Councillors and committees

Agenda item

COVID-19 LOCAL OUTBREAK CONTROL PLAN UPDATE

The report details progress on Surrey’s Local Outbreak Control (LOC) Plan which was published on 30 June 2020, including key outcomes and milestones to date, challenges and next steps going forward.

 

Minutes:

Witnesses:

 

Ruth Hutchinson - Director of Public Health (SCC)

Jane Chalmers - COVID Director, Surrey Heartlands Clinical Commissioning Group

 

Key points raised in the discussion:

 

1.   The Director of Public Health introduced the report highlighting the new national restrictions announced by the Prime Minister of the United Kingdom on 22 September 2020, noting the ever-changing situation. Although large announcements were made nationally on a frequent basis, there were often other policy changes weekly and it was the job of the Public Health team to keep on top of the guidance and incorporate it into Surrey’s Local Outbreak Control Plan (LOCP) - updated at least fortnightly.

2.   She explained that a key part of the LOCP informed by the data and intelligence was the Escalation Framework based on a RAG rating (red, amber and green). At one end was outbreak prevention and containment - light green - which was being done all the time and was based on test positivity and cases per 100,000, as well as raised local alertness - dark green - and in the middle when cases started to escalate and that tipped over to raised local concern - amber. At the other end the red category of national oversight was splits into three sub-levels: area of concern such as Spelthorne, area receiving enhanced support and an area requiring intervention.

·      The Escalation Framework was based on national COVID-19 Contain Framework and detailed the triggers, how and who to notify, what the communications were, what the role of the SLRF was, what do when there was an outbreak, the deployment of testing across different settings and enforcement. 

3.    The Director of Public Health noted that Spelthorne was put on the national COVID-19 watchlist on 18 September as an area of concern and an announcement was due at 11am today on whether it remained, as the rates were slowly decreasing. She would keep the Board updated of Spelthorne’s status.

·         She thanked Board members for their support and colleagues in primary care and GPs who within a number of hours texted all their patients in Spelthorne to alert them to the borough as an area of concern. She also noted the concentrated effort across Spelthorne from the environmental health team who worked closely with businesses - particularly in hospitality - as well as the work of the IMT through partnerships with schools, grassroots sport and children’s sporting groups, and reaching out to public health teams in the surrounding area.

4.      Regarding local legal powers, she explained that:

·         There was now a process in which the Chief Executive and the Director of Public Health at Surrey County Council could issue a direction under the new Health Protection (Coronavirus, Restrictions) (England) (No.3) Regulation 2020; which extended the powers of Local Authorities who could close individual premises, public outdoor spaces, and prevent specific events - such as the Ocean Village Boat Show 2020 and Boats 2020 in Southampton cancelled due to being an imminent threat to public health.

·         There was a local legal Process Guide signed off by partners including district and borough councils relating to steps to be taken before a direction on the closure of premises could be sought. As well as an COVID-19 events checklist for application to events which had dissuaded many organisers.

5.    She commented that since the last Board the concept of local contact-tracing was new. Initially anyone that received a positive test result would receive a phone call or text from the national NHS Test and Trace service asking who the individual had been in contact with so they could be asked to self-isolate - around 82% of Surrey residents responded to and were processed by that service compared to 50% in other areas. Local contact-tracing meant that Local Authorities would receive the data of those not able to be contacted in twenty-four hours by the national contact-tracing service and were given local responsibility to contact those individuals. Evidence suggested that local numbers were more trusted.

·         As Spelthorne was on the national COVID-19 watchlist, Surrey had been put forward as the first region in the South East to develop that local contact-tracing service. It was hoped to be developed in three weeks’ time in collaboration with Surrey County Council’s Customer Services team.

6.    She highlighted that preventative activity was established in educational settings such as early years and schools, but particularly in universities of which there were three larger ones in the county with over one million students and so it was a high-risk situation and concern to local residents. Over the summer the Public Health team had been liaising with those universities which all had protocols in place based on national guidance and standard operating procedures. Local testing sites had been secured at the Royal Holloway, University of London and the University of Surrey. Challenges however included managing the night-time economy, the recent 10pm closing time for pubs and restaurants was a concern as there could be an increase in house parties and mental health issues might increase as a result of social isolation.

7.    She noted that COVID-19 champions were being newly introduced in Surrey and would be piloted shortly in Spelthorne and thanked the Cabinet Member for Adults and Health for her help. Those champions were trusted members of communities trained to give out reliable messages which reinforced Surrey’s communications campaigns.

8.    She also highlighted the COVID-19 marshals who were normally paid individuals that worked in town centre environments, Epsom and Ewell had marshals in different guises. The SLRF’s Tactical Co-ordinating Group (TCG) was working with district and borough councils to explore the use of COVID-19 marshals and the Public Health team wereawaiting further guidance from the Government on their role. There was a possibility that some of the Government’s funding based on the 2020/21 Public Health Grant allocation could be used to support the marshals.

9.    The Director of Public Health noted the new Test and Trace Support payment of £500 for those on lower incomes who cannot work from home and have lost income as a result. Local Authorities were expected to set up this self-isolation support payment scheme and be in place by 12 October.

10.  The COVID Director, Surrey Heartlands Clinical Commissioning Group stressed that COVID-19 testing was a complex area and test accessibility was a frustration to residents and Members especially concerning essential workers who fell under pillar 2 and the National Self-Referral Portal.

11.  She described the different pillars relating to testing and which could be influenced locally compared to areas driven by a national process.

·         Pillar 1: swab testing of hospital patients and staff, using NHS hospital or PHE labs.

·         Pillar 2: swab testing for the wider population and was split into different parts -

- The majority of testing in the pillar was part of the national process, accessed via the National Self-Referral Portal and tests were analysed and results produced by UK Lighthouse Labs. As such it is a commercial operation and there was no local control over the process.

- Conversely, Surrey had local control over and was managing the regular testing in care homes, aided by the local Health Protection Team. The SLRF’s Testing Cell processed requests for testing which were sent to a local lab and shared with the care home in question.

- Locally, Mobile Testing Units (MTUs) can be deployed routinely, planned in advance or at the request of the Public Health team such as to areas of concern like Spelthorne.

·         Pillar 3: anti-body testing, which was locally run and managed in the SLRF’s Testing Cell, with local labs used to process the tests. There was also local control over managing the deployment of clinics and MTUs for health and social care staff.

-  The Director of Public Health commented that where MTUs were deployed in areas where there was a rise, that rate would increase further with more testing and so deployment was effective.

·         Pillar 4: blood and swab testing for national surveillance run by the Office of National Statistics and supported by PHE and research and scientific partners.

12.  The Chairman agreed that the access to and speed of testing administered through national processes was frustrating and the hoped that it would improve with more testing kits available. He added that locally, the Public Health team and partners had done what they could and the SLRF continued to lobby the Government on testing.

13.  The Vice-Chairman commented that COVID-19 champions were a good initiative and noted that there were many local influencers in Surrey who were active in the first wave and on social media. He asked what the Board and district and borough councils could do to support the Public Health team and SLRF to identify both the COVID-19 champions and marshals. In response the Director of Public Health noted that she would welcome support from the Board to help identify those individuals and she had asked the lead of the group concerning the pilot on COVID-19 champions in Spelthorne to circulate the key messages to the Board and district and borough councils.

-     Regarding the COVID-19 champions, the Cabinet Member for Adults and Health commented that there had been a positive response from key community members in Spelthorne who wanted to be more engaged and that the Board’s feedback and help was invaluable. She added that it was a good initiative and example of best practice from other Local Authorities. 

-     The Chairman concluded that he welcomed the summary from the lead of the group concerning the Spelthorne pilot and that it would useful to also circulate it to the Surrey Leaders Group and the Surrey Chief Executives. He added that the work in Spelthorne had been brilliant and it would be good to get that proactivity in Elmbridge and Runnymede where cases had been rising.

 

RESOLVED:

The Board:

 

  1. Noted the report.
  2. Would continue to provide political oversight of local delivery of the Test and Trace Service.
  3. Would continue to lead the engagement with local communities and be the public face of the local response in the event of an outbreak.
  4. Members would ensure that appropriate information on the programme and on COVID-19 in Surrey was cascaded within their own organisations and areas of influence.

 

Actions/further information to be provided:

 

  1. The Director of Public Health would keep the Board updated on Spelthorne’s status, whether it was to be removed from the national COVID-19 watchlist shortly.
  2. Board members are encouraged to help the Public Health team and SLRF identify both COVID-19 champions and marshals.
  3. The Director of Public Health will liaise with the lead of the group concerning the pilot on COVID-19 champions in Spelthorne to circulate a summary of the key messages to the Board, district and borough councils as well as Surrey Leaders Group and the Surrey Chief Executives.

 

Supporting documents: