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Local Outbreak Engagement Board

(Health and Wellbeing Board sub-committee)

Monday 24th August 2020, 1.00pm

Present: Councillor Matthew Winnington (Chair), Councillor Judith Smyth, Cllr Jeanette Smith, Roger Batterbury (Healthwatch), Helen Atkinson (Director of Public Health), Alison Jeffery (Director of Children’s Services), Louise Wilders (HIVE Portsmouth), Steve Labedz (Portsmouth Education Partnership), Paddy May (Strategy Unit, PCC).

 

Apologies: Councillor Suzy Horton, Dr Linda Collie (Portsmouth CCG), Stef Nientowalski (Shaping Portsmouth).

  1. Notes of last meeting (27th July 2020)

The notes were agreed as an accurate record of the meeting.

  1. Local Intelligence Summary

Matthew Gummerson provided a presentation on the current data picture in Portsmouth, covering infections, deaths and emerging test and trace data.

  • Portsmouth rate has plateaued since June although hints of slight increases
  • Portsmouth rate lower than local comparators and England overall. All upper tier local authorities in HIOW are low
  • From this data set – 6 new infections in the previous week leading to publication date – giving a rate of 2.8/100,000. In the actual last 7 days there has been 10 new cases in Portsmouth
  • Slough within the SE now in the “top 10” list with a rate of 20/1000,000 – this is first SE authority to hit this list
  • No covid-19 deaths at QA since June and no covid-19 admissions at QA in last 7 days
  • The “excess deaths” data shows we are below the average for this time of year
  • Test &Trace is showing that we are in line with national average for completing the process and successfully tracing – achieving about 4 in 5 people for both measures
  • There is still community transmission out there – so even with limited infections we still need to reduce contact where we can

Cllr Smyth asked whether there was any patterns in the new cases:

  • Young to middle aged is now the majority of infections – 20 to 50
  • Household infections are increasing the spread
  • Not seeing connections between households at the moment

Cllr Smyth asked how we can minimise spreads between adults – from schools or care settings

  • Helen Atkinson shared the link from the CMO on this
  • She also said that children are less likely to have severe symptoms or consequences and more likely to be asymptomatic but they can still spread the virus. However, teachers are not seen as a high risk workforce. Risk assessments are key.
  • Alison Jeffery added that CMO letter talks about adults and importance of social distancing, not gathering around school gates etc. Schools have been given a model letter on infection control and the importance of following school guidance

Roger Batterbury asked for a copy of this letter and it was agreed that this would be circulated.

The Chair thanked Matthew Gummerson for the presentation.

  1. Director of Public Health Update

Helen Atkinson provided the following updates:

  • PHE was being disbanded. She then talked through the responsibilities of the NIHP, as currently known. This is being chaired by Baroness Harding. It will formally be in place from Spring next year but is already taking on responsibilities
  • Test & Trace – Local Authorities are more involved now. They have been shown to have been working well in local lockdowns. LAs are now getting the data and are feeding local data back too. It was thought that LAs may be able to make contact with people more easily. LAs take over if there has been no contact after 48 hours. This process is being agreed locally at the moment, and locally there is a desire that this should be consistent across the HIOW area
  • Reservist programme – this is needed for wave 2 . LAs may have to do more contact tracing. The aim is to have a reservist list for 3 teams with 20 on the initial list for Sept so that they can start their training and be on the rota for October

Cllr Smith asked whether Cllrs could join the reservist list, and Helen Atkinson said she would check with HR and report back to a future meeting.

Cllr Smyth said she was full of support for Public Health and their staff. She agreed with the points made about the reservists but had concerns about how Public Health will remain with the right oversight with the reservists.  Helen Atkinson agreed that this is an important point, and one that the programme  is being designed to take into account.

Louise Wilders said that HIVE work with BAME groups and wondered whether we could work together more to help on targeted activity. Helen talked about the back office support role of the reservists and that the aim was not to “tread on toes” – but would want to work with the HIVE on contact tracing.

Cllr Winnington confirmed that the Administration supported the reservist roles.

In relation to testing, Helen reported that a new testing site at the University of Portsmouth had opened and that this had been achieved through strong partnership working. was true partnership workingCllr Winnington noted that positive partnership working had been a very positive feature of the local pandemic response.

  1. Return to schools

The Board noted the planning for return to schools document

It was noted that:

  • A sub-group of the Return to Schools working group was dealing with infection control and health & safety. This has led to lots of useful discussions, FAQs, Guidance etc.;
  • The Local Outbreak Plan had been sent to schools along with resources such as model letters;
  • Work had been carried out with transport colleagues to avoid crossing bubbles for those children using home to school transport, and an extra 20 minibuses had been commissioned to support this;
  • In terms of issues with quarantines with teachers returning from holidays – liaising with schools about this;
  • Comprehensive information also available on creating parental confidence.

Steve Labedz reported that schools were being kept well informed and that the response to the pandemic had created very strong links between school and education.  Different schools were taking different approaches to bubbles and recognised the need to protect adults, but schools were very keen to get the young people back into school

Cllr Smyth asked a number of questions:

  • How will you differentiate between normal coughs and colds and what this will mean in terms of self isolating etc. – and will this lead to lots more tests?
  • Will siblings break bubbles?
  • Is there an emphasis on skilling teachers in e-learning?
  • Has excessive anxiety been passed to young people and is this leading to mental ill health for young people and the problems associated with lack of routine and lack of discipline? Will there be a need for extra CAMHS support?

In response it was stated:

  • It will be very difficult to differentiate between “normal” coughs and colds and this will potentially be a problem but the same solutions of good hand hygiene will support this too
  • There will be breaks of bubbles with siblings – this can’t be helped
  • It is really important that we accelerate digital learning as part of our response – it was important before but more important now – but there are issues with e.g. access to kit or broadband
  • Portsmouth has support for mental health in schools initiative – this is now being deployed across the city. Schools have access to Bite Size training and resources on the website. However we are not sure what the situation will be and this ill become clearer as the term unfolds.

Cllr Smyth reported that she felt reassured following the answers to her questions.

  1. Assurance report

The Board received the report which covered:

  • Local context – updated with the information taken from the data reporting
  • Local activity – bringing together a range of information about what our work is telling us about our preparedness
  • Assurance to PHE
  • Key risks.

It was stressed that whilst the rating against city provision of PPE was Green, there is a concern on Wave 2 and therefore planning for reasonable worst case scenario.  An Amber was used to rate the Outbreak Plans because we are continuing to identify risks and make necessary adjustments to reflect learning, so this feels like the right rating.

Cllr Smyth raised an issue of domiciliary care provided by staff without PPE. She said she would raise the specific case through Adult Social Care but thought the general point should be raised at the Board.  In response, Helen Atkinson said that given the work that has been done with providers in the city, she was surprised to hear this but would need to respond quickly. To reassure the Board, it was outlined that there is regular checking, and there is a  dashboard on cases and concerns and a CQC Case Tracker – this is not showing issues in Portsmouth.  Webinars are held with the care sector and guidance is clear (although it is worth noting that a live in carer doesn’t need PPE).

Cllr Winnington also commented that the relationship with providers in  is effective, and PCC can remind all providers of what they need to do and deal with specific issues when these are reported.  However, it is also the case that some providers have no direct engagement with the council.  Cllr Smyth asked whether client questionnaires done regularly would help maintain standards and Cllr Winnington replied that following the systems thinking approach a new app is in development which will help share information and concerns and deal with the issues as suggested.

  1. Local Outbreak Plan

Helen Atkinson talked through the Outbreak Plan. There will be an update in September to reflect learning, new guidance and new information. This will come to the next Board.

  1. Any other business

Cllr Winnington reminded members of his request to think of which groups they would be able to link with in the event of a future outbreak as a conduit to the Engagement Board.

The meeting concluded at 2.45pm.