Preparing for the pandemic: two universities discuss mental health support, outbreak plans and test sites

The universities of Keele and Staffordshire tell UB about how they will keep students safe during an unsettled term

Since the first reported outbreak of coronavirus at a UK university campus higher education has scarcely avoided the headlines.

Scrutiny piled on institutions, and their leaders, as the numbers soared. Earlier this week, in a statement to the House of Commons, universities minister Michelle Donelan confirmed that more than 9,000 students at 68 universities in England had tested positive for coronavirus since returning to campus. Many thousands more will be spending the next days and weeks in self-isolation.

The first weeks of the new academic year are usually ebullient; the images of halls of residence, with post-it note messages in the windows, told a different, gloomier story. The calls for a nationwide “circuit breaker” lockdown mount while ministers push cities and towns into tier 2 and 3 restrictions.

Without sounding like a broken record, the availability, speed and capacity to offer reliable testing is the number one priority
Dr Mark Bacon, Keele University

Two neighbouring universities in the West Midlands spoke at length to University Business about their work behind-the-scenes to prepare for the return to campus, and the second wave.

The universities of Staffordshire and Keele have forged a deep and special relationship since the pandemic struck. Separated by just four miles, they sit in the heart of the Potteries Urban Area of nearly half a million people.

“Keele and ourselves, particularly in this kind of area, have an incredibly close relationship,” Ian Munton, director of student services at Staffordshire University, tells us. “If it is possible, we probably overshare with one another,” he adds with a laugh.

His direct counterpart at Keele, Katie Laverty, adds: “We speak to each other frequently, whether to bounce ideas off of each other or to work with each other more formally.”

Katie and Ian have worked closely since Keele and Staffordshire jointly won a £750,000 grant from the Office of Students last year, one of 10 cross-sector mental health projects supported by the regulator. The universities work in partnership with the local police force, two councils, three NHS trusts and three college groups to open access to mental health provision.

“Start to Success tries to take a whole community approach: it’s about young people and students within the region,” Katie continues. “Because the focus is on mental health and well-being around transition periods in higher education, we had to adapt some of that project in response to Covid-19.”

Projects like theirs illustrate the extensive work universities across the country already undertake with the NHS and public sector organisations. No man is an island and, in this fraught climate, no institution can afford to be either.

Preparing for the pandemic: two universities discuss mental health support, outbreak plans and test sites 4
Keele University and Staffordshire University have worked closely together in preparation for the new term

Testing and tracing

Dr Mark Bacon, chief operating officer at Keele, has a simple message for the UK government. “Access, sufficient capacity, and diagnostic speed of testing will be critical to keeping the university operating without major disruption.”

We ask if the NHS track and trace service is the essential piece in the puzzle. He disagrees. “The ability to access testing, which delivers capacity and speed, is more important. We have a good institutional posture to trace and underpin any NHS request. We have our institutional requirements to monitor attendance in educational settings and our wider amenities, including the gym, library, all catering outlets, and places of worship. Without sounding like a broken record, the availability, speed and capacity to offer reliable testing is the number one priority.”

Responsibility for testing sites for the universities lies with different councils. Keele confirmed on 2 October that an on-site testing facility would open, following discussions with Staffordshire County Council (Staffordshire CC). Conversations to get the test site up and running started in mid-August. Before that, students booked a postal test kit.

Staffordshire University confirmed the opening of a testing site within a mile of its Stoke campus a week later. Formal confirmation from the city council took about five weeks. Before then, the nearest testing site was a drive-through site at the Bet 365 stadium, nearly three miles drive away. Most Staffordshire students do not have a vehicle, and those with severe symptoms would struggle to reach the drive-in centre on foot. Ian reports that some students walked to New Castle testing site, some six miles away from the university campuses.

The Higher Education coronavirus (COVID19) NHS Test and Trace handbook, published on 10 September, noted that: “Walk-through test sites are the preferred testing channel option for students due to their improved accessibility and fast turnaround of test results.” The government now expects “around 200 local test sites set to be running by the end of October”. In many cases, these sites will open weeks after students returned to campus.

Despite the wait, the new testing centre “will make a real difference going into the winter months”, Ian says. “The absence of a testing site has caused concern and anxiety. I think that our public health teams and council recognise that no less than us. But there are all kinds of logistical and political challenges to get those things in place.” He says the reports he has had from students suggest the availability of testing has improved. That anxiety is passing.

We’ve agreed that we will take on the role of track and trace for students. We have public health scripts that we’ve edited and amended for our benefit
Ian Munton, Staffordshire University

Staffordshire University staff had “anxiety” about the availability of testing ahead of the return to campus

On Friday last week, Staffordshire County Council (Staffordshire CC) ordered around 200 Keele University students book a coronavirus test, because of cases of Covid-19 in the student body. The council expects those Barnes Hall residents to take the test even if asymptomatic. The local public health team and university have moved to quash any outbreak as quickly as possible.

Staffordshire has taken on responsibility for tracking and tracing outbreaks in its student community. “We meet with the public health teams once a week,” Ian tells us, “and we’ve agreed that we will take on the role of track and trace for students. We have public health scripts that we’ve edited and amended for our benefit. There is a team of staff in place who are monitoring and analysing data from our live feeds.

“We provide the local public health team with a daily report, which gives an update on self-isolating students, symptoms and any positive cases that we have. That intelligence is shared as soon as we have it.

“There is a team responsible for monitoring incoming student web forms, which provide us with information on students that have symptoms and are awaiting a test, have received a negative test or are self-isolating.”

Ian is discussing the specialist Covid response team, which constantly monitors the information provided to it by students and the local public health team. They are supported by the Student Services team, which in turn is supported by university volunteers, who staff the Covid Q&A hotline for students in search of guidance. Some Staffordshire students have tested positive, but so far the university has avoided an outbreak.

“When a student tests positive or declares symptoms, a member of staff is attached to that student and their household,” Ian continues. “That staff member becomes the single point of contact for those students throughout their two-week self-isolation. Students complete a form, which is now attached to our system and Power BI. We can visualise the data in real-time. The data underpins auto-response messages to students, which explain the next steps on how to a self-isolate.”

“We think our system is scalable, although it puts pressure on our staff, our students must have human contact throughout: they will have guidance and continuity seven days a week. We also have a well-being coordinator who works through the night on Friday, Saturday and Sunday, which means Staffordshire can offer support at all hours of the week. All that data and work feeds into our silver command group, which has a direct link with our public health teams.”

It is a closed-loop of information sharing. It has yet to undergo the pressures of an outbreak, but Ian says the defences are as strong as they can be. Together, the two institutions form a triumvirate with the local public health team.

Preventing an outbreak

Each university has its approach to teaching and learning, with Keele relying on a five-tiered approach to campus operations and Staffordshire offering students 30% of teaching in-person. Both universities reduced occupancy rates at halls of residence to two-thirds of capacity. Staffordshire has restricted students from mixing households indoors – even if the number meeting complies with the government’s “rule of six”.

Different rules for “different sets of students” would undermine the approach taken by the university to minimise any risk of an outbreak, Ian says, adding that without simplicity and constituency “the message will never permeate”.

“How do we know that two people in a house of four are comfortable with two other people visiting? This is where a student household is completely different from a residential household and should be treated as such.”

Preparing for the pandemic: two universities discuss mental health support, outbreak plans and test sites 3
Keele University has prepared thoroughly to support students’ mental health this term, including extending on-call services and offering 24/7 support

The guidance from the government for universities reopening during the pandemic offered scant advice on student accommodation. Defining a household falls to a university in conjunction with Public Health England (PHE).

Staffordshire discussed with students the practicalities of self-isolation. The majority wanted regular supermarket deliveries. Staffordshire contacted Asda and arranged for a priority code for its students that guarantees delivery within 24 hours of an order. The supermarket deposits daily deliveries with the university to distribute among the flats and houses where self-isolating students reside.

Students at Staffordshire and Keele have respected the rules and regulations and infringements are rare, the two directors tells us. “We had one particularly group of students, who after self-isolating, organised a trip to the laundrette together. They told us how much they enjoyed it. That was their big trip out for the day,” Ian laughs.

Read more: Sir Keir Starmer: students tell Labour leader mental health impact of lockdown in halls

Supporting mental health

As we prepared the campus for students to come back, we wanted to make sure we did not leave any gaps in our provision. We wanted to avoid any assumptions about what people would need
Katie Laverty, Keele University 

During the first wave of the pandemic, Keele undertook a detailed survey of a group of students to understand what impact it was having on their mental health. Katie’s team repeated the process with the same group of students to understand any change over time. As the summer term drew to a close, Keele undertook a phone survey to hear from students their experiences of learning through the lockdown. The results helped Katie understand what more the university needed to do for students when they returned.

“Alongside those surveys, we have undertaken some specific persona work. As we prepared the campus for students to come back, we wanted to make sure we did not leave any gaps in our provision. We wanted to avoid any assumptions about what people would need. The persona work prompted us to think about all the situations and scenarios different student might experience. We tested what we were doing against these different personas we identified.

“Combined with the survey results, our work told us more about the barriers students might face when we returned in the academic year. It could be something as simple as lacking a quiet place to study or something as complicated as caring responsibilities.” Keele launched a Covid fund to help students who have lost employment or financial support from their families. Unlike its hardship fund, the quick-access fund removes the full application process for students who need money urgently.

Mental health referrals through the Keele anonymous online service All Together have risen. Katie says survey results indicate that many students have preferred to engage with mental health services through an online conversation. The university has a counselling and mental health team, resident advisors, a buddy scheme and resident advisors in place to help anyone that self-refers.

“We extended our on-call system through until midnight. We have made mental health support available 24/7. Students can book a virtual appointment with the mental health support team. We are offering some in-person services, primarily the quick access services, but students appear not to need that as much as we thought they would.

“We started very early on in the summer communicating with our new students about campus this term. We have all seen images of post-it notes in windows recently. We want to get the message across about what we are doing and the importance of it. But we also want to encourage students to seek support if something happens.”

It will be a difficult term, perhaps year, for students and staff, Katie and Ian tell us. Meeting students’ expectations will be hard, Katie continues, but there is no shortage of effort.

Read more: Michelle Donelan under fire during education select committee hearing

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