Risk Recognition Policies for the Long-Term Care Workforce during the First Year of the COVID-19 Pandemic: A Multi-Country Study

Abstract

Context:The precarious work arrangements experienced by many long-term care workers have led to the creation of a "shared" workforce across residential, home, and community aging care sectors. This shared workforce was identified as a contributor to the spread of COVID-19 early in the pandemic.Objective: This analysis sought to review policy measures targeting the long-term care workforce across seven high income jurisdictions during the first year of the COVID-19 pandemic. The focus was on financial supports introduced to recognize long-term care workers for the increased risks they faced, including both (1) health risks posed by direct care provision during the pandemic and (2) economic risks associated with restrictions to multi-site work.Method: Environmental scan of publicly available policy documents and government news releases published between March 1, 2020 and March 31, 2021, across seven high income jurisdictions.Findings: While there was limited use of financial measures in the United States to compensate long-term care workers for the increased health risks they faced, these measures were widely used across Canada, as well as in Wales, Scotland, and Australia. Moreover, there was a corresponding use of financial measures to protect workers from income loss in parts of Canada, Australia and the UK.Limitations: Our analysis did not include additional policy measures such as sick pay or recruitment incentives. We also relied primarily on publicly available policy documentation. In some cases, documents had been archived or revised, making it difficult to ascertain and clarify original information and amendments.Implications: While these financial measures are temporary, they brought to light long-standing issues related to the supply of and support for workers providing care to older adults in long-term care homes.

Care Workers and Managers’ Experiences of Implementing Infection Control Guidance in an Epidemic Context: A Qualitative Study in the South East of England, during the COVID-19 Prevaccination Era

“…Policy responses to emergencies, including economic measures that support the workforce both in the short and long term [40], benefts and incentives to work during an emergency, and clear, consistent, and timely communications [41], are important tools that governments have to recognize the essential work of social-care workers. Te experiences relayed by the interviewees show important shortcomings on each of these levels and reveal how the lack of work incentives and benefts for care staf, inadequate dissemination and quality of infection control guidance, and inconsistent communication between social-care providers, NHS settings and the public translated into added work and pressure for managers and care workers.…”

‘You’re out on a limb, on your own’: Social care personal assistants’ (PAs’) reflections on working in the Covid-19 pandemic ‐ implications for wider health and care services

“…TLAP [ 7 ] noted how PA employers felt their inability to pay PAs for sickness absence or isolation made recruiting a PA harder and PA employers wished to see the introduction of retention payments to allow them to keep paying PAs in these circumstances. From an international perspective, Reed et al [ 16 ] analysed publicly available policy documents relating to financial support arrangements which included care workers across seven high-income international jurisdictions from March 2020 to March 2021. These authors compared access to financial support initiatives across countries demonstrating a range of options available to policy makers in planning for future emergencies.…”

“…Furthermore, it exposed the importance of PAs as a group who need to be included in infection control and disaster planning. In England, risks to social care were realised late, with the National Health Service (NHS) being prioritised over community settings [ 14 – 16 ]. Against this background, PAs were not generally mentioned in national policies.…”

Abuse and Wellbeing of Long-Term Care Workers in the COVID-19 Era: Evidence from the UK

“…It highlighted the differentiated experiences across different groups of workers and between health and social care settings in England. This lack of recognition of the impact of COVID-19 on the LTC workforce in the UK was reflected in minimal support measures during the pandemic compared to other countries such as Australia and Canada [2]. The second policy implication is the linkage between the exposure to mistreatment and abuse and the intention to quit.…”

“…The COVID-19 pandemic created significant challenges for the UK's long-term care (LTC) workforce. Government policy prioritised the protection of the National Health Service (NHS), while the risk for the LTC sector was largely unrecognised [1,2]. It is estimated that around 25,000 older people were discharged from hospitals to LTC settings to 'free up capacity' without testing or quarantine and the provision of adequate personal protective equipment (PPE) for staff in the first months of the pandemic [3] (p. 11).…”