Directly age and sex standardised admission rate for emergency admissions for acute conditions that should not usually require hospital admission per 100,000 registered patients, 95% confidence intervals (CI). March 2022 - The coronavirus (COVID-19) pandemic began to have an impact on Hospital Episode Statistics (HES) data late in the 2019-20 financial year, which continued into the 2020-21 financial year. This means we are seeing different patterns in the submitted data, for example, fewer patients being admitted to hospital, and therefore statistics which contain data from this period should be interpreted with care. Further information is available in the annual HES publication: https://digital.nhs.uk/data-and-information/publications/statistical/hospital-admitted-patient-care-activity/2020-21/covid-19-impact As of the October 2020 release, the CCG OIS is now published on an annual basis, as a result provisional data periods will no longer be published. The annual update will be based on finalised data for the April to March reporting period each year. As of the March 2020 release, the data included in the December 2019 publication for the 2018/19, July 2018 to June 2019 (Provisional) and October 2018 to September 2019 (Provisional) data periods has been revised. This is due to a revision of a large proportion of records for East Sussex Healthcare NHS Trust (RXC) which had missing information for the condition the patient was in hospital for and other conditions the patients suffer from. The revised data for these reporting periods also differs from that originally published in December 2019 in that the HES database is routinely updated (overwritten) on a monthly basis for the year in progress. Data for the two provisional periods remain provisional, but is now more complete than it was when the December 2019 publication was released. This effect cannot be readily separated from the effect of the East Sussex Healthcare NHS Trust (RXC) resubmission which also took place after processing for the December 2019 publication. Legacy unique identifier: P01844

The inequities of the COVID-19 pandemic were clear by April 2020 when data showed that despite being just 3.5% of the population in England, Black people comprised 5.8% of those who died from the virus; whereas White people, comprising 85.3% of the population, were 73.6% of those who died. The disproportionate impact continued with, for example, over-policing: 32% of stop and search in the year ending March 2021 were of Black, Asian and Minority Ethnic (BAME) males aged 15-34, despite them being just 2.6% of the population.

The emergency measures introduced to govern the pandemic worked together to create a damaging cycle affecting Black, Asian and Minority Ethnic families and communities of all ages. Key-workers – often stopped by police on their way to provide essential services – could not furlough or work from home to avoid infection, nor support their children in home-schooling. Children in high-occupancy homes lacked adequate space and/ or equipment to learn; such homes also lacked leisure space for key workers to restore themselves after extended hours at work. Over-policing instilled fear across the generations and deterred BAME people – including the mobile elderly - from leaving crowded homes for legitimate exercise, and those that did faced the risk of receiving a Fixed Penalty Notice and a criminal record.

These insights arose from research by Co-POWeR into the synergistic effects of emergency measures on policing, child welfare, caring, physical activity and nutrition. Using community engagement, a survey with 1000 participants and interviews, focus groups, participatory workshops and community testimony days with over 400 people in total, we explored the combined impact of COVID-19 and discrimination on wellbeing and resilience across BAME FC in the UK. This policy note crystallises our findings into a framework of recommendations relating to arts and media communications, systems and structures, community and individual well-being and resilience. We promote long term actions rather than short term reactions.

In brief, we conclude that ignoring race, gender and class when tackling a pandemic can undermine not only wellbeing across Black, Asian and Minority Ethnic families and communities (BAME FC) but also their levels of trust in government. A framework to protect wellbeing and resilience in BAME FC during public health emergencies was developed by Co-POWeR to ensure that laws and guidance adopted are culturally competent.

Two viruses - COVID-19 and discrimination - are currently killing in the UK (Solanke 2020), especially within BAMEFC who are hardest hit. Survivors face ongoing damage to wellbeing and resilience, in terms of physical and mental health as well as social, cultural and economic (non-medical) consequences. Psychosocial (ADCS 2020; The Children's Society 2020)/ physical trauma of those diseased and deceased, disproportionate job-loss (Hu 2020) multigenerational housing, disrupted care chains (Rai 2016) lack of access to culture, education and exercise, poor nutrition, 'over-policing' (BigBrotherWatch 2020) hit BAMEFC severely. Local 'lockdowns' illustrate how easily BAMEFC become subject to stigmatization and discrimination through 'mis-infodemics' (IOM 2020). The impact of these viruses cause long-term poor outcomes. While systemic deficiencies have stimulated BAMEFC agency, producing solidarity under emergency, BAMEFC vulnerability remains, requiring official support. The issues are complex thus we focus on the interlinked and 'intersectional nature of forms of exclusion and disadvantage', operationalised through the idea of a 'cycle of wellbeing and resilience' (CWAR) which recognises how COVID-19 places significant stress upon BAMEFC structures and the impact of COVID-19 and discrimination on different BAMEFC cohorts across the UK, in whose lives existing health inequalities are compounded by a myriad of structural inequalities. Given the prevalence of multi-generational households, BAMEFC are likely to experience these as a complex of jostling over-lapping stressors: over-policed unemployed young adults are more likely to live with keyworkers using public transport to attend jobs in the front line, serving elders as formal/informal carers, neglecting their health thus exacerbating co-morbidities and struggling to feed children who are unable to attend school, resulting in nutritional and digital deprivation. Historical research shows race/class dimensions to national emergencies (e.g. Hurricane Katrina) but most research focuses on the COVID-19 experience of white families/communities. Co-POWeR recommendations will emerge from culturally and racially sensitive social science research on wellbeing and resilience providing context as an essential strand for the success of biomedical and policy interventions (e.g. vaccines, mass testing). We will enhance official decision-making through strengthening cultural competence in ongoing responses to COVID-19 thereby...

Directly age and sex standardised admission rate for unplanned hospitalisation for asthma, diabetes and epilepsy in under 19s per 100,000 registered patients, 95% confidence intervals (CI) March 2022 - The coronavirus (COVID-19) pandemic began to have an impact on Hospital Episode Statistics (HES) data late in the 2019-20 financial year, which continued into the 2020-21 financial year. This means we are seeing different patterns in the submitted data, for example, fewer patients being admitted to hospital, and therefore statistics which contain data from this period should be interpreted with care. Further information is available in the annual HES publication: https://digital.nhs.uk/data-and-information/publications/statistical/hospital-admitted-patient-care-activity/2020-21/covid-19-impact As of the October 2020 release, the CCG OIS is now published on an annual basis, as a result provisional data periods will no longer be published. The annual update will be based on finalised data for the April to March reporting period each year. As of the March 2020 release, the data included in the December 2019 publication for the 2018/19, July 2018 to June 2019 (Provisional) and October 2018 to September 2019 (Provisional) data periods has been revised. This is due to a revision of a large proportion of records for East Sussex Healthcare NHS Trust (RXC) which had missing information for the condition the patient was in hospital for and other conditions the patients suffer from. The revised data for these reporting periods also differs from that originally published in December 2019 in that the HES database is routinely updated (overwritten) on a monthly basis for the year in progress. Data for the two provisional periods remain provisional, but is now more complete than it was when the December 2019 publication was released. This effect cannot be readily separated from the effect of the East Sussex Healthcare NHS Trust (RXC) resubmission which also took place after processing for the December 2019 publication. Legacy unique identifier: P01833