Evaluation of the implementation of pandemic preparedness plans during COVID-19 at the interface with infection prevention and control services in acute and community care.

Background: During the UK COVID-19 epidemic Infection Prevention & Control (IPC) services faced unique challenges in preventing transmission of infection in health and social care settings. It is unclear how healthcare pandemic preparedness plans informed the response to COVID-19 and the extent to which they were effective. Evaluation of the pandemic response is essential in order to learn critical lessons for IPC services and build more effective and resilient IPC plans for future pandemics Research question: How did IPC services in local healthcare systems in England function in relation to pandemic preparedness, and innovate to provide an expert service for preventing transmission of COVID-19 to patients, healthcare workers and the public during the pandemic? Aims: to understand and learn critical lessons from challenges faced by IPC services managing the COVID-19 pandemic across local healthcare systems in England and inform the effective and resilient pandemic preparedness plans for recovery and the future. Objectives: Conduct a secondary analysis of key documents to inform the development of a pandemic policy timeline and identify how IPC services featured in the decision-making processes. Identify how local pandemic plans impacted on the operationalisation of IPC services response to COVID-19. Identify how national guidance and policy decisions impacted on IPC services workload, advice, activity and success in preventing the transmission of COVID-9. Explore how local pandemic plan worked/ did not work in the context of IPC services and how IPC services innovated technically and system wide in response to national and local circumstances. Map how IPC service decisions were made, managed, operationalised and communicated nationally and within local healthcare system. Assess the impact of IPC services decisions on the experience of patients and relatives. Methods: A two-phase, explanatory mixed methods design will be used to evaluate the local context of IPC services in implementing pandemic preparedness plans and the impact of national guidance and policy decisions. Phase 1 will comprise an analysis of UK policy documentation and review of pandemic planning literature, together with a survey of IPC leaders to investigate how local pandemic plans informed the IPC service response to COVID-19. Phase 2 will use 6-8 case studies of local healthcare systems to determine how the IPC service adapted and managed the complexity of the COVID-19 pandemic and why IPC services need to be re-designed to meet the IPC challenges of novel pandemic infections. Findings will be triangulated to produce a pandemic preparedness framework for IPC services and set of indicators to assess local healthcare system preparedness and response to novel pandemic threats. Timeline: 18 months Anticipated impact: Enhanced clarity about the role, requirements and activities of IPC services in pandemic preparedness to underpin NHS England policies and guidance and DHSC oversight of emergency preparedness. Improved understanding how to operationalise the IPC service in pandemic planning for future outbreaks, improving patient safety and patient experience. Dissemination: policy makers, practitioners, patients and the wider NHS system through a stakeholder event, publication and other formats such as blogs, infographics and social media.