Agenda item

Report of the Director of Public Health County Durham.

 The Committee considered a report of the Director of Public Health County Durham that updated Members on health protection assurance arrangements in County Durham.

 

The Director of Public Health gave an overview of the Health Protection Assurance report 2018/19 that included updates from the implementation of the health protection action plan that was overseen by the Health Protection Assurance and Development Group (HPADG).  She informed the Committee that the HPADG met quarterly and sought assurance on five main strands of health protection:

 

·        Screening programmes

·        Immunisation programmes

·        Outbreaks and communicable diseases

·        Strategic regulation interventions

·        Preparedness and response to incidence and emergencies

 

The Director of Public Health updated the committee that a good local response had been achieved to the screening programme with the number screened for cervical cancer being higher than the national figures for England.  A campaign was to be launched to encourage a higher number of people to attend the free screening sessions.  The immunisation programme had received a higher rate of staff within the Aycliffe Secure centre being vaccinated and there was a higher percentage in Durham for childhood immunisations due to the outbreak of measles and mumps.  There had been a flu campaign launched to target people at risk to encourage people to have their flu jabs. An update on the flu programme would be given at a future committee meeting.  The Infection control nurses worked with care homes and prisons which were particularly challenging with the management of Tuberculosis (TB).  She added that sexual infection rates were lower than the national average.

 

Councillor Bell referred members to paragraph six within the report regarding a working group that had been established to raise awareness and increase the uptake in vaccinations. He queried if there was a good handle of vulnerable groups and knowledge of who to target with regards vaccinations and if the group had success in increasing the uptake on vaccinations.

 

The Director of Public Health affirmed that the Flu Prevention Board had been tasked to identify vulnerable at-risk groups to offer vaccinations that included those over 65 year olds and pregnant woman.  The group had identified a supply shortage in October within the childhood vaccination programme but data collected would help to plan for next winter.  The full evaluation for the vaccination programme for the year was not available yet but the intelligence gained would feed into the coronavirus action plans. The Chair suggested that the full evaluation report for the vaccination programme be brought back to this Committee when available.

 

Councillor Chaplow was concerned that TB was evident in the prison service as she thought the disease had been eliminated.

 

The Director of Public Health noted that although TB was evident in the prison service it was at low levels and the spread of the bacterial infection was connected to people living in close proximity to each other. 

 

Councillor Chaplow was worried that children were immunised against the disease at the age of 12 but this had now stopped.

 

The Director of Public Health confirmed that the disease was not at a level that required immunisations and that was why children no longer received it. 

 

Councillor Temple congratulated the Director of Public Health on the good figures that were shown within the report.

 

Councillor Robinson felt that the coronavirus should be discussed at future committee meetings along with screening figures.  He thought the screening results were excellent for Durham with 70% being screened for breast cancer and 80% for cervical cancer which were both above the national average but he was anxious that there were still people who were not being screened at all. 

 

The Director of Public Health advised the committee that NHS England were reviewing the screening process to look at the inequalities and fair access to the programme as there had been a change in life expectancies.  She felt that it would be helpful to update the Committee at a future meeting.

 

Councillor Jopling felt that if people did not want to be screened, they would not go. She believed that there was not enough information on what screening programmes or vaccinations were available to people.  She referred members to the report that stated there were vaccinations available against shingles which she was not aware of nor had she seen any information on bowel screening.  She deemed the biggest issue was around raising awareness to screening and GP surgeries should illustrate how important screening was. 

 

Councillor Huntington reiterated Councillor Jopling’s comments on the lack of information to show what screening was available to people.  She felt that it was down to the efficiency of the GP surgeries to get the message across. 

 

Councillor Quinn felt that different GP surgeries promoted different things as she was aware that the shingle vaccination was available and posters illustrating this were displayed in her GP surgery.

 

Councillor Crathorne was concerned that breast screening for women over the age of 70 was not available and they should be.  She had enquired about them as she still wished to take part but was told to ring up and make an appointment when the van was in her area but she was not aware of when it was in her area to make an appointment.  She thought it was unfair women of a certain age were taken out of the equation for screening.

 

Councillor Bell referred members to paragraphs 26-27 within the report that highlighted contingency plans that were already in existence and in place that under normal circumstances would not be realised that would deal with the coronavirus. He felt reassured and commended all the hard work that had already taken place.  He was happy that an update on the coronavirus was to be presented at future committee meeting which he would find most helpful.

 

The Director of Public Health made the Committee aware that the national situation had seen over 16,000 members of the public being tested negative for the virus and it had not been classed as a pandemic but an outbreak.  She reported that 85 people had been tested positive in the UK with one case being confirmed in Newcastle.  Public Health, England and the Director of NHS, England had been contact tracing to see who they had been in contact with as a measure to contain the virus.  She informed the committee that the virus had emerged last year which attacked the respiratory system with flu like symptoms that included a cough, fever and runny nose. 

 

The Director of Public Health stressed that the World Health Service were looking at the virus on a global scale but each Country were looking at it from both a national and local level.  The Government were overseeing the virus on a national level with COBRA having met to respond to it and communicate key actions that would be upscaled all the time. She added that the Government had produced national guidance for the public, colleagues within the NHS, Health and social care workers along with school and transport workers.  The links were on the Governments website that was updated on a regular basis with new information.

 

On a local level within the North East, the Director of Public Health made the committee aware that the North East Influenza framework that was established in 2009 for a potential respiratory new virus was being implemented.  The framework would be used collectively as a plan to respond to the virus.  Work was being carried out with Colleagues by testing patients, providing advice for people who had recently returned from travelling abroad and self-isolation.  At a local level, relations with Public Health England were helping to carry out contact tracing to identify people who had been in contact with the virus to contain it as the transmission of the disease was thought to be from person to person. The localised planning framework also worked across the board with business contingency plans being implemented.

 

The Director of Public Health informed the committee that within Durham County Council regular updates were being provided for elected members and the local community through communications sent through Public Health, England.  The Council had business contingency plans through the Corporate Management Team.  She added that the public could protect themselves by good hand hygiene and social distances.  She added that work was ongoing to look at the figures that came out of China in relation to the virus.  It was thought that it was likely that 80% of the population would become infected but not all would show symptoms or only mild ones.  The virus was still being detected in places and anyone experiencing symptoms should contact the 111 service for advice with the potential of self-isolating.  She noted that if the virus continued then plans would be moved to cancel big events and close school to promote social distancing.

 

The Head of Integrated Commissioning informed the Committee that the Durham CCGs’ Director of Nursing was coordinating a response across County Durham and the CCGs to support organisations to ensure they all had business contingency plans that were to be constantly refreshed to be able to respond to the virus.  

 

The Deputy Chief Executive, NEAS confirmed that work had already been carried out and the same plans put in place that had dealt with the flu pandemic.  It was felt they were robust, tried and tested and well-rehearsed to respond to the coronavirus. He added that business contingency plans, command and control centres were in place as a regional cell with each area having a local co-ordination that was governed by the National Response Team.  He noted that communications were key with a huge press release regarding the 111 service being launched.

 

The Head of Communications and Charity, CDDFT reiterated comments made by the Head of Integrated Commissioning and the Director of Public Health.  She felt that services were well prepared with business contingency plans in place.  She was amazed at the resilience at how services were managing and how they responded day to day. She stressed that everything was in place in accordance to national guidance with signage to support and symptoms being tested. She emphasized that residents should contact the 111 service for any advice which was managing well.

 

Councillor Crute was reassured with the update on the coronavirus that corporate communications were getting the message across.  He had been initially concerned as a section of the community were panicking and not realising that things were going on behind the scenes with several organisations involved and how they drew together for the public’s health. 

 

Councillor Crute was comforted that the Director of Public Health was at the heart of operations to feed regular updates back to the committee and how far the work had evolved to keep the public updated. 

 

Councillor Batey informed the committee that she had been involved with the hand foot and mouth crisis and knew that all the protocols were already in existence to be used when an emergency arose to serve with assurance.   She noted that there had been continued updates on hand foot and mouth to ensure there was not a mass panic in the community.  She felt that Members had a role to play to help with the coronavirus to promote the one point of information and the 111 service. 

 

The Director of Public Health stressed that good communication was important to dispel any myths.  She advised that joint working was underway with the community and voluntary sectors to support and protect them to ensure that their business contingency plans were in place as they were important to the Council. She added that work was ongoing with the Corporate Director of Adults and Health Services team as the key contact for services and care providers who dealt with the elderly who were at risk with the coronavirus.  The team were working closely with the infectious control team to develop guidance for the care sector and planning for the next phase. She advised that the Corporate Director of Adults and Health Services was part of the local planning interface with the NHS, care homes and housing solutions that carried out wellbeing visits as part of the plans to get the message out to the elderly. 

 

Councillor Quinn stated that she was an employee of a nursing home where staff in their day to day duties were diligent in their hygiene especially with barrier nursing.  She felt that the day to day policies within these environments would be spot on.

 

A member of the public was in attendance who voiced his concerns with regards to the coronavirus.  He felt that health officials should not be complacent as the issue was not going to go away.  He believed that the situation would not ease with summertime approaching as the virus had originated from hot countries.  He thought that health officials should be ensuring that there was enough extracorporeal membrane oxygenation (ECMO) machines and beds in ICT units to cope as the virus took hold as he was concerned that the service was already under pressure.

 

Councillor Smith explained that an ECMO machine was a machine that kept a patient alive until their heart and lungs had repaired themselves enough that the patient could breathe on their own.  She advised the group that the Freeman Hospital in Newcastle had one.

 

The Head of Communications and Charity, CDDFT reassured the committee that health officials were not being complacent and were constantly reviewing and monitoring the situation to ensure that there were enough beds and contingency plans were being followed to deal with any emergencies.

 

Councillor Robinson noted that the situation would be a good story for the public on how well partners were planning for every eventuality with the coronavirus.

 

The Director for Public Health stressed that the message that was being portrayed was that partners were working collectively and pulling together to take the coronavirus seriously.

 

Resolved

 

             i.        That the report be noted;

            ii.        The Flu vaccination evaluation report be brought back to the Committee for consideration when available;

           iii.        Regular updates in respect of the Council’s response to the Coronavirus outbreak be brought to the Committee.