What we did and what we found

What we did

We recruited six NHS Trusts from across the UK, which offered either paediatric surgery, maternity services, or both. Maternity services included those provided in hospital and community ante- and post-natal services. Between November 2020 and July 2021, we spoke to 37 healthcare professionals and hospital managers across the participating trusts.

Our participants, 26 female and 11 male, were doctors (9), nurses (12), midwives (5), and hospital managers (11). Interviews lasted around an hour. In April 2020, as the first wave of the COVID-19 pandemic was subsiding, the UK Government declared that non COVID-19 clinical services must resume, alongside maintaining the capacity to manage subsequent waves of COVID-19.

Initially, this ‘reset’ phase was anticipated to be the start of a return to ‘normal’, but the subsequent waves of infection, and lockdowns, have meant that the ‘reset’ phase has continued for longer than originally anticipated. Even now that many restrictions have been lifted, trusts are continuing to manage Covid and non-Covid services alongside one another.

We asked our participants about their experiences of decision-making during this ‘reset’ period. These interviews were all held online, via Zoom or MS Teams.

• Read more about the final report for interview participants

Reset ethics research: background

The Reset Ethics team recruited six NHS Trusts from across the UK, which offered either paediatric surgery, maternity services, or both. Maternity services included those provided in hospital and community ante- and post-natal services. In April 2020, as the first wave of the COVID-19 pandemic was subsiding, the UK Government declared that non COVID-19 clinical services must resume, alongside maintaining the capacity to manage subsequent waves of COVID-19.

Initially, this ‘reset’ phase was anticipated to be the start of a return to ‘normal’, but the subsequent waves of infection, and lockdowns, have meant that the ‘reset’ phase has continued for longer than originally anticipated. Even now that many societal restrictions have been lifted, trusts are continuing to manage Covid and non-Covid services alongside one another.

Between November 2020 and July 2021, we carried out individual interviews with hospital managers and healthcare professionals.

We spoke to 37 participants across the participating trusts. Our participants (26 female and 11 male), were doctors (9), nurses (12), midwives (5), and hospital managers (11). Interviews lasted around an hour.

These interviews were all held online, via Zoom or MS Teams.

We asked our participants about their experiences of decision-making and healthcare practices during the ‘reset’ period.

• Focus Group with hospital psychologists: background, findings and proposed next steps

What we did

We held 5 focus groups during May and June 2021. These were all held online, via Zoom. We had 26 participants, 24 female and 2 male, who either had experience of using maternity and paediatric services during the COVID-19 ‘reset’ phase, when NHS services were returning to ‘normal’ following initial lockdown, or who were involved in patient groups with their local NHS Trust.

Focus groups lasted around 90 minutes. The questions asked included how involved participants felt in local NHS Trust decision-making and how local Trusts could seek to involve more local people, how Trusts had communicated during the ‘rest’ phase, how participants felt Trusts had made decisions during this phase, and how these decisions affected the care that they received during this time.

• Read more about the final Report for Participants

This response to the call for evidence to inform the Government’s review into COVID-status certification, has been prepared by the members of the multi-disciplinary team running a UK Research and Innovation Arts and Humanities Research Council(UKRI AHRC) funded study looking at decision-making and the ethical challenges of restarting of NHS services in maternity and paediatrics since April 2020. The team members, from the Universities of Liverpool, Warwick and Lancaster, have expertise in bioethics, law and clinical medicine.

• Read more about the response from the NHS Reset Ethics Research Team

This response to the Public Accounts Committee’s Call for Evidence concerning initial lessons from the government’s response to Covid-19 has been prepared by the members of the multi-disciplinary team running a UK Research and Innovation Arts and Humanities Research Council (UKRI AHRC) funded study. Our research is exploring decision-making and the ethical challenges of restarting and reconfiguring NHS services in maternity and paediatrics since April 2020. The team members, from the Universities of Liverpool, Warwick and Lancaster, have expertise in bioethics, law and clinical medicine.

• Read more about the response from the NHS Reset Ethics Research Team

At the beginning of the coronavirus (Covid-19) pandemic, many non-Covid healthcare services were suspended. In April 2020, the Department of Health in England mandated that non-Covid services should resume, alongside the continuing pandemic response.

This ‘resetting’ of healthcare services created a unique context in which it became critical to consider how ethical considerations did (and should) underpin decisions about integrating infection control measures into the routine practice of healthcare to protect hospital communities from Covid-19 infection.

This presentation draws on data collected as part of the UKRI-funded ‘Reset Ethics’ project, which explored the everyday ethical challenges of resetting England’s NHS maternity and paediatrics services during the coronavirus (Covid-19) pandemic.

• Read more about this presentation

A planning meeting for our project proposal on the workforce in health, care and education services. We are all very aware of the critical condition of the workforce - compromising high quality services through shortages of staff and eroding working conditions.

This project will probe beneath the surface of workforce questions, and ask what is needed for high quality services for parents and carers of very young children. This planning event is the start of a collaboration to create an innovative and winning proposal.

• Read the summary of discussions to date 

Caroline Redhead was invited to deliver a presentation at The Royal Society of Medicine on behalf of the Parent-Infant Covid Organisational Academic Learning [PIVOT-AL] Collaborative. The PIVOT-AL Collaborative was formed during the SARS-CoV-2 pandemic, allowing researchers to share learning and develop collaborative research regarding maternity and children's health services.

• Read the summary of the presentation  

In April 2020, as the first wave of the pandemic was subsiding, the UK Government declared that non COVID-19 clinical services must resume but that capacity to manage subsequent waves of COVID-19 should be maintained.

This created a unique ‘reset’ context in which it became critical to consider how ethical considerations did, and should, underpin decisions about how to restore and recover (or ‘reset’) health services.

Our ‘Reset ethics’ research is exploring these ethical issues as hospitals ‘reset’ normal services alongside coping with the coronavirus pandemic.

• Read the summary of the presentation  

At this online event, chaired by Professor Jane Sandall CBE, the Head of Midwifery Research for NHS England and Improvement and ARC’s maternity and perinatal mental health theme lead, researchers from the PIVOT-AL Collaboration presented early insights from the work being done by the Universities and third-sector organisations forming the Collaborative.

Caroline presented joint findings relating to pandemic-specific service activities and approaches that should not be continued.