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)

Dr Rachel Gill - Public Health Consultant (SCC)

Borough Councillor Maureen Attewell - Deputy Leader and Portfolio Holder for Community Wellbeing and Housing, Spelthorne Borough Council
Deborah Ashman - Joint Group Head of Community Wellbeing, Spelthorne Borough Council
Adam Letts - Public Health Lead - Public Health Improvement (SCC)
Jess Lira - Resilience Manager, Applied Resilience Limited

Avril Mayhew - Area Director East Surrey - Adult Social Care (SCC)

 

Key points raised in the discussion:

 

Local Contact Tracing Partnerships

 

1.    The Director of Public Health (SCC) explained that since 28 May 2020 anyone in England who received a positive Covid-19 test was automatically placed into the national contact tracing system and they and their contacts would be asked to self-isolate.

2.    She discussed that in order to be effective the Scientific Advisory Group for Emergencies (SAGE) recommended that 80% of positive cases must be reached by the contact tracers, that was not the case nationally, although Surrey’s contact completion rate was around 80%.

3.    She noted that as a result of the low completion rate, some areas such as Blackburn with Darwen set up local tracing partnerships and there was an expectation for all areas to establish one to supplement national contact tracing. As a result, a local contact tracing partnership was to be established in Surrey to contact the remaining 20% of contacts not contacted after the locally agreed timescale of twenty-four hours.

4.    She highlighted that the programme would be launched first for those boroughs and districts in Surrey that bordered London or had higher rates first, phase one was to go live on 26 November 2020 with the whole of Surrey to follow in phase two.

5.    She clarified that the Surrey Local Contract Tracing service would be delivered by Surrey County Council’s Customer Services team and Community Helpline staff. Staff would receive training and the Public Health team (SCC) would provide support due to the complexity of cases.

6.    She explained that it would be a phone-based service in which a text or phone call from GOV.UK Notify would alert individuals who had received a positive test to expect a call from a local geographical number or voicemail message if unavailable. When contact was made there would be a set questionnaire to establish that individual’s contacts and it was estimated to take one hour to complete.

7.    The Director of Public Health (SCC) noted that upon advice from established local contact tracing partnerships, welfare support and advice on financial assistance would be offered and that there was a potential to run the programme through door-knocking in the future.

8.    She emphasised that residents must continue to engage with the national contact tracing service and soft communications would be launched on local contact tracing via a press release, information on the programme including the phone number and FAQs would be on Surrey County Council’s website.

9.    The Director of Public Health (SCC) concluded that there were Data Sharing Agreementsin place with districts and boroughs to search relevant databases to access alternative phone numbers, as part of Information Governancethere were Privacy Notices, Data Processing Impact Assessments and access to PHE Power BI contact tracing data for daily downloads, and best practice would be shared at bi-weekly meetings of Public Health teams across South East.

10.  In response to a Board member’s query on the decision to launch a phone-based service rather than a hybrid with door-knocking, the Public Health Consultant (SCC) replied that local numbers had increased the success rate. Although initially to be launched via the telephone a hybrid approach would be looked at later on after the assessment of the phone-based service.

11.  The Director of Public Health (SCC) responded to a Board member’s suggestion of the benefit of speaking to all in household at same time rather than just the positive contact, by explaining that those in the same household as the positive contact would be contacted indirectly in line with the training. 

12.  A Board member highlighted the criticism of nationally scripted information, which was inflexible, in response the Director of Public Health (SCC) noted that there was ten hours of training for those supporting Surrey Local Contract Tracing. Despite the detailed script to follow, there was greater flexibility at a local level. 

13.  A Board member queried whether local contract tracers could be involved earlier in the process to support the national contact tracing service by contacting the secondary contacts during the initial national service contact tracing period. The Director of Public Health (SCC) explained that in the current framework the national contact tracing service contacted secondary contacts and she could share the summary of the process and flow chart for clarification.

 

David Munro left the meeting at 2.15pm and re-joined at 2.27pm

14.  A Board member suggested the possibility of using Covid-19 Champions and Covid-19 Marshals to aid local contact tracing such as through welfare support and advice on financial assistance. In response, the Director of Public Health (SCC) explained that there was a potential to use them in future door-knocking provision although extensive training including safeguarding was needed. She noted that Covid-19 Champions in Spelthorne could not be rolled out immediately due to training requirements and Data Sharing Agreements, and that was also the case with social prescribers. Such a layered approach with different partners was used in Stoke-on-Trent.

 

Covid-19 Champions

 

15.  The Chairman made a statement on Covid-19 Champions - see Annex C.

16.  The Deputy Leader and Portfolio Holder for Community Wellbeing and Housing, Spelthorne Borough Council introduced the Covid-19 Champions programme. As a result of Spelthorne’s placement on the national Covid-19 watchlist and the suggestion by the Cabinet Member for Adults and Health (SCC) - LOEB Chairman, Spelthorne was the first borough in Surrey to launch Covid-19 Champions.

17.  She summarised the key points of the programme’s initial stages:

·         research was undertaken on the programme launched earlier in other councils.

·         an information pack was created which included details on the role of Covid-19 Champions, a recruitment video, an online form to register details, and a privacy notice on how their data would be used.

·         the Public Health team (SCC) created a short training video and a welcome pack which included info on good practice and a code of conduct.

·         an information briefing sheet was created which covers five key points including Spelthorne specific and national updates as well as rotating themes such as wellbeing.

·         weekly virtual meetings were held with council officers, the Public Health team (SCC), and Covid-19 Champions were invited to discuss their experiences and good practice.

18.  The Deputy Leader and Portfolio Holder for Community Wellbeing and Housing, Spelthorne Borough Council explained that a targeted approach was adopted to recruit Covid-19 Champions, wide representation was sought from: different geographical areas, population groups including those most at risk, vulnerable, from deprived backgrounds or underrepresented communities such as BAME, as well as councillors and staff members, foodbanks, businesses, charities, Residents’ Associations and faith leaders.

19.  She noted the challenges faced including: ensuring the weekly information briefing was informative and concise, Spelthorne specific and that Covid-19 Champions were the first to hear key updates. There were also IT accessibility issues regarding virtual meetings, scheduling a suitable time and receiving questions in advance. She thanked the Public Health team (SCC) and the Chairman for their support.

20.  The Chairman thanked the Deputy Leader and Portfolio Holder for Community Wellbeing and Housing, Spelthorne Borough Council for her drive and commitment to the programme, the Joint Group Head of Community Wellbeing at Spelthorne Borough Council, the Active Lifestyle & Wellbeing Manager at Spelthorne Borough Council and the Senior Public Health Lead (SCC).

21.  A Board member queried how health as a stakeholder could help support the programme, such as through disseminating information to other GPs in Spelthorne and utilising patient participation groups and social prescribers. In response, the Joint Group Head of Community Wellbeing, Spelthorne Borough Council noted that as the programme had only been running for three weeks, active members of the community were incorporated primarily, and she welcomed future support from health and other colleagues to disseminate information through their networks.

22.  The Vice-Chairman noted that Reigate and Banstead Borough Council had launched a similar programme to Spelthorne, he thanked the support given from Spelthorne Borough Council and the sharing of lessons learnt and best practice. He noted that trust in communities was not universal, so it was key to harness trusted existing community groups, individuals and faith leaders to share key messages to their communities and particularly the socially isolated members. He emphasised that the programme created an opportunity for the future to continue as community champions and ensure the sharing of critical messages.

23.  A Board member noted that it was good to see the enthusiasm for the programme and what had been achieved in a short time and that the strong partnership work between Surrey County Council and the borough and district councils was vital. He queried how the effectiveness of the programme would be measured and if there was any feedback. In response, the Deputy Leader and Portfolio Holder for Community Wellbeing and Housing, Spelthorne Borough Council explained that there had been initial feedback from Covid-19 Champions and she was looking at any feedback on social media. She was pleased to share any further information that would be helpful for the other boroughs and districts.

-       The Joint Group Head of Community Wellbeing, Spelthorne Borough Council added that a success from the programme was that the Covid-19 Champions were distributed between wards ensuring tailored support.

24.  The Public Health Lead - Public Health Improvement (SCC) expressed his thanks to the Chairman and the Deputy Leader and Portfolio Holder for Community Wellbeing and Housing, Spelthorne Borough Council and the recognition of the future opportunities created post Covid-19 such as ensuring self-sufficient communities. He explained that the Covid-19 Champions programme was a voluntary scheme, it focussed on engaging with trusted local individuals and community leaders to empower and be the voice of communities and complemented existing county-wide and local communications campaigns. It was led by district and borough councils with technical support from the Public Health team (SCC).

 

Covid-19 Marshals

 

25.  The Resilience Manager, Applied Resilience Limited provided an update on emergency planning on behalf of all of Surrey’s boroughs and districts. She noted that the Covid-19 Marshals scheme was announced by the UK Prime Minister in September. Guidance had received by boroughs and districts, which then assessed what measures were needed on the ground as part of the compliance and enforcement mandate.

26.  She explained that there was a varied amount of work regarding the scheme and different names for the groups formed - Epsom and Ewell Borough Council was the first to establish Covid-19 Marshals, utilising existing members of staff. In essence, the marshals supported environmental health officers to gather intelligence from the ground and adopted the ‘four E’s’ initiative of Engage, Explain, Encourage minus Enforce. The role of the marshals was not to enforce but to support businesses with guidance, solve non-compliance and work with the environmental health officers and the police teams and police who used enforcement as a last resort.

27.  A Board member sought confirmation as to whether Surrey Police’s Borough Commanders were kept informed on the programme, and the location of Covid-19 Marshals in each borough and district so the two could work together - Surrey Police had also adopted the ‘four E’s’. In response, the Resilience Manager, Applied Resilience Limited noted that many of the county’s boroughs and districts were having weekly meetings with their Borough Commanders.

28.  A Board member queried if Covid-19 Marshals were linked into the discussions around using premises for Covid-19 mass vaccination. In response, the Resilience Manager, Applied Resilience Limited noted that there were points of contacts in district and borough councils looking at possible sites and marshals were on the ground in town centres and business areas rather than in particular premises.

-       The Deputy Leader and Portfolio Holder for Community Wellbeing and Housing, Spelthorne Borough Council reassured the Board that Spelthorne Borough Council had been active in identifying possible sites and would continue to do so.

 

 

 

 

Care Homes

29.  The Area Director East Surrey - Adult Social Care (SCC) noted that local authorities had received a grant via the Adult Social Care Infection Control Fund, which had been issued to care homes. The first round of that grant in the summer totalled £13.7 million and a further round of £15.8 million between October to December had been received. She explained that 62% of the grant would be ring-fenced to care homes and allocated on a per bed basis; the rest of the grant could be used flexibly to support other care providers.

30.  The Area Director East Surrey - Adult Social Care (SCC) gave some examples of how the grant could be used, for example: staffing - ensuring that they were fully paid when they were self-isolating or providing alternatives to public transport for staff to get to work, or providing alternative accommodation for staff when they chose not to stay with their families.

31.  Regarding infection control support, she noted that training had been rolled out across Surrey’s four hundred and ten care homes, through a mixture of face to face training and Personal Protective Equipment (PPE) demonstrations as well as online information and webinars. She added that all care homes should have a named care co-ordinator via the Primary Care Networks.

32.  She noted that the national PPE Portal had been extended to provide free Covid-19 related PPE to care homes and social care providers and locally, there were emergency supplies that care homes could access via the Surrey Local Resilience Forum.

33.  She noted that new guidance from the Department of Health and Social Care on designated settings required care homes to seek further Care Quality Commission (CQC) approval if they accepted individuals from hospital with a positive Covid-19 test status. The Adult Social Care team (SCC) was working with care providers and health colleagues to ensure that there were alternative pathways for people coming out of hospital who had a Covid-19 diagnosis.

34.  She explained that the new guidance released earlier in the month now encouraged care homes to facilitate safe visiting for families and loved ones.

35.  She noted that care homes should be able to access weekly testing via the national testing portal for staff and monthly for residents.

 

Winter Pressures

 

36.  The Area Director East Surrey - Adult Social Care (SCC) noted that regarding hospital discharges the coming winter would be a challenge due to the Covid-19 surge as well as the usual winter pressures. New national ‘discharge to assess’ requirements have been in place since 1 September 2020 meaning that anyone discharged from hospitals and needing care and support would receive this for up to six weeks and that this would be funded by the NHS. During that period, it was expected that social care and health colleagues would complete assessments of those people to determine their care needs and funding arrangements on an ongoing basis.

37.  She noted that the Adult Social Care team (SCC) was working with providers to ensure there was enough capacity in the care market via home based, residential and nursing care and that SCC staff in social care and wider independent social care staff were encouraged to have a flu vaccine.

38.  A Board member queried the pressures on hospital admissions in the second wave and sought reassurance of the plans in place. In response, the Area Director East Surrey - Adult Social Care (SCC) explained that each of the acute trusts and health providers had daily and weekly escalation arrangements to ensure that surge or bed capacity issues were addressed. She added that there was in-depth planning in relation to surge as data was collected on the numbers of beds available, admissions, patients in intensive care units and Covid-19 positive patients and was shared with Integrated Care Partnerships and other system partners.

-       A Board member provided reassurance that during the first wave the Royal Surrey NHS Foundation Trust (RSFT) had built a new twenty bed isolation ward to cope better with Covid-19 patients and that had been in full use. She noted that there had been fewer inpatients and fewer needing intensive care treatment during the second wave and that monthly Covid-19 reports from the public board were on the RSFT website.

39.  The Chairman noted that she had been reassured on PPE stock in the county and that the Board would keep an eye on Covid-19 hospital admissions.

 

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.    Approved the Local Tracing Partnership launch date of 26 November 2020.

5.    Members would ensure appropriate information on the programme and on COVID-19 in Surrey is cascaded within their own organisations and areas of influence.

 

Actions/further information to be provided:

 

1.    The Director of Public Health (SCC) will share the summary of the local contact tracing process and flow chart with Board members.

2.    The Portfolio Holder for Community Wellbeing and Housing, Spelthorne Borough Council will share any further information that would be helpful for the other boroughs and districts with Board members.

3.    The Board will keep an eye on Covid-19 hospital admissions.

 

Supporting documents: