Abstract
IntroductionDomiciliary care workers (DCWs) continued providing social care to adults in their own homes throughout the COVID-19 pandemic. Evidence of the impact of COVID-19 on health outcomes of DCWs is currently mixed, probably reflecting methodological limitations of existing studies. The risk of COVID-19 to workers providing care in people’s homes remains unknown.ObjectivesTo quantify the impact of COVID-19 upon health outcomes of DCWs in Wales, to explore causes of variation, and to extrapolate to the rest of the UK DCW population.MethodsMixed methods design comprising cohort study of DCWs and exploratory qualitative interviews. Data for all registered DCWs in Wales is available via the SAIL Databank using a secured, privacy-protecting encrypted anonymisation process. Occupational registration data for DCWs working during the pandemic will be combined with EHR outcome data within the SAIL Databank including clinical codes that identify suspected and confirmed COVID-19 cases. We will report rates of suspected and confirmed COVID-19 infections and key health outcomes including mortality and explore variation (by factors such as age, sex, ethnicity, deprivation quintile, rurality, employer, comorbidities) using regression modelling, adjusting for clustering of outcome within Health Board, region and employer. A maximum variation sample of Welsh DCWs will be approached for qualitative interview using a strategy to include participants that vary across factors such as sex, age, ethnicity and employer. The interviews will inform the quantitative analysis modelling. We will generalise the quantitative findings to other UK nations.DiscussionUsing anonymised linked occupational and EHR data and qualitative interviews, the OSCAR study will quantify the risk of COVID-19 on DCWs’ health and explore sources of variation. This will provide a secure base for informing public health policy and occupational guidance.
Highlights
Domiciliary care workers (DCWs) continued providing social care to adults in their own homes throughout the COVID-19 pandemic
This study aims todelineate the impact of COVID-19 on domiciliary care workers through individual level linkage of occupational registration data to secure anonymised electronic health record (EHR) and administrative data for the Welsh population
Subsequent analyses focusing upon workers in social care present a mixed picture of the impact upon domiciliary care workers in the UK, probably due to differences in methodological approach
Summary
Domiciliary care workers (DCWs) continued providing social care to adults in their own homes throughout the COVID-19 pandemic. Domiciliary Care Workers (DCWs) form a substantial part of the UK social care workforce and are employed in both the public and private sector to support adults at home [? ]. Support provided by domiciliary carers varies but often includes personal care, which demands close contact between a DCW and the person being supported. ]. By June 2020, there were 19,637 registered DCWs in Wales, of whom 84% were female, 48% worked in the private sector and 44% had started in their current role within the last three years [? In England, most DCWs are female (84%), and most work parttime (54%), about half work on zero hours contracts (48%), are aged on average 44 years old, and staff turnover is high (35%) [? ]
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