Agendas, Meetings and Minutes - Agenda item

Agenda item

Covid-19 Impacts

Minutes:

Matthew Fung, Consultant in Public Health, led the Board through a presentation of the key impacts of COVID -19 on Worcestershire and the Joint Strategic Needs Assessment (JSNA) Review. He also set out the findings of the National Public Health England (PHE) reports on COVID -19 and Black, Asian and minority ethnic (BAME) Groups and its COVID -19 disparities review.

 

Up to 28 June there had been 2,332 confirmed cases of COVID-19 in Worcestershire. This figure had been obtained from Pillar 1 testing, those identified through clinical need and Pillar 2 testing in the wider community. The analysis of the first 1,034 confirmed COVID-19 cases tested up to 20 May had shown that there were slightly more cases in acute care compared to within the community, with a peak of hospital patients at 141. The demographic data revealed that the median age of those affected was 77 years, and for those who had died, 81 years. The split between male and female was roughly even, compared to the national situation where men formed a much higher percentage of those affected by COVID-19. Within this first 1,034 cases, it was reported that sadly there had been 299 deaths, a mortality rate of 29%. In terms of COVID cases by ward, details of the 10 wards with the highest number of cases were provided and it was observed that wards in deprived areas were slightly over-represented. Matt advised that this data would be tracked going forward and merged with other data sets to enable more detailed analysis.

 

In terms of the PHE report on the disparities in the risk and outcomes of COVID-19, the key risk factors were considered including age, sex, deprivation, ethnicity,  care home residency and co-morbidities. These would be the risk groups that the Board would need to keep in focus going forward. A further PHE report on the impact on BAME groups identified inadequate reporting of ethnicity data as a major issue and had recommended mandatory comprehensive and quality ethnicity data collection and recording as part of routine NHS and social care collection systems. Matt commented that some of the areas for improvement identified in the report relied on having a clear understanding of the ethnicity data at the outset.

 

The Board was informed that work was required to ensure that the Joint Strategic Needs Assessment (JSNA) was updated in light of COVID -19 and the ongoing risks it presented to the population. The initial thinking on a ‘Retain, Rethink, Retire’ basis was shared with the Board. As part of the JSNA reset collaborative work, it would be important to carry out a Health Improvement Assessment in Worcestershire, a framework for which was provided. The Board also received details of suggestions as to how local authorities and their partners could seek to mitigate the impact of health inequalities at a local level. Any help or support that partners could offer to mitigate the impact of health inequalities in their local area would be welcomed.

 

Board members raised a number of issues and queries which were responded to as follows:

 

·         In terms of the Wards with the highest number of COVID-19 cases, Matt was unclear why Bedwardine was one such ward, but through further analysis of the data, a reason might become apparent. They would repeat the hot spot identification over time as well as factoring in any concentration of cases in care homes. It was highlighted that many people were asymptomatic with COVID, so it was clear that many more people were likely to have had the virus than shown in the figures.

·         The BAME data for the County’s health and care services had evolved over time and was patchy and inconsistent in places. It was reported that the data relating to the COVID cases in Worcestershire to the end of June contained no details on ethnicity, although this had now started to be included. It was vital that there was a clear commitment to undertaking the PHE report’s recommendation to ensure comprehensive and quality ethnicity data was available going forward.

·         It was agreed that the Board supported taking action to obtain all relevant data and to use this to react appropriately

·         Census information, although now 9 years old provided some direction to areas where there were higher levels of ethnic difference in the population. With regard to the migrant workforce and risk assessment in relation to inequalities, the Board was informed that the local authorities were working with partners, including Regulatory Services, to gather information on this workforce. They were also proactively engaging with those communities providing accessible information and advice.  Working in partnership was important in being able to address this.

·         The ‘live’ nature of the JSNA was welcomed allowing changes to be made throughout the year and it would be helpful in the commissioning process for use by the local authority and CCG’s.

·         Peter Pinfield referred to a letter Healthwatch had sent to the Director of Public Health on the PHE disparities review in which they sought information on the situation in Worcestershire. The Director of Public Health advised that accurate data collection was key to this. She highlighted, for instance, that in terms of care home residents, there was now a comprehensive support system around care homes with positive engagement and a much better understanding. This would be continued and developed going forward. The Cabinet Member with responsibility for Adult Care suggested that the content of Healthwatch’s letter might best form part of a later review stage.

 

RESOLVED that the Health and Well-being Board:

 

1.    Noted the contents of the report and presentation and the National Public Health England (PHE) reports on COVID-19 and black, Asian and minority ethnic (BAME) groups and COVID-19 disparities review.

2.    Committed to act on reducing health inequalities, including recommendations from the aforementioned PHE reviews.

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