This report provides an update on the Local Outbreak Management Plan (LOMP) including top-level outcomes of recent stress tests made since the last update was presented to the Board on 16 February 2021.
The Board considered an update on the Local Outbreak Management Plan (LOMP), which was introduced by the Director of Public Health. The Board’s attention was drawn to a request made by the Department of Health and Social Care (DHSC) to submit a revised LOMP. This was submitted before the deadline of 31 March 2021 and positive feedback had been received.
It was acknowledged that, generally, there had been a sharp reduction in COVID-19 prevalence, however there was a need to be cautious as progress was made along the Government’s roadmap. Work was ongoing to support easing of restrictions and the LOMP provided the framework for this to happen safely in collaboration with partners.
With reference to additional surge testing in South London, the Board was assured that emerging issues were monitored, and testing could be quickly stepped up in Medway, as required. The Board’s attention was drawn to the successes of the asymptomatic testing programme; over 128,000 Medway residents had been tested. A proactive outreach programme continued to encourage Medway residents to take up the offer of testing and indeed vaccination. The Board was updated on the vaccination programme.
Reflecting on the challenge of pupils returning to school on 8 March 2021, the Board was advised that this had been well managed. There had been some increase in cases of infection in pupils aged 13-17, however, this was expected given the extra testing being undertaken. Corresponding cases of infection in households had not been evident. Infection rates had also since decreased.
In response to a request for more publicly available and detailed information on (1) the changes made to the LOMP, (2) the additional information provided by the Government following the review and (3) the results of ongoing risk management stress testing on the LOMP, the Board was advised that given the sensitive nature of some of the operational content, not all information could be shared in the public domain. However, a public facing version of the LOMP was due to be published on the Council’s website imminently and an undertaking was given to share this with the Board Member.
Regarding Government feedback on the LOMP, it was explained that most of the Government’s queries related to information already held elsewhere. The information was provided as points of clarification and together with the LOMP was assessed against the Government’s framework. The Government were assured of the LOMP.
With regards to risk management stress testing, it was explained that this was an iterative process. The LOMP was a live document, revised daily in response to emerging issues. The Director of Public Health undertook to discuss the detail further with the Board Member outside of the meeting.
In response to concerns around complacency in the wake of the COVID-19 vaccination programme as restrictions eased and owing to testing, the Director of Public Health explained that whilst much of the population was vaccinated in key, at risk, groups, there would still be cohorts of individuals who could be infected. Also, asymptomatic testing was a useful tool, but it would not prevent infection. He urged all individuals to continue to adhere to social distancing rules, ensure good hand hygiene and wear a face covering. The Director of Public Health encouraged Board Members to continue to share this message. A cultural shift was needed to ensure these actions were commonplace. It was expressed that whilst we could be cautiously optimistic, national modelling showed that there would likely be an uptick in infections and NHS activity linked to the relaxation of restrictions.
The Board was assured that from a management perspective, work continued. The Local Resilience Forum continued to meet as did several other groups, including the Health and Social Care Cell, the Health Protection Board and the Testing Cell. It was explained that the Communications Cell refreshed messaging on a regular basis and utilised several channels to maintain awareness and reach target cohorts, such as young people. As required, enforcement tools were available should they be needed.
With reference to a recent example where national access to vaccination for those aged 45+ opened and the timing of communication about walk-in vaccine availability at the Pentagon Centre, Chatham for 50+ individuals only, a question was posed about joining up communications and ensuring ease of access. In response, it was explained that pandemic management was dynamic. Often local areas needed to react quickly to Government direction which might cause unintended consequences. The Board was assured that lessons were learnt in this regard. The Board was advised that the Pentagon Centre had been added to the national website for vaccination booking that afternoon.
Asked whether detailed feedback would be provided on lessons learned during the COVID-19 pandemic, it was anticipated that there would be a broad national evaluation which Medway could feed into. Locally, regular debrief meetings were held to ensure that any necessary improvements were identified and implemented quickly.
In response to concerns about accessing primary care services, particularly in areas affected by vaccination delivery in the Strood Rural and Peninsula areas, the Kent and Medway CCG representative undertook to revert to the Board Member outside of the meeting. More generally in relation to the future of primary care and community services, it was explained that a model for sustainable delivery of these services was under review to ensure that they were not compromised whilst ongoing vaccine/booster delivery was undertaken.
Asked when primary care would return to its ‘normal’ state based on the Government’s roadmap, it was explained that the roadmap focused on easing restrictions to offer a route back to a more normal life. In some cases, delivery of NHS services had altered in response to the COVID-19 pandemic, and it was unlikely that the existing models of delivery would return. This should be considered positively. The Board was advised that the ICP, and MCH as one provider in particular, had focused on learning lessons from what had gone well and not so well during the pandemic to help shape service restoration and recovery to a new ‘normal’ whist ensuring staff maintain their resilience.
A concern was expressed, generally, about poor access to GPs in Medway before the COVID-19 pandemic which had been exacerbated during the pandemic. A suggestion was made that this matter be added to the Board’s work programme.
It was acknowledged that it had been an extraordinary year, which had created backlogs and pressures on service systems which would take some time to clear. Work was ongoing to ensure that services were prioritised to deal with critical issues and there was a renewed focus on supporting the most vulnerable populations and on addressing health inequalities. The Board was advised that Medway Council’s Director of Public Health would lead on Population Health Management across Kent and Medway. The Board was assured that work was ongoing in relation to wider determinants of health and prevention. It was suggested that the Board might want to discuss primary care under agenda item 8 (NHS White Paper the Future of Health and Care).
The Health and Wellbeing Board:
a) noted the update presented in the report,
b) noted that a public facing version of the LOMP was due to be published on the Council’s website imminently and agreed to request that this be shared with Board Members.