Agenda item

This item provides a verbal update from the Directors of Covid 19 and Public Health on Covid-19.  The update will also provide an analysis of data regarding the local vaccine uptake.

The Chair welcomed Dr Nicola Lang and Linda Jackson who provided a joint update on vaccine take up within the borough and current Covid-19 rates of infection which had increased to 44 new cases per 100,000 people (up from 29 per 100,000 previously). A new testing regime had been implemented in schools, but Dr Lang urged the need to remain vigilant and to comply with infection control measures.  A pilot contract tracing project had begun and since implementation on 23 March 2021, 70 people had been contacted.

Linda Jackson outlined the significant challenges in ensuring vaccine uptake. The Primary Care Networks (PCNs) had since December 2020 operationally supported three mass vaccination hubs.  A fourth site at the Novotel had commenced on 15 March 2021, a fantastic reflection of partnership working between the local authority and NHS colleagues. The importance of delivering the vaccine in line with the Joint Committee Vaccination and Immunisation (JCVI) eligibility criteria was emphasised and significant engagement work was being undertaken to address concerns about the vaccine within some community groups. The borough had the highest rate of care home vaccinations at 96.2% in NWL and was attributed to the work of Dr Lang, undertaken jointly with health partners.

Linda Jackson explored the reasons why an individual might decline vaccination which was not necessarily rooted in social media and misinformation as most were well informed. This was evident within the black Afro-Caribbean community. It was recognised that a broad spectrum of engagement was required to fully inform the council’s public health offer.  The council was facilitating a programme of small, tailored Q&A sessions with community and voluntary groups.  The informal conversation format of the events successfully offered participants a chance to articulate concerns and be listened to. This was empowering and encouraged greater confidence in the vaccine.

The borough and H&F CCG joint vaccination plan was a “live” and iterative document which set out how vaccination programme would continue to be managed, prioritised and delivered.  There had also been significant success in vaccinating people at home and those in care homes. People in receipt of direct payments had also been contacted together with staff employed through the scheme as personal assistants.

Councillor Richardson thanked officers for their presentation and commended the engagement activities which had been impressive. The borough had historically experienced significantly low levels of vaccine uptake prior to the pandemic and Councillor Richardson looked forward to receiving further updates as this work progressed. 

Councillor Lloyd-Harris welcomed the report and commended officers for the impressive work undertaken. Councillor Lloyd-Harris reported the positive feedback that she had received but asked if it would be possible to circulate up to date vaccination rates.  Views were sought as to the reasons for low uptake within the borough and how this could be improved.  Linda Jackson stated that one reason for the difference in rates was that other boroughs had begun vaccinating much earlier.  It was acknowledged that flu vaccination rates, for example, were historically low within the borough and that there were lessons to be learned from this.  The adopted approach to better understand community concerns was designed to be long term so progress would be incremental but sustainable.  A great deal had been learned about population health management and community engagement and this would continue to inform work currently being progressed in line with the borough vaccine plan.

Councillor Coleman commented that while the responsibility to ensure vaccine delivery and uptake lay with the NHS, there had been commendable joint work undertaken. The historically low uptake of flu vaccinations had been raised with NHS colleagues at with Health and Wellbeing Board members.  It had been concerning to see the significantly low level of Covid-19 vaccine take up manifest within minority ethnic communities and their lack of trust of government, local authorities, and the NHS (as an organisation). The conversation about tackling health inequalities post-pandemic had not yet fully recognised that mistrust was rooted in decades of systemic cultural bias experienced by minority ethnic communities.  That such experiences led to a not uncommon belief that substandard treatment was provided, indicated the extent of the challenge to improve vaccine take up within minority ethnic groups.

Jim Grealy welcomed the change and progress being reported.  Given that most over 70’s and 80’s had been vaccinated and that there had been warnings nationally about low supply levels he asked if this would slow the momentum of vaccinating other JCVI groups. In a second question he reported anecdotally that some people without access to digital technology had not been contacted or found it very difficult to make a vaccine appointment. He asked if demographic factors such as low income, age and English not being a first language, had been considered in overall vaccine delivery planning.  Linda Jackson offered an assurance that whilst there might be a national shortfall for small period there would be enough supplies of the vaccine available to the borough for those falling within the JCVI priority groups 1-9, including second doses.  It was also confirmed that GP practices had contacted people directly about appointments.  The council’s Community Aid Network (CAN) contact centre staff had helped facilitate bookings. 

Reporting the experience of one HAFSON member who had experienced scheduling difficulties, Janet Cree acknowledged that this may attributed to a specific scheduling issue at Parsons Green which would be investigated and gave assurances that enough vaccine doses were available for the borough’s JCVI priority groups 1-9.

ACTION:Jim Grealy to share details with Janet Cree following the meeting

Co-optee Victoria Brignell queried vaccine take up data and the absence of figures indicating the take up rate for care workers and agency staff who were in some cases employed by vulnerable people. She enquired if a resource pack with information about vaccination could be provided.  There was also an increased assumption amongst some support staff that they won’t be infected, and she encouraged officers to consider deploying incentives to encourage vaccination. Linda Jackson outlined some of the incentives already being offered such as offering care home staff time off in lieu but welcomed any additional incentives that could be suggested.  The Committee welcomed positive news that take up by staff in care homes had significantly increased. 

Councillor Coleman added that care providers had been strongly encouraged to lead this work which was critical in safeguarding residents particularly where care staff were entering people’s homes. Although progress had been slow there had been week to week improvement.  Lisa Redfern confirmed that the council continued to work with providers to explore financial incentives such as a one off bonus for staff being vaccinated.

Co-optee Roy Margolis welcomed the updates and commended the work being undertaken to support the vaccine programme. He inferred from information about local variations in low take up that a lower proportion of older and vulnerable people outside of care homes had been vaccinated.  He asked if this was linked to concerns about vaccination in minority ethnic communities and mistrust of the NHS generally or if there were other factors.

Linda Jackson responded that the engagement work had revealed that concerns about cultural bias and discrimination had informed greater mistrust of the NHS as organisation and vaccination.  Residents had also felt that their care givers should be vaccinated and there was significant pressure building within the media about this. There was a need to improve the cultural narrative within social care around vaccination and to remember the positive benefits of being vaccinated.

Co-optee Keith Mallinson shared his experience as volunteer in the White City vaccine hub. Take up by ethnic minorities had been good and the experience positive, with those who were vaccinated being encouraged to share their experiences with friends and family.  The team of doctors, nurses and volunteers were exceptional and worked with great dedication. He enquired about vaccinations for homeless people and how this was being supported.  Janet Cree explained that a concerted effort had been made with outreach teams working with the homeless population. The CCG had from February 2021 used existing teams to offer reassurance and information so that people could make informed choices.

Co-optee Lucia Boddington asked about unpaid carers who were struggling to get vaccinated despite caring for vulnerable children within tier 6. Linda Jackson clarified that unpaid carers were included and could be vaccinated in line with the JCVI eligibility criteria for groups 1-9. She acknowledged that this had been a concern despite the council’s efforts to contact unpaid carers. Despite available guidance people did not regard themselves as carers.  The council as a priority were in the process of mapping this, working closely with the Carers Network and GPs.

Councillor Bora Kwon recounted her experience of translating and supporting similar minority ethnic vaccine engagement activities with the Korean community in Kingston Upon Thames. The key issue was to address misinformation about the Oxford AstraZeneca vaccine. Sourcing Korean clinicians with vaccine expertise for engagement allowed communities to hear the voices of second generation minority ethnic clinicians employed by the NHS and who were more respected and trusted than high profile public figures.  A Zoom Q&A session had been well attended and people had got in touch to say that they had booked their appointments. The voices of clinical frontline, NHS workers powerfully communicated assurance about vaccination, and this was amplified when conducted in community languages. Linda Jackson confirmed that this was the informal, conversational approach that was currently being undertaken. The generous support of clinicians and experts that were also culturally representative was key.

Councillor Mercy Umeh thanked officers and Councillor Coleman for the Q&A vaccine engagement sessions with minority ethnic communities, voluntary and faith groups. She reported she had received many positive comments and that the sessions had encouraged people to be vaccinated. It was acknowledged that some communities were not receptive to the influence of councillors, but the sessions were most helpful when people from the community were being supported by members of the same community. Councillor Richardson welcomed Councillor Coleman’s report that the borough was one of three local authorities that had been selected as part of a local pilot contact test and trace scheme.  The lack of a robust, national test and trace scheme was deeply concerning and should have been within the remit of local authorities. Evidence had indicated that the borough was significantly more successful at tracing people compared to the national scheme. 

ACTION: To provide an update for members on vaccination numbers; to be kept informed about engagement work

RESOLVED

That the verbal report and comments be noted.