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Table 5 Early headlines generated from thematic analysis to support focus on system wide development for successive waves of the pandemic

From: RETRACTED ARTICLE: A thematic analysis of system wide learning from first wave Covid-19 in the East of England

• The pandemic has shown how interdependent every aspect of health and social care is and has strengthened the imperative to take a whole systems approach to enable this by acting as a catalyst for health and social care integrated transformation.

• Learning and insights have been drawn from across acute, community and residential care home settings, incorporating the experiences of interdependent partners across the economy that reflect every aspect of health and social care across Norfolk and Waveney ICS.

• Themes reflect that more things have gone well than did not.

• Covid-19 has acted as a catalyst for green shoots in genuine integration and joint working to enable transformation across health and social care at many levels to start as long as momentum is maintained.

• The greatest strength has been the willingness and resilience of the workforce and its teams to be flexible and work together on finding solutions for care that are person centred and safe.

• Individuals and teams being enabled to find innovative solutions to ‘problems’ without becoming stifled by ‘poor’ governance.

• The number of teams (new and existing) who are or have become effective in how they work together and support each other to provide services to patients, residents and communities is humbling.

• The use of IT is widely recognised as being beneficial and these benefits need to be retained and further grown specifically in relation to:

   - Supporting virtual visiting and End of life connections,

   - Clinical consultations.

   - Patient, team and stakeholder consultations.

   - Emotional support for staff wellbeing.

   - More efficient and collaborative ways of working with greater productivity.

   - Learning and development and induction.

   - Speeding up recruitment processes.

   - Environmental benefits- reducing the carbon footprint.

• Good broadband infrastructure across communities is a necessity to support the above.

• Learning at the systems level identifies the need for:

   - Consistent approaches across and within sectors.

   - Consistent clear messages about what is expected from staff and the public.

   - Good business relationships and continuity planning to ensure staffing, supply chains, managing the number of deaths, continuing with other health priorities is critical e.g people with cancer; maintaining adequate stocks and supply of PPE.

   - Embedded (systematic) support systems for staff.

   - Integrated volunteer systems across boundaries- passport for volunteers inclusive of DBS and shielding arrangements.

   - Continued learning and development support with safe working in the workplace- quality improvement, infection control.

   - Enabling teams to be empowered to make a difference as interdependent partners across the system.

• Learning for national policy includes the needs for:

   - Consistent and clear messages to the public in a timely manner.

   - Whole system planning (business continuity and supply chains and relationship with suppliers which is specifically relevant to PPE).

   - Consideration of and planning for impact on vulnerable people.

   - Introduce one national capacity tracker system for recording Covid tests.

• Learning at the individual level has strongly resonated with:

   - Re-igniting individual strengths and recognising those they didn’t know they had.

   - The importance of appreciating the ’little’ (frequently taken for granted) things.

   - Family and home, hobbies and interests.

   - Having a job they loved.

   - Appreciating the support of the public and others.

   - Humanitarian values - Valuing every person as a person and their contribution, be that colleague, patient, resident, relative, volunteer, friend, citizen.