Is the adult social care outcomes toolkit (ASCOT) relevant to health protection teams? Development of an outbreak support tool

Background Outbreaks of infection in care homes can be mitigated by Public Health and Social Measures (PHSM) including isolation of cases, quarantine of exposed contacts, and shielding the most vulnerable. We aimed to assess the relevance and utility of Adult Social Care Outcomes Toolkit (ASCOT) in outbreak decision-making, with a view to reducing the adverse impact of control measures and informing pandemic planning. Methods We worked with health protection practitioners (HPPs) to determine the relevance of ASCOT domains to health protection. The domains were adapted into a ‘Wellbeing Checklist’ and piloted with 5 HPPs over 8 weeks, followed by a focus group to evaluate its impact. Results Use of the checklist depended on HPPs’ pre-existing communication styles with care homes. The checklist was considered more relevant to larger or longer-lasting outbreaks. Feedback confirmed the relevance of wellbeing to outbreak decision-making, but highlighted the need for a framework integrated with routine risk assessments. Conclusions The ASCOT domains have potential to enable explicit inclusion of wellbeing considerations in outbreak decision-making. ASCOT could be embedded in Health Protection Team outbreak advice and decision-making to help optimise quality of life outcomes. However, further development is needed to make the tool more practical for routine use.