Agenda item

This report will provide an update on the Local Outbreak Control Plan (LOCP) including top-level outcomes of recent stress tests made since the last update.

Discussion:

The Board considered an update on the Local Outbreak Control Plan (LOCP), which was introduced by the Director of Public Health. The Director of Public Health assured the Board that the infection rate in Kent and Medway was now lower than the national and south east average and he reflected on the success of the asymptomatic testing programme. He did, however, express that continued adherence to government guidelines was important and he advised the Board that the government would announce the route out of lockdown on 22 February 2021.

The Board raised several comments and questions, which included:

Vaccination roll out – in response to concerns around the planning and pace of the vaccination roll out in parts of Medway, particularly Strood Rural and the Peninsula, the Board was advised that the target to offer the vaccine to all eligible individuals within the top four Priority Groups had been achieved. It was acknowledged that the vaccine programme in Strood Rural and the Peninsula started later as it took time to mobilise local resources. It had since moved at pace and the data indicated that the coverage was now very high.

A small number of housebound individuals were initially unknown to health services, but these individuals had since been offered a vaccine and were being proactively engaged. A reconciliation meeting was due to take place on 16 February 2021 to identify individuals yet to receive a vaccine and regular discussions were had with the local MP in this regard. The Managing Director MCH undertook to liaise with the Member outside of the meeting concerning specific issues.

It was explained that the Public Health team had supported NHS colleagues with a targeted approach and generally a positive reaction had been received within the community; several charities had helped to support individuals who were housebound to access their vaccine. The Director of Public Health outlined scenarios where individuals might not be eligible for a vaccine and also undertook to investigate any specific queries outside of the meeting. He referred to the national booking service (online and telephone) and encouraged eligible individuals who had not been vaccinated to use this service.

Board Members were assured that now the infrastructure was in place to support vaccine delivery, there should be no undue delay going forward. The Kent and Medway CCG representative undertook to provide Members with data relating to the vaccination coverage once the final national figures were available.

A view was expressed that in due course any issues around cooperation of health institutions should be addressed by the NHS accordingly. It was acknowledged generally that lessons would be learnt, and this was due to be discussed at the reconciliation meeting. It was requested that Board Members receive an update on lessons learned at a local level together with the aforementioned data on vaccination coverage. A request was made that this be shared with all elected Members.

Schools reopening – in response to a concern expressed around increasing virus transmission rates when schools reopen, it was explained that the aspiration was that schools would open on 8 March 2021 and safeguards would be put in place to protect staff and pupils, including symptom free testing. It was added that a vaccination trial was underway elsewhere in the country for children aged 6 to 17 and the findings were due imminently.

It was explained that notwithstanding the impact of the more transmissible variant of the virus, the biggest impact to schools before the most recent national lockdown related to business continuity rather than transmission among children and young people. The greatest risk of transmission was from children and young people travelling to and from school, which was why keeping community transmission as low as possible was very important. There would be a clear communications strategy in response to schools reopening.

Fraudand communications – in response to concerns in relation to increasing incidences of vaccine fraud, Board Members were collectively asked to clearly communicate ways individuals would be contacted to receive their vaccine.

Indeed, a view was expressed that there had been a perception of poor communication in some areas of Medway as Priority Groups had been offered the vaccine at different rates in neighbouring localities. It was acknowledged that there were lessons to be learnt in terms of communication. In the early phase of the vaccination roll out, a key issue was that different vaccine services were approved at different rates and therefore came online at a different rate. It was explained that individuals would be contacted by their GP/Primary Care Network or they would receive a letter from the national booking service. As was the case recently, if individuals felt that they had been missed, they would be encouraged to come forward at a later stage. It was considered that now services were in place, there would not be a differential in vaccine offer between neighbouring places going forward.

Targeted vaccine programme in care homes – this programme was highly commended. Vaccine roll-out was monitored and over 90% of residents in older people’s homes in Medway had been vaccinated and the numbers were nearing this figure for working age adults. All the care homes in Medway had reported on a weekly basis they had no concerns about staffing, including the 22 domiciliary care agencies working within the community. It was acknowledged that supporting good mental health in care homes was a priority and discussions were ongoing about how visiting could safely return.

Test and Trace – in response to a question about the effectiveness of Test and Trace, it was explained that Medway had a 90% follow up and completion rate, anything over 80% was considered very good according to SAGE (Scientific Advisory Group for Emergencies). This was important to bring down infection rates. The Director of Public Health encouraged elected Members to urge their constituents to proactively respond if contacted by Test and Trace.

Asymptomatic testing – in response to questions about changes to uptake and the future of asymptomatic testing, it was explained that asymptomatic testing would continue. It would be scaled up or down according to risk. It was anticipated that the priority areas for testing would be set out by the Government. The uptake of asymptomatic testing had reduced owing to recent inclement weather, but this had since increased. There was capacity to offer testing to high-risk groups, for example key workers, and to the wider local population. A reduction in the quality of impact had not been identified. It was explained that as the disease prevalence reduced over time, the emphasis on testing would need to adapt.

Support for BAME communities – asked what action was being undertaken to encourage and support individuals from BAME groups to take up vaccination and what more could be done, the Director of Public Health explained that it was important that people were informed about the benefits of having the vaccine. COVID Champions had engaged with the community in this regard to deliver positive messaging about vaccination. Several cross-organisational meetings were also being held to look at ways to support vaccination uptake. Based on the data currently available, there was no evidence of a substantial shortfall in vaccine uptake in any BAME group.

Workforce – It was noted that the workforce delivering the COVID-19 vaccine contended with 10% sickness absence rates and had been on the front line of the crisis since March 2020. Their contribution was commended. A concern was expressed in relation to future workforce issues in the light of the pandemic in terms of recruitment and retention of staff. It was suggested that the Board receive a future update on the sustainability of the workforce in the health sector nationally and in Medway.

Decision:

The Health and Wellbeing Board:

a)    noted the update presented in the report,

b)    requested an update on lessons learned at a local level and data relating to the vaccination coverage.