Update from the Director of Public Health, Director of Covid-19 and NHS.
Minutes:
5.1 Councillor Coleman set out the three elements of the verbal presentation which comprised of: the borough’s ongoing response to the pandemic; an update of the flu vaccination and the ICP’s role in this, and Covid vaccination.
5.2 Dr Nicola Lang reported that the rate of new cases was 203 per 100,000 people and that this was gradually decreasing and that the rate was consistent with the rest of London. There had been a number of outbreaks in local schools which were being actively managed. Linda Jackson reported that there had been a spike in cases amongst the over 60s cohort, but this had not resulted in a significant impact. The government had recently published its winter plan and the borough was well placed to respond as it continued with vaccination, testing (the highest rate in London), and the contact tracing pilot project. The government had also written to people who were clinically vulnerable and advised that they were no longer required to shield. The borough had continued to maintain contact with this group and currently had no plans to end this support. Generally, the borough continued to maintain low level and essential support.
5.3 Councillor Coleman enquired how well schools where managing, given the widely expected spike in cases at the start of term. Dr Lang responded that the schools had worked well and in partnership alongside Public Health England with an early and interventionist and upstream approach. The Public Health team had taken a proactive approach to prevent outbreaks in settings such as schools and schools with special needs where there were vulnerable groups by implementing mitigating measures such as restricted movement, mask wearing and hygiene control. This had been seamless, and the schools had done a great job.
5.4 Jacquie McShannon felt that this was a measure of how much confidence schools had with the borough’s Public Health and Children’s Services teams and that they continued to have engage brilliantly and have good contact with the council. Dr Lang regularly met with schools to maintain strong links. Much time and energy had been invested in this work which would remain unfunded by government and supported by the council. The removal of contact tracing was a concern and Dr Lang explained the changes in contact rules for a young person under 18. Schools were having mature conversations with parents about measures and there had been a highly sophisticated response in finding ways to navigate complex public health concepts. It had been heartening to see trained school professionals doing public health work.
5.5 Councillor Coleman enquired about the quality of support offered by government in respect of quarantine hotels and travellers returning from abroad. Linda Jackson explained that there had been one large quarantine located in the borough which had been well supported and organised by the Department of Health (DH). A number of Afghani refugees were being housed in temporary bridging accommodation. Random checks by council staff indicated that the sites were well run with the exception of one which was being managed by the Home Office resulting in additional work for the council. Linda Jackson confirmed that despite the negotiation of a package of care with the NHS the full cost of the additional work and expenditure would not be covered. Sue Roostan outlined the co-ordinated NHS response to support five bridging hotels across North West London (NWL). This included offering childhood immunisation and Covid vaccination and the intention was to complete this process by the end of the week (24 September).
5.6 Nadia Taylor queried the difficulty in obtaining in person GP appointments and that virtual care was a compromise which should not become the norm as it would not suit everybody. She asked what guidance had been provided to see patients. Dr Cavanagh said that patients should not feel that they cannot be seen. Patients were being triaged over the phone and then a decision taken as to whether an in person consultation was necessary. Access had increased but it was not always appropriate to see patients with Covid. Digital disenfranchisement was a concern and while Covid continued, surgeries were working to maintain appropriate measures. It was possible to be infected despite double vaccination and the surgery had a responsibility to protect both staff and patients.
5.7 Jim Grealy suggested that improved messaging could help address this issue and alleviate anxiety about not being able to have in person consultation. Currently, surgeries seemed exclusionary, patients felt unwelcome, and it would also be helpful to communicate what patient safety measures were in place. Sue Roostan concurred with the communications point and agreed with the need to have clear and consistent messaging to ensure people accessed the correct care pathways. In terms of infection control, it was not safe to have patients in waiting rooms. The Trusts were managing this carefully and the CCG was working in line with this policy.
RESOLVED
That the verbal update was noted.