/S2589-7500(21)00080-7

• “The QCovid population-based risk algorithm performed well, showing high levels of discrimination for COVID-19 deaths in men and women for both time periods.”

Clinical frailty scale as a point of care prognostic indicator of mortality in COVID-19

Clinical frailty scale as a point of care prognostic indicator of mortality in COVID-19: a systematic review and meta-analysis
EClinicalMedicine 21 May 2021 v36(100896)

• Analysis of data from 34 studies (n=18042) suggest a differential stratification of Clinical Frailty Score (CFS) scores in the context of COVID-19 infection, in which CFS 1–3 patients may be considered at lower risk, CFS 4–5 at moderate risk, and CFS 6–9 at high risk of mortality regardless of age.

COVID-19 Health Inequalities Monitoring in England Tool (CHIME)

COVID-19 Health Inequalities Monitoring in England Tool (CHIME)
PHE 20 May 2021

• The CHIME tool brings together data relating to the direct impacts of COVID-19, such as on mortality rates and hospital admissions and presents it by age, sex, ethnic group, level of deprivation and region.

COVID-19 Mortality in English Neighborhoods: The Relative Role of Socioeconomic and Environmental Factors

COVID-19 Mortality in English Neighborhoods: The Relative Role of Socioeconomic and Environmental Factors
J 2021, 4(2), 131-146; https://doi.org/10.3390/j4020011

• The analysis of this study focuses on neighborhood mortality variations during the first wave of the COVID-19 epidemic in England against a range of postulated area risk factors, both socio-demographic and environmental. A regression analysis shows that after allowing for health deprivation, ethnic mix, and ethnic segregation, environment (especially air quality) is an important influence on COVID mortality.

Factors associated with deaths due to COVID-19 versus other causes

Factors associated with deaths due to COVID-19 versus other causes: population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform
The Lancet Regional Health - Europe 8 May 2021 https://doi.org/10.1016/j.lanepe.2021.100109

• Analysis of primary care data (England) and death registrations to identify how specific factors are differentially associated with COVID-19 mortality as compared to mortality from causes other than COVID-19. Factors examined included age, sex, deprivation, obesity, some comorbidities, smoking history, cancer, chronic liver disease and ethnicity.

Use of a Telemedicine Risk Assessment Tool to Predict the Risk of Hospitalization of 496 Outpatients With COVID-19: Retrospective Analysis.

Use of a Telemedicine Risk Assessment Tool to Predict the Risk of Hospitalization of 496 Outpatients With COVID-19: Retrospective Analysis.
JMIR Public Health and Surveillance. 2021 Apr;7(4):e25075. DOI: 10.2196/25075.

• A COVID-19 telemedicine home monitoring program serving health care workers and the community in Atlanta, Georgia USA, prospectively applied to an outpatient population (n=496) with COVID-19 identified populations with low, intermediate, and high risk of hospitalization.

Covid 19: supporting the vulnerable during lockdown

Covid 19: supporting the vulnerable during lockdown
Public Accounts Committee 21 April 2021

• In its report published today the Public Accounts Committee says the Government’s “quickly drawn up”, centrally-directed scheme to support those most vulnerable to covid-19 disease who were instructed to “shield” at home “suffered from the problems of poor data and a lack of joined up systems that we see all too often in government programmes”.

Linked electronic health records for research on a nationwide cohort of more than 54 million people in England: data resource

Linked electronic health records for research on a nationwide cohort of more than 54 million people in England: data resource
BMJ 2021; 373 :n826 doi:10.1136/bmj.n826

• This paper describes use of NHS Digital Trusted Research Environment (TRE) for England, a novel England-wide electronic health record (EHR) resource, to enable whole population research on covid-19, exemplar cardiovascular conditions (incident stroke or transient ischaemic attack and incident myocardial infarction) and all cause mortality between 1 January and 31 October 2020.

The Data Divide

The Data Divide
Ada Lovelace Institute 25 March 2021

• Public attitudes to tackling social and health inequalities in the COVID-19 pandemic and beyond.
• Findings of a telephone-based, nationally representative survey of 2,023 UK British adults, to explore public attitudes towards a range of technologies deployed during the COVID-19 pandemic for health outcomes, including mental and physical-health apps, symptom-tracking apps, digital contact-tracing apps and vaccine passports.

Securing a positive health care technology legacy from COVID-19

Securing a positive health care technology legacy from COVID-19
Health Foundation 16 March 2021

• This long read explores the challenges of implementing health care technologies and investigates patient and staff experiences of technology during the first phase of the coronavirus (COVID-19) pandemic. It draws on learning from the Health Foundation’s programmes and YouGov surveys of over 4,000 UK adults and over 1,000 NHS staff conducted in October 2020.

Government transparency and accountability during Covid 19: The data underpinning decisions

Government transparency and accountability during Covid 19: The data underpinning decisions
Public Administration and Constitutional Affairs Committee 15 March 2021

• The Government must learn from past failures in data handling and sharing if it is to build the long-term public consent necessary to overcome the challenges of the Covid-19 pandemic. In a report published today, the Public Administration and Constitutional Affairs Committee warns that the failure to provide sufficient explanation of the data underpinning key decisions during Covid-19 placed needless strain on public confidence. It urges the Government to reinvigorate how data is communicated with the public and shared with partner agencies in the fight against Covid-19 to enable fast, flexible response to the future challenges of the pandemic, and ensure they are supported by society.

UK prevalence of underlying conditions which increase the risk of severe COVID-19 disease

UK prevalence of underlying conditions which increase the risk of severe COVID-19 disease: a point prevalence study using electronic health records
BMC Public Health 21, 484 (2021). https://doi.org/10.1186/s12889-021-10427-2

• Analysis of anonymised electronic health records from the Clinical Practice Research Datalink GOLD to understand the population at risk of severe COVID-19. Includes age- and region- stratified prevalence for each condition to support effective modelling of public health interventions and planning of vaccine resource allocation.