Minutes:
The Board considered a verbal update report from the Chief Executive, T Collins and a report and presentation of the Director of Public Health, A Healy relating to COVID-19 and the Local Outbreak Control Plan (for copy see file of Minutes).
The Chief Executive noted he wished to offer his condolences on behalf of the Council to all families that had lost loved ones, friends and family to COVID-19. He wished to express his thanks to all the partners working together in County Durham in response to the emergency, including: Clinical Commissioning Groups (CCGs); Foundation Trusts; Durham Constabulary; County Durham and Darlington Fire and Rescue Service; Local Resilience Forum (LRF) including their work with the military; Durham University; Colleges; Schools; Third Sector Organisations and most importantly the fantastic people of County Durham, offering their support and help. He reiterated that all partners had worked incredibly hard and he would thank them for their efforts.
The Chief Executive noted that the agenda for the meeting was very interesting, including the Local Outbreak Control Plan, and that he was pleased to note that at this time the infection rate and risk was generally quite low in County Durham. He explained that from a recent regional meeting he understood the regional rates were also comparatively low. He expressed that partners remain vigilant for any possible outbreaks and that a great deal of planning was taking place within the local area. With the experience he had with local partners, both pre-COVID-19 and during the last few months, he was sure that all would work together effectively to do the best for the people of the County.
The Chief Executive was continuing to work with government to provide efficient testing facilities within the County, when needed, and ensuring the Council was provided with the relevant data to enable the appropriate decision making in terms of any such outbreaks. He reiterated that partners were working together very effectively, and he was aware that the issues with national data and testing were starting to improve.
The Chief Executive thanked the Director of Public Health, her team and partners for their hard work, including in the preparation of the comprehensive Local Outbreak Control Plan, which he felt sure would stand the County in good stead.
The Director of Public Health gave a detailed presentation that highlighted the following:
· Purpose of a Local Outbreak Control Plan, protecting the health of our local communities;
· The role of the Health and Wellbeing Board;
· The governance arrangements for Durham outbreak control;
· The seven outbreak controls themes within the Plan: Care Homes and Schools; high risk places, locations and communities; local testing capacity; contract tracing in complex settings; data integration; vulnerable people; and Local Boards;
· Local Outbreak Control Teams;
· NHS Test and Trace;
· Key Public Health Messages: stay at home as much as possible; work at home if you can; social distancing, 2m apart where possible; washing hands regularly; avoiding touching one’s face where possible; coughing and sneezing into a tissue, to be binned safely, or one’s arm if no tissue; and not to leave home if anyone from your household has symptoms;
· Communication, including preventative elements, reactive and support elements; and control and contain elements
The Director of Public Health noted that the next steps in relation to the Local Outbreak Control Plan were to continue to work with the partners and prepare for any outbreak in the area and she thanked them for working very rapidly to help develop the Plan. She added that a Local Dashboard was being developed which could be shared with the Board and partners to highlight cases, outbreaks in specific places or localities and other issues. She added that there would be continued work on this, and further information would be brought back to the next Board.
Members of the Board noted there would be a continued focus on prevention and engagement with the public and partners to ensure the ability to respond rapidly to any outbreak. The Director of Public Health explained that the Council and partners would learn from any outbreaks and adjust the outbreak response rapidly and accordingly, noting information and lessons learned.
The Director of Public Health noted that the Local Outbreak Control Plan would develop into a more focussed action plan, alongside a toolkit for those key themes identified. She added that it would rely upon all partners working together, responding as rapidly as possible to contain and prevent onward spread.
The Chair thanked the Director of Public Health and asked Members of the Board if they endorsed the Local Outbreak Control Plan as per the recommendation within the report. All agreed.
The Chair noted there were several questions from the public and asked the relevant Members of the Board to read out the questions and provide the relevant answers accordingly.
Dr S Finlay, Chief Officer from the County Durham CCG and Vice-Chair of the Health and Wellbeing Board thanked the Chair and noted a question received via the Area Action Partnership (APP):
“What assurance can the Board give to residents with non-Covid-19 related illnesses who are worried about whether to book an appointment with their GP?”
Dr S Finlay wished to assure the public that GP Surgeries were extremely safe, and staff were all used to wearing masks in public spaces and were all socially distancing, not only from patients, but also from other staff members. He explained that staff were wearing the appropriate Personal Protective Equipment (PPE) when in contact with patients and during consultations. He noted most surgeries had either set up “hot site” branch surgeries or “hot areas” within their surgeries so that patients with suspected COVID-19 and those without suspected COVID-19 could be separated. The Board noted that anyone attending a GP Surgery would be triaged via telephone first, with consultations to be via telephone or video conferencing wherever possible.
Dr S Finlay noted that of the antibody tests carried out so far on primary care staff, with over a 1,000 carried out, only nine percent of staff had been infected with COVID-19, a lower rate than in most Acute Trusts, demonstrating that the Practices had been protecting their staff as best they could. He added that there had been no new recorded cases of COVID-19 for a number of weeks within primary care practices. It was explained that the worry now was that people were not contacting GPs with potentially serious illnesses and Dr S Finlay noted that people needed to be encouraged to return to their GP with illnesses that potentially could become serious if left untreated.
The Board noted that in addition, GPs were resuming some of their routine activities, such as cervical screening and shingles vaccine, and continuing with other important activities such as the children’s vaccination programme.
Dr S Finlay concluded by assuring the public that GP Surgeries had taken all necessary precautions so that the risk of contracting COVID-19 in a GP Surgery was extremely low.
The Chair thanked D S Finlay and asked S Jacques, Chief Executive of the County Durham and Darlington NHS Foundation Trust to read the next question and give the answer.
The Chief Executive, CDDFT noted the question read:
“What advice can we give residents about whether they need to be tested for Covid-19 before working actively with and within their communities as some people are worried that if they are asymptomatic, they could spread the virus without knowing it?”
The Chief Executive, CDDFT noted the specific reference to asymptomatic carriage, however, she would advise anyone in those circumstances be very vigilant and aware of the signs and symptoms of COVID-19: the recent onset of a new and continuous cough; a high temperature; and loss of, or change in, normal sense of taste or smell. In terms of testing, she noted that anyone with symptoms could get a test, adding that asymptomatic testing was only available to essential workers in England, a list of those being on the Government website.
She explained that there were many strategies designed to limit transmission within communities including keeping one’s distance from those outside of one’s household and keeping 1m “plus” away from people as a precaution and taking additional mitigating steps. She noted such steps included avoiding being face-to-face with those from outside of your household or support bubble, try to stay side by side; keeping one’s hands and face as clean as possible, washing hands often with soap and water and drying them thoroughly; and use hand-sanitiser outside of the home in particular when one enters a building or has contact with surfaces, together with avoiding touching one’s face. She added that if in an indoor space, one should ensure it was well ventilated, with windows kept open where possible.
The Chief Executive, CDDFT explained that people should avoid crowded space and should work from home wherever possible, using technology to reach out to community groups. She added that if there was a need to travel, people should try to walk if possible or cycle, and if using public transport try to avoid peak times.
She noted that in terms of face coverings, they should be worn in enclosed public spaces where one could not socially distance and where one would come into contact with people one would not normally meet. She emphasised that face coverings did not replace social distancing, and it was important to ensure people did both. It was added that shouting and singing close to people outside of your household or support bubble should be avoided and that people should reduce the amount of time they spend with in those groupings.
The Board noted advice to wash clothes regularly, as the virus could live on fabrics for a few days and noted that when meeting those community groups within business of public premises the advice specific to those premises should be followed, those buildings having advice available to the public.
The Chair thanked the Chief Executive, CDDFT and asked the Corporate Director of Adult and Health Services, J Robinson to read out the next public question and respond accordingly.
The Corporate Director of Adult and Health Services noted the question read:
“During the Covid-19 response there has been a reliance upon access to
Information Technology (and residents being IT literate) or having access to a car for those vital services that local people need, like health care and
shopping which has impacted disproportionately on the most disadvantaged. What would the Health and Wellbeing Board’s message be to those people who have experienced these challenges?”
The Corporate Director of Adult and Health Services noted she would like to thank the residents of County Durham for their actions during the pandemic, our communities making an immense contribution to the County Durham Together response to support our most vulnerable residents. She noted that additionally the Council made available £1.5 million to support local community groups to provide assistance to residents in need that required help to deal with the impact of COVID-19 on their lives. It was explained that over £1 million of that fund had been allocated to a plethora of schemes across the County in addition to the critical assistance that over 30 mutual aid groups that spontaneously sprang up over the County had provided, as well as the many acts of kindness provided by friends and neighbours over the last few months. The Corporate Director of Adult and Health Services noted in addition that The Hub had been contacting vulnerable individuals to understand their needs and put them in touch with staff or external agencies that could provide the help that they need. She explained that anyone that had telephoned The Hub with access issues had been supported through a combination of either Council staff that had been redeployed, volunteers or NHS GoodSAM volunteers.
She noted deliveries had been provided to people’s door to enable those self isolating to do so and the County’s voluntary and community service had been responsive in supporting people in local communities with many undertaking “door-knocks” to those thought to be potentially more vulnerable.
The Corporate Director of Adult and Health Services explained The Hub had supported those with IT challenges and guided them in many activities, such as setting up priority online shopping.
She added that it was recognised that not everyone was comfortable using technology or had access to it and therefore a variety of media had been utilised to communicate the support available to communities such as social media, printed media, radio, and directly addressed mailshots to those known to have multiple social vulnerabilities, as well as the County’s shielding population. She added that the promotion of The Hub has also taken place through other existing routes such as pharmacies, primary care, secondary care, housing providers and social care.
The Corporate Director of Adult and Health Services noted the support put in place had been done quickly and comprehensively and demonstrated the effectiveness of both partnership working and the local communities within the County.
The Chair thanked the Corporate Director of Adult and Health Services and asked the Portfolio Holder for Transformation, Culture and Tourism, Councillor J Allen to read out the next public question and for the Corporate Director of Children and Young People’s Services, J Pearce to respond accordingly.
“Social isolation has been a by-product of the Covid-19 lockdown that has
impacted on many people’s mental health. What provision is available for
those who need additional mental health or social support?”
The Corporate Director of Children and Young People’s Services noted that in terms of the support offered to children and young people and their families, there was a range of resources to support their mental health and emotional wellbeing. He added those resources were targeted at parents, carers, teachers and other professionals, together with additional resources targeted specifically for children and young people. He noted that it was recognised that it was a challenging time for many young people and their families, and some may continue to experience difficulties as restrictions continued to take effect and we moved into the next phase.
The Corporate Director of Children and Young People’s Services noted that for many the impact of social isolation, and the impact upon their mental health and wellbeing, may not yet be manifesting itself and therefore it was important to continue to have a service offer going forward and the Council was shaping its services in that way accordingly. He added that all the Council’s key resources were available on the Council’s updated local offer, a dedicated page on the Council’s website, and within that there was a section on social, emotional and mental health support. It was explained the Council had been working very closely with our schools and looking at how to support children and young people back into learning and to look at the impact there would be for many children and young people who would have had many months out of school by the time that they return.
He noted the guidance around returning safely and settled provided a whole range of information that could be used by children and young people and their parents and also by schools, teaching staff and governors, again available via the local offer and also circulated out to schools for their use. The Corporate Director of Children and Young People’s Services noted that information was broken down into blocks, with a number of activities in terms of guidance and support for the curriculum, re-engaging young people in learning, as well as professional development for staff and governors. He added that there was more broad support through the Council’s Family Support Service and One Point Centres, which had continued to operate during the lockdown period, providing activities, social support into families. He noted some excellent examples of the work they had done and impact that had for families. He explained that the One Point Service was also available to connect families into community resources and reiterated that we were very lucky in County Durham to have the breadth and quality of local community resources available and the One Point Centres had been able to support children and young people and their families to access those resources and would continue to do so as we progressed into the next phase.
The Chair thanked the Corporate Director of Children and Young People’s Services and asked the Portfolio Holder for Children and Young People's Services, Councillor O Gunn to speak in relation to the question.
Councillor O Gunn noted that she would follow on from the comments of the Corporate Director and focus on children and what was happening in schools. She explained that, as mentioned, there were a number of documents circulated to schools, with one relating to children returning to schools safe, happy and settled. She noted it had been developed within the Council with a particular focus on encouraging health and wellbeing and added that there was quite a rich array of information including sources of advice and help and direct support, together with staff development.
She explained that it was known that, even prior to COVID-19, research had suggested that many children and young people could find the transition between schools unsettling and stressful so following COVID-19 it was more than likely, given information from parents themselves too, that many children and young people would experience quite similar feelings in respect of returning to school after social isolation. Councillor O Gunn noted she had received e-mails from parents expressing their concerns about this and emphasised that it was important that the Council had done what it had in terms of getting that information out to schools. She added it was important to support a successful and “soft landing” back into school. She concluded by noting that it was a process, not a single event, and there was not one particular agency involved, rather a number of partners all coming together as a team to effectively support children and continuing to do all they could to support our children and young people.
The Chair thanked the Portfolio Holder and thanked all the Officers and Members for their attendance.
Resolved:
That the Health and Wellbeing Board endorse the COVID-19 Local Outbreak Control Plan.