For the Committee to receive a verbal update from the Director of Public Health on Covid-19 and Director COVID-19 & Lead for Afghanistan refugees.
Minutes:
5.1 Councillor Richardson welcomed back Dr Nicola Lang and Linda Jackson who provided an update on the council’s ongoing Covid-19 response. The rate of infection for borough was currently 875 for every 100,000 and was in a slow decline, similar to the rest of London. At the end of December 2021, the rate was 2600 per 100,000. Most of the borough’s schools had reported cases, predominantly higher in primary school, amongst children aged 5-10 years, replicating the peak of cases arising in secondary schools over autumn.
5.2 Co-optee Keith Mallinson commended the work and commitment of Dr Lang and her colleagues, which he felt was undermined by the comparatively poor response of Transport for London (TfL). Councillor Amanda Lloyd-Harris endorsed comments in respect of Dr Lang and also TfL. Enquiring about the rates of infection primary schools, she sought a comparison with overall London figures. Dr Lang confirmed that there were approximately 1800 new cases being reported weekly which was slowly decreasing. The current rate ranked the borough as the 12th highest (mid placed overall). One of the underlying factors attributed to higher local figures was the volume of testing which was predominantly one of the highest in London.
5.3 Residents were well motivated about getting regularly tested and the council continued to work closely with primary, secondary and special needs schools, offering support and guidance on preventative measures. Dr Lang observed that younger children found it harder to maintain social distancing and also attributed the higher rates prevalent amongst primary aged children to being unvaccinated, as they were the last of the population groups to be vaccinated. Dr Lang commended the excellent work of local headteachers who had worked hard to boost morale and encourage greater resilience amongst their pupils during a very difficult period, dealing with wave after wave of Covid-19. In response to a follow up question from Councillor Lloyd-Harris, Dr Lang confirmed that she was not aware of parents holding “Covid-19” parties so that children could become infected.
5.4 Lisa Redfern thanked and commended Dr Lang’s clinical foresight in 2020 to appoint an infection control nurse. It was likely that H&F was the only local authority amongst the eight north west London (NWL) boroughs to have taken this approach which strengthened the council’s outbreak management control. Expertise applied to support care homes and for those in receipt of direct payment, was also applied to support schools. Health colleagues had acknowledged the huge benefit of this kind of well balanced, and dynamic intervention, which had helped facilitate a controlled reopening of care homes. Cllr Richardson commended the response of council officer teams, led by Dr Lang and Lisa Redfern.
5.5 Co-optee Victoria Brignell sought an update on the hospitalisation numbers, whether this had plateaued or was declining. She also sought an update on vaccination rates. Dr Lang reported that the vaccination rate for H&F, was 63% of registered patients (not by the number of residents). Numbers had gradually increased, partly attributed to concerns about Omicron, some of whom had come forward for their first vaccination, roughly equating to 20-30 per day. The success of local booster vaccination was attributed to a nimble pop up system supported by ten pharmacies, and two sites at Charing Cross and Hammersmith hospitals. Similar agility had also helped with second doses and reflected a slightly different pattern of take up in other boroughs. Councillor Coleman added that the rate of 63% was calculated based on the Office for National Statistics projected figures used by the government. This gave the current population figure 225, 000. However, a more accurate figure based on Greater London Assembly (GLA) data was 190,000. Based on the GLA figure, this indicated a vaccination rate of 88% for first doses, 84% for second doses, and 52.9% for boosters. A letter had been sent to central government highlighting the disparity and explaining that inaccurate reporting had fundamentally undermined local morale. NWL health colleagues had concurred with the council’s perspective but it was not possible to change the formulation for the entire country. This had particularly disadvantaged H&F and other local authorities in a similar position.
5.6 Dr Chris Hilton, an NWL NHS Gold committee member, provided a headline update on hospital rates. There were currently 460 occupied beds representing a rate of 15% of acute to adult hospital beds and which was stabilising. Councillor Richardson thanked Dr Hilton for stepping in the absence of local National Health Service (NHS) colleagues.
5.7 Councillor Richardson led comments from the committee in commending the work of officers who had worked unstintingly to deliver the council’s Covid-19 response. It was imperative that this impressive work continued as the UK came out of Covid-19 restrictions and remained agile in responding to future variants. Jim Grealy commented that a Fulham pharmacist had recently told him that he had 23 no shows for Covid-19 appointments and that those doses had been “wasted” indicating spare capacity. It was not possible to understand if this was occuring elsewhere but it did not detract from what was otherwise a remarkable performance by the NHS in delivering scaled up vaccination. Dr Lang observed that this was not a supply but a demand issue. The surge in Omicron rates also meant that an infected person was required to wait for 28-days before vaccinating.
5.8 Victoria Brignell sought information about the vaccination levels amongst NHS staff and an indication as to how many might lose their jobs if they remained unvaccinated by the April deadline. Linda Jackson explained that there was an ongoing dialogue with care and NHS staff about their reasons for not being vaccinated. The implementation of the April deadline would also require legalities that were yet to be announced. Lisa Redfern added that the impact of NHS staff refusing vaccination was a concern, given the implications for maintaining safe staffing levels but business continuity plans were in place to respond to this scenario. There had been similar concerns anticipating an impact on care homes but the outcomes had been minimal. A cautious approach was recommended with regards to the potential number of unvaccinated staff leaving the NHS.
5.9 Dr Hilton confirmed that the protocols in place for the preparation of business continuity plans at WLT would be similarly replicated across partner NHS trusts. It was reported that, as of 25 January 2022, there were 189 individuals within the organisation who were unvaccinated, out of a potential 4000 staff members. To date, five members of staff had left the organisation voluntarily because they had declined vaccination. He confirmed that there were ongoing conversations with staff to encourage them to accept vaccination before the April deadline.
5.10 Councillor Lloyd-Harris commented on the disproportionate percentages of H&F population figures and how this impacted on the local vaccine take up, and the need consistency. Councillor Coleman confirmed that it had not taken 18 months to identify the issue of inaccurate population figures. This was a long standing issue that the borough had asked the government to rectify for many years and had similarly affected other local authorities (Royal Borough of Kensington and Chelsea and Westminster City Council), and across the UK where there were high rates of movement into and out of the area.
ACTIONS:
1. The numbers of local, NWL NHS staff who might lose their jobs if unvaccinated; and
2. That percentage details about vaccination rates for first, second and booster vaccination would be provided following the meeting.
RESOLVED
That the verbal report and actions were noted.