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Local Outbreak Engagement Board

(Health and Wellbeing Board sub-committee)

Monday 25th January 2021, 1.00pm

Present: Councillor Matthew Winnington (Chair), Councillor Judith Smyth, Cllr Jeanette Smith, Councillor Suzy Horton, Roger Batterbury (Healthwatch), Helen Atkinson (Director of Public Health), Dr Linda Collie (Portsmouth CCG), Stef Nientowalski (Shaping Portsmouth), Louise Wilders (HIVE Portsmouth), Richard Lee (Assistant Director- Regulatory Services, PCC), Dominique Le Touze (Consultant in Public Health, PCC), Daniel Williams (Public Health Manager, PCC), Claire Currie (Consultant in Public Health, PCC), Matthew Gummerson (Strategic Lead for Intelligence, PCC), Alison Jeffery (Director of Children, Families and Education, PCC), Kelly Nash (Strategy Unit, PCC).

  1. Notes of last meeting (15th December)

The notes were agreed as accurate record of the meetings.

  1. Local Intelligence Summary

Matt Gummerson provided an overview of the latest data and key messages.

There have been 1,021 new infections in Portsmouth in the last week, meaning that there have now been 11,739 people in Portsmouth with at least 1 positive Covid test (lab confirmed or through a lateral flow device).  This is a slowing in the infection rate from recent weeks, and a similar pattern is being recorded in other HIOW authorities.

Portsmouth’s infection rate over the last 7 days was recorded at 475.1 across all age groups, a decrease of 29% over the last 7 days.  This compares to a rate of 437.8 for England, and 428.7 for the wider South East region.  Cases are reducing in all age groups, although rates remain highest amongst the working age adult population (30-59), which is indicative of community transmission.

This community transmission means that there is pressure on the hospital – as of Friday, overall bed occupancy at PHU was at 94.6%, with 50 covid-positive patients in ICU.  There were 292 admissions and in-patient diagnoses in the last 7 days. Hospital workforce sickness absence is at 10%.

There have been 151 covid-related deaths of Portsmouth residents since the end of October (37 in the last 7 days) and a total of 231 deaths in total.  Over the past four weeks, deaths in Portsmouth have exceeded the average of previous five years.

The Chair thanked Matt for the presentation.

  1. Director of Public Health and Head of Regulatory Services Update

Helen Atkinson reported that a bid will be submitted around community testing in the area – combined with the rest of Hampshire and the Isle of Wight.  This community testing offer will focus on critical workers who cannot work from home and have to continue to work in a public-facing role.  The bid proposes a testing site in each of the unitary authorities and districts in HIOW.  The initial focus of the Portsmouth Community Testing sites will be Portsmouth City Council critical workers, then expanding to other public sector critical workers. Tests will be offered twice-weekly for individuals and delivered using lateral flow devices.  We are aware that DHSC are working with other government departments and sectors to support other industry including   Businesses with over 250 staff who can make contact via DHSC who will link them with the relevant government department around arrangements.

Cllr Smith asked where do schools fit in?  Also, there are reports of people being forced to go into work or not get paid and how will testing address this. Helen reported that schools are already part of the national programmes and have access to lateral flow testing.  We are currently lobbying region and DHSC for early years providers to be picked up in a national programme, but pending this, will look to include in the community testing programme.   In relation to people being forced to work, this is a clear breach of legislation, and if details are provided, this can be followed up.

Cllr Smyth asked about PCC housing contractors, such as Mountjoy, and would they be included in the programme.  Helen confirmed that these would be included in the community testing, as would critical workers of key voluntary sector partners.

Richard Lee provided a regulatory services update.  In terms of business regulation, the team are working within the ‘Stay at Home’ guidance, although new powers are being introduced regularly.  In terms of the Covid Business Compliance Officers, this team is now completing around 300 interventions a week, mainly focusing on evening activities.  The teams are also now looking at some open spaces and businesses to ensure spaces are moved on.  The team have also been working with supermarkets and convenience stores to ensure the environments are well controlled.  Compliance across business is generally good but the team is taking enforcement action when required.  Portsmouth is working closely with other local authorities in the area to ensure a generally consistent approach, but maintaining focus on local priorities.  The team is engaging on a daily basis with local police, and still receiving reports to follow up via the single point of contact. It was important to note that government funding for the covid business officers is due to expire in March and so we are working to understand how long funding will be available.

Cllr Smyth asked how does compliance compare in Portsmouth with other areas?  Richard Lee reported that it doesn’t feel like Portsmouth is an outlier, although there have been some businesses that have been engaged with and that the team have unfortunately still had to pursue enforcement action against.

Cllr Smyth highlighted that the seafront attracts lots of people, so we should be thinking about closing the roads in the area again to support people being able to walk or cycle.  Cllr Smith noted that open space is at a premium in the city, so would advocate need to try and close roads to support people to safely exercise.  Cllr Winnington reported that there is a Special COVID Response Board who  consider when it is necessary to close roads on an evidence-based basis.

  1. Vaccination Programme Update

Claire provided an update on the programme for Portsmouth:

There are a number of modes of delivery:

  • Hospital Hub at QAH – focus on frontline Health and Social Care staff
  • PCNs – focused on the age group priority cohorts and CEV groups – PCNs also visit care homes to deliver vaccination
  • Community Vaccination sites – will operate through the community booking system
  • Community pharmacy – will operate through the community booking system (this route is being led nationally by NHS England so little local input to this, and not sure how many there could end up being in Portsmouth).

In terms of priority groups, these are defined nationally in a document referred to as the Green Book.  Priority groups are residents and staff in care homes, over 80s and Health and Care workers, now looking at 75+, 70+ and CEV groups, and the operational priority is to get as many first doses delivered as possible.

There are now three vaccinations cleared for use in the UK, all found to be safe and effective at preventing serious illness.

In terms of uptake, this is influenced by a range of factors, including access.  Need to take a multi-faceted approach to ensure that people are encouraged and supported to take up vaccination offer, and to address vaccine hesitancy.    There is a need for more granular data to get a clear idea of uptake and associated issues locally.

Roger Batterbury asked whether there is any guidance locally on what to do with doses of vaccine left at the end of a clinic that need to be used up.  Have there been any issues with short notice notification of supplies?  Have any clinics been cancelled?

Claire Currie reported that all providers are asked to have a standby list so that they can call people forward quickly if there is surplus vaccine available.  There has been very little wastage locally, although there have been local reports that supply has been patchy.   Guidance on eligible groups is found in the Green Book, and this also allows for colleagues to exercise clinical judgement, although colleagues across the region are keen that this should be a consistent approach.

Dr Collie reported that in terms of last minutes vaccines, lists included dentists, care workers etc and proof of work ID is asked for to check eligibility.  Cancellations did occur when people were booked in for second vaccines and the national policy changed, but generally bookings are last minute rather than in advance to avoid re-bookings if there is a problem with supply.

Stef Nienatowlski asked if and when volunteers would be required to support the vaccination site?  Louise Wilders reported that there are lots of volunteers listed, so not necessarily looking to recruit more people at this point.

Cllr Smith asked what is happening re the BAME groups and looking at their concerns around vaccination.  Claire Currie noted that most communications are nationally led, but there is some research and insight work locally, and also looking at some local activity using community leaders, and linking with the HIVE.  Claire stressed that all work needs to be in partnership across the wider system.  Louise explained that HIVE are also looking at a focused programme of work with BAME communities, which will include a Question Time session and where the information can be used to share and give people tools to teach others. Other ideas being considered include some community blogs.

  1. Testing programme update

Dominique Le Touze provided an overview of the local testing programme.

Dominique outlined that the current programme for symptomatic testing in the city includes two local test sites in the city; an occasional mobile testing unit; access to the regional testing site at Southampton Airport; and home testing remains available.

In terms of asymptomatic testing, there are national programmes that cover:

  • NHS patient facing staff
  • Care home staff and residents
  • Extra Care and supported housing
  • Home Care testing of domiciliary staff
  • Secondary schools
  • Primary Schools, school-based nurseries and maintained nurseries
  • University

There are also a number of pending programmes:

  • Day care settings
  • Food manufacturing plants
  • Prisons and asylum centres
  • Operational and supply chain
  • Hospices

Community testing (as previously updated by Helen) will add large scale asymptomatic testing for critical workers.

There is also work underway to roll out a saliva testing programme, which is being led by Southampton University Hospital Trust.  These are regular self-administered tests, and soon to be rolled out in 3 schools and 1 further education setting in Portsmouth

There were no questions in relation to testing.

  1. Local contact tracing

Daniel Williams provided an overview of the local contact tracing programme.

Dan reported that the local contact tracing service was established to enable PCC to take on cases passed to it by NHS Test and Trace nationally, to try and increase the success rate.  Launched in November, there is a team of 5 team leaders, 16 staff and 4 currently in training – most of these staff are volunteers, although paid staff are now being taken on due to the increases in volume. To date, the team have worked on 1079 cases, and it is notable that since the service resumed early in the New Year after the Christmas break, there have been many more cases coming forward, with a tripling of the daily average.

In recent days, there has been a fall in numbers of cases, although we are likely to see this increase again with a higher rate of lateral flow tests now being included  – it is difficult to predict at this point.  People generally respond positively and understand the importance of the process.  There is room for improvement and opportunity to refine procedures. The next step identified is to start with door knocking, especially for older and vulnerable people.  The team is linking with the HIVE to achieve this, and to ensure that people have support in place to enable them to self-isolate.  The local team is also working with the national team where it is necessary to get a self-isolation dispensation.

There were no questions in relation to contact tracing.

  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 risk, which in this case relate to the new variant, and cases resulting from the relaxation of restrictions at Christmas.

There were no questions.

  1. Cabinet Office report

Kelly Nash provided an outline of the process that was undertaken in January, when representatives from the Cabinet Office undertook a virtual visit to the city to see how national policy is working in practice; and to try and identify any areas where they could take messages back to the centre to help.  It was noted that there were three areas where the group had noted best practice, which were in relation to the work of the modelling cell, the support for vulnerable people, and the joint work with the University.  The report resulting from the visit has been circulated to the Board, although please note that this is not for onward circulation.

  1. Any other business

There was no other business.