Reflections on a year like no other...

It is hard to believe that a year has passed since we left the University campus and moved to working from home. Like many, we have had to deal with endless MS Teams and Zoom meetings, online teaching, virtual conferences and webinars. All this alongside the personal challenges of restrictions on seeing friends and family, limitations on where we can travel, home schooling and increased caring responsibilities and social isolation. It has indeed been a year like no other.

Whilst I look forward to returning to campus, and connecting in person with friends and colleagues, I’m amazed by what can be achieved virtually. As well as continuing with our core academic activities, generating research income, teaching our students, and supporting our colleagues, we have been reflecting on the relevance of our research to COVID-19 and conducted new COVID-19 related research. Below I summarise some of our reflections and contributions.

Understanding people’s preferences and behaviour

We have expertise in HERU at using health economics research methods to identify the preferences that individual people have. For example, for their care and treatment, or how their time and risk preferences affect their behaviour. Using a range of methodologies, we can study the preferences of healthcare professionals, patients, and the public. In this way we can understand what people want from treatments and services and why they behave the way they do. These are some of the projects where our preference research can help shape the policy response to the pandemic.

Making decisions about who to admit to intensive care – The COVID-19 pandemic increased the challenges that ICU doctors face when they decide who to admit to intensive care.  Previous research by Mandy Ryan, in collaboration with the University of Warwick Medical School, developed a decision support pack for intensive care unit (ICU) admissions. This research used a discrete choice experiment (DCE) to understand the factors that are important to health professionals when they make these decisions and inform the decision support pack. This research informed NICE rapid guideline on managing COVID-19. 

Lives and livelihoods during a pandemic: what do you think? - Our 'Lives and livelihoods' project, conducted by our Methods of Benefit Valuation team, aims to understand public preferences and trade-offs for government responses during a pandemic. Public health responses to the COVID-19 pandemic have impacted on people's civil liberties as well as their physical and mental health and economic circumstances. We used a DCE to examine the trade-offs individuals are willing to make between lockdown restrictions, excess deaths and economic consequences. We collected data from across the four nations of the UK and will test if respondents’ preferences differ based on their attitudes or circumstances. Analysis is ongoing and we will feature the research in future blog posts. 

Explaining COVID-19 vaccination hesitancy - We’ve also been involved in work looking at people’s preferences for COVID-19 vaccinations. Verity Watson was part of a team looking at vaccine hesitancy in France. The study aimed to assess what factors affect vaccine hesitancy in a representative working-age population. The results suggest that the characteristics of new vaccines and the national vaccination strategy are amongst the factors most affecting vaccine hesitancy. The team also looked at vaccine hesitancy in Scotland. Data analysis is currently taking place. The results will be published and featured in our blog.

Patient public involvement and engagement in research: responding to COVID-19 and rising health inequalities - Patient public involvement and engagement (PPIE) in research is important for the relevance and the impact of research. The pandemic has made it even more challenging to achieve real engagement. Shielding and social distancing have changed ways of involving the public in research. Verity Watson and Luis Loría are involved in research with the University of Liverpool on ‘remote working practices for PPIE in health and social care research’. The research looks to understand and overcome the barriers to PPIE and to address inequalities to ensure everyone can have their say in research.

Do people's time and risk preferences reduce their social interactions in the pandemic? -At HERU, we have a strong record of research into time and risk preferences. The way that these factors influence the number and frequency of a person’s social interactions can help understand people’s behaviour. Measures to reduce the transmission of the virus are dependent on individuals meeting less often with people from other households. People who are more risk averse and more future oriented are more likely to reduce their social interactions during a pandemic. Marjon van der Pol, in collaboration with Dr Heather Brown of the University of Newcastle, is using data from a UK longitudinal household survey to test this association between time and risk preferences and the reduction in social interactions.

Understanding the workforce

Understanding individual and organisational behaviour within the workforce is an important aspect of our research. Our expertise in identifying the financial and non-financial incentives and constraints that shape behaviour can provide important insights for the wider COVID-19 response.

Economic insecurity and population mental health in the COVID-19 era - For many people, the COVID-19 pandemic led to more fear of adverse economic events. Daniel Kopasker was involved in research that showed a causal link between economic insecurity and worse mental health. It was also shown that individuals’ mental health can recover relatively quickly from exposure to economic insecurity. Furthermore, the research showed that industries with lower levels of insecure employment are also more productive. Therefore, reducing economic insecurity is good for business and for population mental health. As we pointed out in our blog post, these outcomes have always been important. In the post-COVID-19 era they are likely to be vital.

Public sector resource allocation following an economic crisis - Daniel was also involved, with Diane Skåtun and Bob Elliott in our work on the staff Market Forces Factor (sMFF). The sMFF is used to compensate healthcare providers in England and Wales for the higher costs some will encounter when hiring staff. The sMFF is based on estimates of private sector wage differences across different geographical areas.

Our research highlighted the effect of the 2008 financial crash on wages. A failure to account for the effect of the crash impacted on the allocation of government funding to the NHS. The research highlights how important it is that policy decisions are based on the best available data. As our blog post indicated, there are lessons for decision-making as we emerge from the COVID-19 crisis. 

Whilst the pandemic is not over, the roll out of the national vaccination programme and easing of restrictions suggests the new normality is getting closer. I look forward to working with colleagues to address the challenges COVID-19 has placed on our health service as we transition to a new normal. I also look forward to sharing a coffee, and hopefully at some point in the not too distant future, a hug.  

Thanks to HERU Director, Mandy Ryan, for writing this blog post.

HERU is supported by the Chief Scientist Office (CSO) of the Scottish Government Health and Social Care Directorates (SGHSC). The views expressed here are those of the Unit and not necessarily those of the CSO.