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

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.