Agenda item

Kathryn Cobain introduced the Item by reminding the Board that there was a requirement for all upper tier authorities to have an Outbreak Control Plan, which was a dynamic document.  The Board would receive quarterly updates, for assurance purposes, from the newly formed COVID-19 Health Protection Board and that this was the first report.  Rachael Leslie took the Board through the Agenda Report.

The COVID-19 Health Protection Board (HPB) had been formed in July 2020 and had met three times.  Membership included representation from a wide range of organisations, for example, Worcestershire Health and Care NHS Trust, Worcestershire Acute Hospitals NHS Trust, Worcestershire Children First, West Mercia Police, District Councils and Worcester University.  Attendance and engagement had been very good to date.

Each upper tier local authority was required to develop and publish an Outbreak Control Plan (OCP) by 30 June 2020, which was a dynamic document, public facing and available on the Worcestershire County Council website.  It had been updated twice, with version 1.3 published 3 September 2020.  It would remain a live document with web links to the latest dashboard data in relation to COVID-19 as numbers were published at least weekly.

The latest picture for Worcestershire was not unlike the picture nationally.  Cases were increasing, but not as rapidly as in other areas and there were different trends across the County.  The OCP had a link to District data, which showed a significant recent rise across Wyre Forest and Redditch.  For the week ending 25 September 2020, 206 new cases across the County were recorded, attributed, in the main, to household gatherings, workplace settings and a small number of schools.

The HPB also had oversight of the Local Outbreak Control Team (LORT), which was led by Public Health and included Officers from a number of work areas, including the Worcestershire Here 2 Help service.  The LORT was available seven days a week between 9am and 6pm to respond to cases across all settings and work to prevent outbreaks.  Since its creation in July, the LORT had been very busy and due to the rapid response had been successful in halting transmission in a number of cases.  Additional resource was being sought, primarily in administration support, in order to respond to increasing demand and the onset of other winter pressures.

Board Members were asked to continue to promote the main prevention messages around COVID-19 and encourage the take up of the flu vaccination across their organisations and networks.

The Board Chairman added that the HPB had initially met every two weeks, moving to a four weekly cycle.  It was felt that with cases increasing there may be a need to revert to meeting more frequently.  Membership included all District Council Leaders and if a case was confirmed, the relevant District and County Councillors would be informed.  Every week, the latest data was shared, which could then be circulated as appropriate.

In the ensuing discussion, Board Members asked a number of questions which were answered as follows:

·         Since 1 September, when all schools fully reopened, the LORT had received 477 notifications from schools, however, only a small number of these had resulted in a positive case.  Every school had a small supply of swabs, which could be replenished, and parents were asked to self isolate their child and book a test.  It was widely acknowledged that obtaining a test had its challenges, however, parents had been asked to persevere until a test could be obtained.  In early September, there had been some confusion about COVID-19 symptoms and further publicity through schools had been developed.  A small number of schools had resorted to closing ‘bubbles’, which was following widely published procedures

·         Winter Flu Vaccinations were in good supply and the number of people eligible for a free vaccine in 2020 had increased to include those aged over 50.  Professionals working in the health and social care sector, alongside those with underlying medical conditions, were particularly encouraged to get vaccinated early.  Herefordshire and Worcestershire Clinical Commissioning Group was actively encouraging residents to get vaccinated, through print, radio and digital channels

·         Worcestershire’s main COVID-19 Test Centre was now in the grounds of County Hall, Worcester, with all testing arranged nationally.  Officers were working with the national team to develop plans for each of the six Districts to have a ‘Walk In’ facility.  These would not be walk up, as an appointment would still be required, however, these centres would be accessible on foot.  Pop Up sites were also available and would be mobilised depending on local need.  Sites in Worcester City and Redditch had already been agreed and two potential sites in Bromsgrove were being actively assessed

·         Worcestershire County Council had been allocated £2.7m to deliver Test and Trace for the County and no additional funding was being sought.  The budget was overseen by the HPB and had been allocated through to 31 March 2021, although there was a little in reserve to assist in any localised activity.  It was unclear whether any carry forward was permissible, however, it could be demonstrated that the full allocation could be spent.  Although it was felt that the funding was reasonable, assurance was made that the County Council would approach central government if the need arose.  However, partners were being asked to consider releasing people from their substantive duties to increase administration capacity in the event of any surge.  It was hoped that each District could develop an Incident Management Team in order that any response was more localised.   

·         The two large scale, well publicised outbreaks, had been cleared and credit was given to the organisations involved for taking appropriate action

·         Worcestershire Acute Hospitals NHS Trust was a member of the HPB and conversations were taking place at least weekly in relation to acute bed capacity.  Patients who were medically fit for discharge were proactively being moved, in a safe way, to their Home or a more appropriate setting.  This would ensure that acute beds were available for those in need.  The Neighbourhood Teams were also working to proactively keep residents well at home to avoid hospital admission if possible

·         Praise was given for the multi agency approach to the pandemic and to the professionals for working together to provide the same message.  Everyone acknowledged that the learning from the first wave was informing action now

·         The ‘NIMROD’ case management system had been developed and built by the County Council’s digital team and enabled the LORT to upload and share information in a secure way.  The nationally commissioned COVID-19 App had been launched that week and all mobile phone users were encouraged to download and actively use it.  Premises and Transportation would have an individual Quick Response (QR) code, which residents would scan and if any significant close contact (within 2 metres for more than 15 minutes) was detected from a mobile phone user who subsequently tested positive, an alert would be sent to all relevant mobile phones with the appropriate advice for potential COVID-19 exposure.  The system relied on as many users as possible to break lines of transmission

·         Although there were numerous groups and teams involved in the governance arrangements for the OCP, some were temporary with the LORT providing constant immediate local response to complement the capacity from Public Health England.

RESOLVED that the Health and Well-being Board:

1.    Noted the development and delivery of Worcestershire’s Outbreak Control Plan, the arrangements for governance and the initial months of Local Outbreak Response Team (LORT) operation

2.    Considered the contribution that Health and Well-being Board partners can make to support surge capacity in the LORT.