Evaluation
http://hdl.handle.net/20.500.12904/16128
2024-03-29T12:11:28ZIncreasing vaccine uptake
http://hdl.handle.net/20.500.12904/16487
Increasing vaccine uptake
Mulla, Abeda; Teladia, Zaheera; Jones, Eleanor; Moore, Ellie; Ward, Richard; Finlay, Freddie; Taylor, Bethany
When the national COVID-19 vaccination programme began in December 2020, it was understood that everyone should have equal access to the vaccine, as appropriate to their need, and as prioritised by the Joint Committee on Vaccination and Immunisation. Within a few weeks however, there were early indications that there were differences in uptake amongst different population groups and in different parts of the country (The OpenSAFELY Collaborative 2021). As a result of these differences, many local examples of initiatives to increase vaccine uptake began to emerge. The Health Inequalities Improvement Team in partnership with the Vaccine Equalities Team at NHS England and Improvement commissioned the Strategy Unit to collect and collate some of these examples in a structured way. What we did: using social media channels and professional networks we identified and requested a half hour conversation with people involved in initiatives to increase local vaccine uptake. We spoke to people in March-April 2021, involved in 50 different initiatives across England and wrote up each of these individual accounts in a structured way. The examples we collected focused on four target groups: place of residence, ethnicity, faith communities and health status and could be grouped as two main types of intervention: information and outreach. Representative examples of each of these are included as case studies on the NHS England website, all 50 examples can be viewed below. A blog outlining the three key lessons for working with communities beyond the vaccination programme is hosted on the NHS Confederation website.
2021-06-01T00:00:00ZPrimary and Community Qualitative Insights
http://hdl.handle.net/20.500.12904/16439
Primary and Community Qualitative Insights
Mason, Paul; Mulla, Abeda
The COVID-19 response required rapid change and innovation across health and care. As part of a wider package of evaluation support, from April to June, the Strategy Unit led some qualitative work (training and supporting CCG staff to conduct interviews) across an STP to capture learning from primary care (primarily PCN clinical leads) and community nursing leads about their experiences. The interviews explored the rapid move to total triage, video and online team communications, changes to day-to-day practices, working with care homes and their views on the backlog and unmet need. We held weekly reflective learning workshops with the CCG to both share learning and provide practical support with the delivery of the interviews. We also provided weekly rapid-cycle reporting of headline findings from an initial analysis of interview notes and recordings. Here we share the three rapid-cycle reports that were provided to the STP during the crisis period.
2020-07-01T00:00:00ZLearning from lockdown: support for people experiencing homelessness
http://hdl.handle.net/20.500.12904/16426
Learning from lockdown: support for people experiencing homelessness
Caswell, Rachel; Battye, Fraser; Callaghan, David
There are few clearer measures of societal health than homelessness. On this count, and despite its enormous material wealth, England is in poor shape. Relative to the recent past, and any country we might want to compare ourselves to, we have a problem with homelessness. The causes of homelessness are undoubtedly complex. But the above comparisons show that the problem can be addressed: policy choices make a difference. This was shown in dramatic fashion last March with the Ministry of Housing, Communities & Local Government decision to house people rough sleeping (‘Everyone In’) in response to the first national lockdown. So Lockdown 1 was a period of great policy innovation. It was also a time of radical service innovation as health and social care services responded to a world of social distancing, remote working and PPE. At that time many Strategy Unit projects were focused on what could be learnt from this period of innovation. What changes were being made? Which changes seemed to be an improvement on pre-lockdown practice? Which ones were a step back? Which needed more evidence and further study? We were asked these questions so frequently, we produced a Guide to working through them. It was a great privilege to be asked by NHS England & Improvement to examine these questions in relation to the service response for people experiencing homelessness. Alongside this, we were also asked to look at how data collection and use could be improved. The reports below contain the detailed results of this work. These results resonated strongly with similar projects from Groundswell, St Mungo’s and Crisis. Above and beyond the results set out in the reports, we also found that: Innovation was taking place on the frontline. Changes made by services were pragmatic responses to changes in circumstance; they were not done in response to plans from ‘on high’. Policy is now running to catch up with practice. Existing problems were exposed. Data were patchy and weak; services were often strained (and sometimes unwelcoming). These pre-existing weaknesses came more sharply into focus. The hope is that temporary measures to cope with the crisis – less hiding behind ‘IG’ for example – can be now nurtured into everyday practice. The basic right of access to healthcare, that has too often eluded those experiencing homelessness, is assured. While seeing that standard administrative data was lacking, we found that it was possible to gather near live information from people experiencing homelessness. We joined forces with (the excellent) Groundswell to bring together our work on services’ experiences with their peer-led work looking at people’s experiences of this support. This combination proved powerful and we shared many lessons during a session at our INSIGHT 2020 festival. The NHS can be criticised for its approach to addressing health inequalities. The hope here must be that the inequalities exposed by Covid draws a fuller and better response in future. Recent reasons for this hope include: the content of NHSE/I’s ‘Phase 3 letter’, which focused heavily on inequality; the recent appointment of Dr Bola Owolabi as Director of Inequalities; and the energy shown by Olivia Butterworth, who led NHSE/I’s response to homelessness. Homelessness is a source of shame for our society. The best way to improve outcomes is not to tweak services, but to prevent the problem. But while homelessness remains, the NHS must feel a sense of duty and responsibility to do the best it can do, and to work closely with local government and the voluntary sector in support of this. This work gave us the chance to combine personal interests and passions with professional skills. It was part of the Strategy Unit’s ongoing commitment to addressing health inequalities and we relished the chance to contribute to a significant and vital agenda. We look forward to working with others to do so again in future.
2021-02-01T00:00:00ZWe don't just need to hear 'you are more affected' - what's the action?
http://hdl.handle.net/20.500.12904/16349
We don't just need to hear 'you are more affected' - what's the action?
Mulla, Abeda; Begum, Mahmoda; Teladia, Zaheera; Townsend, Sharon; Ward, Richard; Jones, Eleanor; Rahim, Shammas
Within months of the COVID-19 pandemic, international evidence on the disproportionate impact of COVID by race and ethnicity began to emerge in countries that collect ethnicity data (the UK, USA, Canada, Norway and Brazil. Each provided more evidence that people living in a country where they were classified as minority ethnic, had a higher risk of contracting COVID-19 infection with more severe outcomes when infected. As a response to this emerging data, the Strategy Unit undertook a small exploratory qualitative study between June and August 2020. We publish these stories, two years into the pandemic as a historical reflection. We recruited via our own personal and professional networks to reach people who are often considered ‘hard to reach’. We conducted 11 in-depth, semi-structured interviews with people who self-identified as minority ethnic and who had experienced symptomatic COVID-19 illness. The purpose of this study was to record individual experiences of: becoming infected with COVID-19; the impact on their households; and, the management of symptoms including how they accessed and used health and care services. Thematic analysis of the qualitative interview data identified five key themes as shown in the figure above. We previously presented these findings at the Strategy Unit’s 2020 Insight festival. We are now publishing a summary of each of these interviews as narrative stories, that is first person accounts under the headings of: My life before COVID My experience of COVID My life after (first infection with) COVID Why my COVID experience matters Whilst acknowledging the many overlapping experiences, we have grouped these 11 stories[1] according to three main categories. We have also provided a summary of each of the three categories. The interpretations are situated in the lived experiences of the qualitative team who undertook this piece of work. We were motivated to challenge the overly simplified narrative of linking the poorer pandemic experiences of minority ethnic people with low socioeconomic status, cultural practices and front-line roles. The accounts collected in these interviews reveal both the counter-arguments and the nuances within these narratives.
2022-03-01T00:00:00Z