Agenda item

(a)   To approve as an accurate record and the Chair to sign the minutes of the meeting of the Health & Wellbeing Board held on 22 July 2020.

(b)   To note the outstanding actions.

A minor correction was noted under Agenda Item 10, page 13, second paragraph which should read “Recovery Curriculum Plan” rather than “Recovery Community Plan”.

Matters Arising

1.          Expansion of Covid-19 testing technology

Toby Hyde confirmed that he had raised this issue with the Director of Pathology.  The laboratory at Charing Cross hospital had capacity to test  1500 samples per day and this was currently operating at 80% capacity. It was anticipated that this would be scaled up to 3000 tests per day by mid-October.  A 17-hour turnaround from receipt in the laboratory to results being provided was sought, and 86% of samples were processed within 24 hours.  It was acknowledged that there had been some difficulties in processing and obtaining re-agents had been an issue, but this was a national problem which was being addressed.

2.          Staff eligibility for testing

Councillor Coleman sought clarification regarding the eligibility for staff with Imperial, given the anticipated increase in capacity.  Toby Hyde confirmed that 80-90% of tests were being used for patients with the remainder being used to test staff.  Approximately 10-20% of tests were potential available to staff. Toby Hyde confirmed that all symptomatic staff at the hospital were eligible for testing and that this included social workers, cleaners, porters and clinicians. Imperial also followed guidance issued by the Royal College of Physicians for clinical specialities who worked with immunocompromised patients to undertake regular testing. 

There was concern that asymptomatic social workers were not eligible.  Lisa Redfern confirmed that she had been in communication with the Programme Director of Integrated Care, responsible for hospital discharge teams.  The issue had been escalated to Julian Redhead, Medical Director at the Trust for resolution.  Toby Hyde clarified that there were two categories of testing: Firstly, any staff who exhibited symptoms would prioritised for testing, including social workers based on hospital sites and working directly with patients.  A second category covered asymptomatic staff who worked with highly vulnerable, immunocompromised patients. Toby Hyde acknowledged the need to expand the roll out of testing to all staff including those who worked in discharge teams and social care, but this was a capacity issue.  The implication was that asymptomatic staff remained active in multiple hospital sites without precautions being taken to protect vulnerable patients.

Given that testing capacity was expected to double, Cllr Coleman reasoned that an additional 10% to 20% of those tests could be potentially available to staff by mid-October.  It was noted that this issue would be further discussed outside the meeting.

3.          Testing in care homes

Dr Lang highlighted concerns following the government suspension of the Department of Health pillar 2 testing portal from mid-July to 7 September 2020.  There had been intermittent or delayed test kits, but these were being delivered again. A formal complaint was initiated by senior officers as each delay in notifying a test result occurred.  The process was being carefully monitored as such delays were unacceptable and further exposed vulnerable groups to risk. Other issues highlighted included courier transport and technical or digital errors. The system to transport samples had become steadier but officers hoped to improve this.

4.          Distinguishing Covid symptoms from flu and testing issues

Jim Grealy sought clarification as to how Covid-19 symptoms could be distinguished from flu symptoms. Toby reported that there was national clinical guidance on identifying Covid symptoms but if any there was any doubt about a patient’s condition they would be tested.  Testing was available across all the Trust sites. 

Vanessa Andreae highlighted the lack of available test kits in primary care.  The cumulative effect on patients was increased particularly given the return to school. A second concern was that organisations with access to funds were easily able to purchase tests, with results available within three hours, in comparison to the significant delays experienced in NHS testing regimes.  Anecdotal evidence highlighted the logistical difficulties in accessing tests and testing sites and this was reflected nationally. 

A move to a more localised testing regime offered the possibility of a more reliable, responsive and robust system however laboratory capacity remained a critical factor.  H&F had set up mobile testing units at key sites such as Westfield Shopping Centre and last weekend had tested 650 people.  It was felt that a local testing system could be established with government funding.  Dr Lang cited the example of the local solution for testing in care homes that H&F had implemented.  This illustrated the value and importance of implementing local solutions which the government had now begun to acknowledge.

ACTION: Officers to investigate the possibility of initiating a local testing regime and whether there was scope to develop a strong business case to support this.

RESOLVED

That minutes of the meeting held on 22 July 2020 were agreed as an accurate record.