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We Must Never Let This Happen Again. But Words Alone Will Not Prevent It.
From the COVID-19 frontline to a lasting commitment to prevention: why These Hands Academy exists, why we continued when the national programme ended, and why nobody should deteriorate unnoticed.
By Tara Marshall, Registered Nurse, Founder and CEO, These Hands Academy
Two roles. Two perspectives. One determination to change things.
During the COVID-19 pandemic, I found myself working what felt like two jobs, in two very different parts of our health and care system.
One was at the end of an intensive care bed, working as a nurse, caring for people who were critically ill and witnessing first-hand the devastating consequences of COVID-19.
The other was leading the regional Managing Deterioration Programme through the Eastern Academic Health Science Network, working remotely with care homes to recognise the early signs of deterioration and support teams to respond before someone reached crisis point.
In one role, I was caring for people at the point of crisis. In the other, I was working to prevent them from reaching it.
That contrast has never left me.
I saw extraordinary dedication and compassion across both health and social care. But I also saw the gaps between services, the challenges of communicating concerns and the consequences when changes in someone's condition were not recognised or acted upon early enough.
Why did we wait for people to become seriously unwell before mobilising our expertise? And why did those who knew someone best, care workers, families and the people receiving care themselves, so often struggle to have their concerns heard?
Those questions became the driving force behind These Hands Academy.
Not because we needed another technology supplier or training organisation, but because we needed to bridge the gap between what we know can make a difference and what actually happens in everyday care.
Above all, I wanted to ensure that nobody deteriorates unnoticed.
The COVID-19 Inquiry: why the lessons must lead to action
On 20 October 2026, the UK COVID-19 Inquiry published its findings on adult social care. The report describes failures in pandemic preparedness, hospital discharge arrangements, workforce protection and communication, alongside the profound suffering experienced by residents and families separated from loved ones.
For those of us who worked through the pandemic, these findings are not simply words in another report. They represent people, families, colleagues and experiences that will never be forgotten.
This must never, ever happen again.
But never again must mean more than better preparations for another pandemic. It must mean valuing social care now, listening to people now and creating stronger connections between services before the next crisis.
We had already begun to demonstrate what was possible
During the pandemic, our regional Managing Deterioration work demonstrated how simple clinical tools, telehealth and workforce development could support earlier recognition and intervention.
In 2022, Caroline Angel and I published Remote Monitoring in Care Homes: A Case for Transformation through the AHSN Network. Our evaluation across 33 residential care homes, representing approximately 1,600 beds, identified estimated savings exceeding £200,000 over six months, alongside staff-reported improvements in clinical responsiveness and confidence.
Additional research with Amy Dolben, Digital Deterioration Monitoring Tools in Care Homes, examined the challenges of embedding technology into everyday practice.
Together, these papers reinforced something fundamental: technology could support change, but sustainable improvement depended on understanding people, their working environments and the systems surrounding them.
Why should prevention end when the pandemic does?
As the emergency response to COVID-19 ended, the national programme supporting much of this deterioration management work also came to an end.
But frailty did not disappear. Long-term conditions did not disappear. Nor did avoidable hospital admissions or the challenges of communicating across organisational boundaries.
So, I founded These Hands Academy and made the decision to continue.
I wanted to take the learning, understand the barriers and build a sustainable model of proactive care that worked every day, not only during a national emergency.
That determination shaped our Connected Care Programme across Leicester, Leicestershire and Rutland and our amazing team behind it.
Working alongside care providers, local authorities and NHS partners, we brought together soft signs of deterioration, NEWS2, SBAR communication, telehealth, workforce development and ongoing quality improvement.
But it was never about how many devices we placed in care homes.
It was about what happened when a care worker noticed that something wasn't right. Did they have the confidence to raise their concern? Could they communicate it effectively? Would somebody listen and respond?
Our programme evaluations have recorded more than 80,000 clinical observations and 6,500 NEWS2 assessments, alongside reported improvements in workforce confidence, communication and avoidable hospital admissions.
The value extends far beyond financial savings.
Early recognition creates time. Time creates options. And options preserve choice.
Time to intervene, involve families, avoid unnecessary hospital transfers and support people to remain in the place they call home whenever clinically appropriate.
From local evidence to national learning and international recognition
Our experience has contributed to a collaborative Care England White Paper examining how the Connected Care Programme supports prevention, earlier recognition of deterioration and neighbourhood health.
It reinforces the value of a shared clinical language, workforce confidence and stronger relationships between care homes and healthcare services.
For me, the connection to the COVID-19 Inquiry could not be clearer.
Social care must not be the last part of the system to know. It must be an equal partner in recognising when something is changing.
Earlier this year, our work also received the Best Overall Integrated Care Award at ICIC26, through the International Foundation for Integrated Care (IFIC). This recognition reflected the importance of connecting people, services, technology and sustainable implementation; I felt I'd come home.
On 3 November 2026, I will be sharing our learning at IFIC's Community-Enabled Integrated Care Special Interest Group webinar, joining colleagues from the UK and Flanders to explore how communities can move beyond involvement towards genuine influence, agency and shared authority.
Because integrated care is not simply about connecting organisations. It is about ensuring those closest to care can help shape what happens next.
What next? Turning lessons into lasting change
For These Hands Academy, the next chapter is about making the learning, evidence and experience from Connected Care accessible to more organisations.
Through our Impact Hub, we are making CPD-accredited deterioration management learning available to care teams, strengthening the confidence to recognise changes, communicate concerns and take appropriate action.
Through our independent Rapid Evaluation, we are helping organisations understand why investments in technology and improvement do not always translate into meaningful outcomes, bringing the authentic voices of frontline staff, managers and providers into that evaluation.
And through our continued Connected Care implementation and improvement partnerships, we are supporting organisations to embed prevention and demonstrate measurable, sustainable change.
These are not separate ambitions. They are different ways of addressing the same challenge: closing the gap between what we know works and what actually happens in practice.
Every person has a voice. Every voice must be heard.
The COVID-19 Inquiry is a painful reminder of what happens when people, services and systems are disconnected.
At These Hands Academy, we work so that every person across health and social care has a voice, importantly, a voice that is heard.
The person receiving care who knows something doesn't feel right. The family member who recognises a subtle change. The care worker who notices what others may not see. The manager supporting their team. And the healthcare professional who needs the right information to make a timely decision.
Every one of those voices matters.
Our work is about creating the confidence, knowledge, connections and systems that allow those voices to be recognised, respected and acted upon.
From my experience at the intensive care bedside during COVID-19 to the work we do today, that belief has never changed.
We cannot undo what happened during the pandemic.
But we can choose what we do next.
Never again cannot simply be a promise. It must become a way of working.
That is why These Hands Academy exists. That is why we continued. And that is why we will keep going.
Because every voice deserves to be heard, and nobody should deteriorate unnoticed.
Turning lessons into action
These Hands Academy works independently alongside care providers, local authorities, commissioners, NHS partners and technology organisations to turn prevention, workforce development and innovation into measurable everyday improvements.
Explore our Connected Care Programme, strengthen your workforce through the Impact Hub, or discover what our independent Rapid Evaluation could reveal about your organisation.
Simple. Direct. Impactful.
These Hands Academy: Bridging Systems and Staying Human.
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