nCoV: Understanding the dynamics of policy development and healthcare worker behaviour in the UK during the Covid-19 public health emergency

In an infectious disease outbreak public health policymakers are under tremendous
pressure, especially from the media. They must respond rapidly to and take decisions
which impact enormously on healthcare provision.
We are studying conventional and social media trends during the Covid-19 epidemic. We
will link these to changes in UK policy, gaining unique insights through collaboration with
key policy players. These include members of the Strategic Advisory Group of Experts (SAGE) that advises the Government, and Public Health England leaders.These expertsare recording information on key meetings and events, and giving regular interviews so we
capture their perspectives in real-time.
We will also examine the impact of the policy changes on healthcare workers in general
practice and hospitals, through interviews and observations. We will learn their
perspective on delivering care during the epidemic, and how they perceive the changes in
policy. These findings will be fed back to policymakers during the outbreak.
Our approach is novel because policy decisions are usually only studied after an event,
making the findings less reliable. Our team have all the necessary expertise and have
already started the work, by using emergency reserve funding.

This COVID-19 Rapid Response award is jointly funded (50:50) between the Medical Research Council and the National Institute for Health Research. The figure displayed is the total award amount of the two funders combined, with each partner contributing equally towards the project.

During public health emergencies policymakers are under incredible pressures from many
sides, including the media, public, healthcare workers, and politicians. The decisions
made have wide impacts on many sectors of society, especially healthcare workers at the
front line of the outbreak response.
This proposal responds to the theme of “understanding and influencing behaviour of
institutions and individuals.”
We aim to understand better how UK policymakers arrive at decisions during the Covid-19
outbreak, and the impact of those decisions on UK healthcare workers. Making sense of
policy decisions usually occurs after an outbreak, and thus can only impact on future
events. Here we propose a novel prospective evaluation, monitoring conventional and
social media data, and gathering information from key policy stakeholders (e.g. Jeremy
Farrar and David Heymann) about their activities, and the drivers of policy choices (Work
Package 1).
In parallel we will purposively select key informants from primary care and hospital
settings to gain insight into healthworker concerns and perceptions regarding the
response to Covid-19, including views on service level adaptations following policy
changes (Work Package 2).
This work requires rapid activation to capture timely, valid information about attitudes
during the outbreak, and deliver prompt results to policymakers.
We are already piloting the research, with pump-prime funding from the NIHR Health
Protection Research Unit in Emerging and Zoonotic Infections, and will scale it with MRC
support.
Our team has extensive experience evaluating the impacts of policy in healthcare systems
in the UK and internationally, leading to change in practice.