Call volume, triage outcomes, and protocols during the first wave of the COVID-19 pandemic in the United Kingdom: Results of a national survey

Objectives

During the first wave of the COVID-19 pandemic in the United Kingdom (UK), to describe volume and pattern of calls to emergency ambulance services, proportion of calls where an ambulance was dispatched, proportion conveyed to hospital, and features of triage used.

Methods

Semistructured electronic survey of all UK ambulance services (n = 13) and a request for routine service data on weekly call volumes for 22 weeks (February 1–July 3, 2020). Questionnaires and data request were emailed to chief executives and research leads followed by email and telephone reminders. The routine data were analyzed using descriptive statistics, and questionnaire data using thematic analysis.

Results

Completed questionnaires were received from 12 services. Call volume varied widely between services, with a UK peak at week 7 at 13.1% above baseline (service range -0.5% to +31.4%). All services ended the study period with a lower call volume than at baseline (service range -3.7% to -25.5%). Suspected COVID-19 calls across the UK totaled 604,146 (13.5% of all calls), with wide variation between services (service range 3.7% to 25.7%), and in service peaks of 11.4% to 44.5%. Ambulances were dispatched to 478,638 (79.2%) of these calls (service range 59.0% to 100.0%), with 262,547 (43.5%) resulting in conveyance to hospital (service range 32.0% to 53.9%). Triage models varied between services and over time. Two primary call triage systems were in use across the UK. There were a large number of products and arrangements used for secondary triage, with services using paramedics, nurses, and doctors to support decision making in the call center and on scene. Frequent changes to triage processes took place.

Conclusions

Call volumes were highly variable. Case mix and workload changed significantly as COVID-19 calls displaced other calls. Triage models and prehospital outcomes varied between services. We urgently need to understand safety and effectiveness of triage models to inform care during further waves and pandemics.

 

COVID 19: Suggestions to Universities, Supervisors and Line Managers from Doctoral and Early Career Researchers.

When the COVID-19 pandemic hit the UK in March 2020, universities closed their doors with uncertainty over when they would reopen. In the early stages of lockdown, many doctoral and Early Career Researchers (collectively, ECRs) felt their institutions had forgotten them.

Vitae and the UKRI-funded Student Mental Health Research Network (SMaRteN) surveyed 5,900 ECRs across 128 UK universities at the end of April 2020, to establish the impact of lockdown on their work. While almost two thirds of respondents agreed that their supervisor/line manager had done all they could to support them, only 38% felt the same way about their institution. A quarter of respondents identified that their relationship with their university had worsened since the pandemic began. Right now, a key question is: what can universities do to support their ECRs?


University of Lincoln, College of Social Science Research

Nicola Byrom, King’s College London

Patricia Jackman, University of Lincoln, School of Sport and Exercise Science

Amy Zile, University of East Anglia

Elizabeth James, Teeside University

Katie Tyrrell, University of Suffolk

Cameron J. Williams, University of New South Wales

Tandy Haughey, Ulster University

Rebecca Sanderson, University of Lincoln, Lincoln Higher Education Research Institute

Michael Priestly, University of Durham

Nicola Cogan, University of Strathclyde


 

COVID-19: Psychological flexibility, coping, mental health, and wellbeing in the UK during the pandemic

The COVID-19 pandemic has profoundly altered the daily lives of many people across the globe, both through the direct interpersonal cost of the disease, and the governmental restrictions imposed to mitigate its spread and impact. The UK has been particularly affected and has one of the highest mortality rates in Europe. In this paper, we examine the impact of COVID-19 on psychological health and well-being in the UK during a period of ‘lockdown’ (15th–21st May 2020) and the specific role of Psychological Flexibility as a potential mitigating process.

We observed clinically high levels of distress in our sample (N = 555). However, psychological flexibility was significantly and positively associated with greater wellbeing, and inversely related to anxiety, depression, and COVID-19-related distress. Avoidant coping behaviour was positively associated with all indices of distress and negatively associated with wellbeing, while engagement in approach coping only demonstrated weaker associations with outcomes of interest. No relationship between adherence to government guidelines and psychological flexibility was found.

In planned regression models, psychological flexibility demonstrated incremental predictive validity for all distress and wellbeing outcomes (over and above both demographic characteristics and COVID-19-specific coping responses). Furthermore, psychological flexibility and COVID-19 outcomes were only part-mediated by coping responses to COVID-19, supporting the position that psychological flexibility can be understood as an overarching response style that is distinct from established conceptualisations of coping. We conclude that psychological flexibility represents a promising candidate process for understanding and predicting how an individual may be affected by, and cope with, both the acute and longer-term challenges of the pandemic.


University of Lincoln, College of Social Science research

Dave Dawson, University of Lincoln, College of Social Science

Nima Moghaddam, University of Lincoln, College of Social Science


 

Combining Our Virtual Isolation Discussions

In this presentation, Jamie, a PhD Student studying the pathways into teaching: exploring the preparation and retention of maths and science teachers, converses with his supervisor Rachael about their combined experiences of the virtual isolation over the past year. They discuss the challenges and benefits put upon them by the situation over the last year, such as research designs and data collection, and how together they have found innovative ways to overcome them. Finally, conclusions are drawn as to possible support for future researchers and supervisors to ensure that the journey whilst challenging is a successful and enjoyable one!


Dr Rachael Sharpe, School of Education
Mr Jamie Ainge, School of Education


Prisons in a Pandemic – Examining the Impact on Prisoner Well-Being and Mental Health

Rachael Dagnall joined the University of Lincoln in 2018 following a 17-year career as a Chartered and Registered Forensic Psychologist within Her Majesty’s Prison and Probation Service (HMPPS). Rachael will deliver a talk on how her previous experiences of working within the Offender Personality Disorder Pathway (OPDP) services have enabled her to become part of a research team that has recently been successful in securing funding for a national research project within HMPPS. Still in its infancy, Rachael will describe the teams plans for the Swansea University led project funded by the Economic and Social Research Council as part of UK Research and Innovation’s rapid response to Covid-19. The project, led by Professor Jason Davies, has collaborators from universities in Belfast, Lincoln, Liverpool and Leicester as well as from the Ministry of Justice. Rachael will describe how the team plan to focus on a sub-group of people living in prison who will be following the Offender Personality Disorder Pathway, to establish the impact of introducing restrictions – and of easing them – on prisoners’ psychological wellbeing and behaviour.


Mrs Rachael Dagnall, School of Psychology


 

Reflecting on PhD supervision during the pandemic.

Postgraduate Research students have faced a difficult time during the Covid-19 pandemic, when carefully planned research has been disrupted due to recurrent lockdowns, mental health problems have come to the fore, and the challenges of doing a doctorate have been made greater due to pressures on work and family. In this short talk, doctoral supervisors from the College of Social Science talk about their experience of supervising students during the pandemic.


Dr Hannah Henderson, School of Sport and Exercise Science
Dr Trish Jackman, School of Sport and Exercise Science
Dr Rachael Sharpe, School of Education
Dr Joss Winn, School of Education


 

Reflections on interviewing at a distance with young fathers and professionals

Following Young Fathers Further is a 4-year qualitative longitudinal and participatory study exploring the lives and support needs of young fathers, funded by UKRI. The pandemic has required us all to adapt our research in various ways. In this presentation, the research team will talk through some of our reflections on interviewing and conducting research at a distance. We began with a series of questions; how do we ensure inclusivity and adhere to principles of participation and co-production? Which technological formats are accessible and valuable to young fathers? How do we access participants and build relationships at a distance? In tackling these questions, we worked closely with our project partners to rapidly develop a new research strategy. In our presentation we will briefly reflect on both the ethics and practicalities of fieldwork at a distance focusing on themes of connection and connectivity. Researching from a distance has provided an opportunity to try new methods and to critically reflect on our methodological practice. At the heart of our approach is a commitment to core ethical principles and a responsibility of care towards our participants.


Dr Linzi Ladlow, School of Social and Political Sciences
Dr Laura Way, School of Social and Political Sciences
Dr Anna Tarrant, School of Social and Political Sciences


Creating Connections in a Virtual World

When the Covid-19 pandemic hit in March 2020 in the UK, it quickly changed our day-to-day lives. With the closure of university facilities, doctoral researchers suddenly found themselves out of the postgraduate office and left to continue their studies from home. This shift triggered an almost overnight change in the environment surrounding many doctoral researchers, especially in terms of the interpersonal relationships with peers and supervisors. As a result, this may have increased the risk of social isolation. This presentation will provide an insight into the PGR Connect Series, which was organised to provide sport and exercise psychology postgraduate researchers at the University of Lincoln with a chance to present their work and connect with researchers at other institutions in the summer of 2020. The team at Lincoln Sport and Exercise Psychology Research will share their experiences of organising and presenting on the seminar series, which ran over nine weeks and eventually involved over 20 speakers from over a dozen institutions across six countries.


Dr Trish Jackman, School of Sport and Exercise Science
Rachel Langbein, School of Sport and Exercise Science
Rebecca Hawkins, School of Sport and Exercise Science
Ollie Williamson, School of Sport and Exercise Science
Dr Matthew Bird, School of Sport and Exercise Science


 

Overcoming the challenges of doctoral study during the pandemic.

Director of Studies, Dr Joss Winn, talks with colleague and PhD Professional candidate, Alison Raby, about the challenges she has faced during the pandemic when undertaking her research, An exploration of the personal tutoring experiences of Chinese students in the UK. The impact of Covid-19 has meant that Alison has had to rethink her data collection methods and timeline, and work around the cancellation of a planned trip to China.


Dr Joss Winn, School of Education

Ms Alison Raby, Department of Marketing Languages and Tourism