This discussion will focus on the work around Covid 19 test and tracing, and plans for implementing this process locally and nationally.
Lisa Redfern provided a verbal update on arrangements to implement test and trace protocols.
When the concern around the vulnerability of care homes had become apparent, a programme board had been established about two months ago, which included Dr Lang, Linda Jackson (Chair), colleagues from environmental health teams to collectively address this. A local system had been successfully implemented.
Lisa Redfern queried as a fundamental failure why the UK had not nationally adopted a test and trace app model, as implemented in places such as Germany. There were still cases of people being discharged from hospital (regardless of support needs) without being tested and therefore lacked information as to whether they were infected by Covid-19. She firmly believed that the lack of a functioning app would limit test and trace protocols as tracking one case of Covid-19 took considerable input.
Linda Jackson provided more detail about the work of the programme board which included officers from across the Council. The group was required to formulate detailed local outbreak control plans which would focus on support for vulnerable groups such as rough sleepers, care home residents, anywhere where there were high numbers of people would congregate.
Working with Imperial colleagues, they had exceeded the brief and had additionally developed plans for e.g. travellers, sheltered housing or residents in homes of multiple occupation. National information had been poor on this and sharing data for safety reasons to inform the plans was not regarded as a breach of data confidentiality and Linda Jackson was confident that this would meet public expectation as the minimum standard required to ensure people were kept safe.
They had tested the outbreak control plans and worked closely with NHS colleagues and GPs to develop them further so that plans could be quickly activated. A communications strategy had been planned which involved the Leader writing to residents of the Borough, language translations and being proactive in advocating the importance of test and trace so that vulnerable communities could be protected. Dr Lang had also proactively engaged with local faith groups to that information about test, trace and prevention was being communicated.
Dr Lang described her work with Public Health England. Each day, data was provided with the anonymised and sparse details of any cases identified within the Borough. The incomplete data on each patient resulted in a fragmented picture of people who had tested positive. Dr Lang briefly outlined Pillar 1 to 4 tiers and the complexities of the testing arrangements, but the difficulties of data sharing meant that it was harder and more time consuming to identify residents.
Bringing together Imperial and Public Health information alleviated data sharing issues, uniting patient details with the post code and building the identity of the Covid-19 positive individual. Pillar 1 testing included those who had tested positive through the NHS, either in a hospital or at a GP site. Pillar 2 were tests conducted through drive through hubs or with a home testing kits. Both pillar 1 and 2 data were provided but anonymised. The advantage of this combined data being provided to the Council meant that in theory, officers could find the person and offer support.
Councillor Richardson submitted a question about digital isolation on behalf of Healthwatch Hammersmith & Fulham: what plans there were to ensure that seldom heard communities and people who did not have access to the digital equipment or internet received information about the test and trace programme. Dr Lang outlined the engagement work undertaken with a local Somali community group. There was a recognised concern about the lack of access to smart phones and devices and being digitally excluded. They had tried to identify who had access to digital and ensure that there is more dialogue facilitated within communications rather than just providing information.
Victoria Brignell commented that as Chair of Action on Disability, she supported the Council and the intention to co-produce. She referenced the recovery plan, paragraph 10.2 and asked about the Council’s commitment to coproduction and to elaborate on the phrase “Covid-19 response mode”.
Linda Jackson welcomed the offer of support and outlined how this had been taken forward with input and oversight from Kevin Caulfield and Tara Flood (Strategic Leads, Co-Production) to ensure that the recovery plan was driven by co-production.
Linda Jackson continued, and outlined how the past three months had been the critical response phase of the Covid-19 pandemic where for example, libraries and parks had been closed. A challenge which arose from developing the recovery model was to understand what the new offer would look like. It was also important to understand that the pandemic was not over and that a second wave of cases was expected. Dependent on the different stages of recovery, different levels of alertness were required to ensure a swift re-calibration of resources when needed so that the Council could return to delivering critical frontline services and PPE.
Councillor Richardson observed that it was essential that the Council and health partners engaged with vulnerable members of the community and ensure an inclusive approach allowing all voices to be heard and listened to. Jim Grealy added that further pressure on the government would be necessary to get a working app in place ahead of the winter period where the risk of Covid-19, coupled with the flu season would see rising rates of illness. This would be critical to ensure that all the positive work undertaken so far was not undermined.
Roy Margolis referred to an article about a German app, developed in partnership with Apple and Google, which he agreed to forward to members of the Committee. Councillor Coleman commented that efforts were being made to set up a local test and trace system which could have been progressed during the lockdown. Two sets of data had been provided, from drive by testing and from the hospital but this was limited information. However, despite the piecemeal information there was an expectation that the Council would deliver a local solution.
Councillor Coleman expressed concern that the UK should be able to utilise existing apps available in Ireland, Germany and Gibraltar and questioned why no progress had been made nationally on this issue and the lack of a government response. He stated that this was an issue that he had planned to raise through the West London Alliance and required a local solution. Councillor Kwon pointed out that contract test and tracing in countries such as Vietnam, Singapore and South Korea were not reliant solely on app technology. The downloading of an app did not necessarily indicate success but was corroborated and supported by local, high levels of human tracing with people being contacted by telephone, by call handlers.
ACTION: To raise the issue of the lack of a national, functioning app with other West London scrutiny committee chairs
That the verbal report be noted and that the action as set out be implemented.