Agenda item

Report of the Director of Public Health, Durham County Council

The Committee received a report which provided members of Adults, Wellbeing and Health Overview and Scrutiny Committee(AWH OSC) with an update on health protection assurance arrangements in County Durham and health protection activities over the course of the year (for copy see file of minutes).

The Director of Public Health explained that to ensure that satisfactory arrangements were in place to protect the health of the local population, the Health Protection Assurance and Development Group (HPADG) had developed a detailed action plan built on five pillars of health protection, in addition to data and communications, which were threaded throughout:

·      Screening programmes;

·      Immunisation programmes;

·      Outbreaks and communicable diseases;

·      Strategic regulation interventions;

·      Preparedness and response to incidents and emergencies.

She explained the key achievements overseen by the HPADG in the last year which included the flu vaccination and the recovery of screenings and advised that an in-depth report regarding covid would be shared with the Committee at the end of the winter season.

Councillor Jopling commented that it was positive to see cervical screening back and asked whether there was a backlog with this area. The Director of Public Health confirmed that this was up to date. Councillor Jopling further asked if it was possible to have statistics on the number of deaths in care homes that related to COVID-19.  The Director of Public Health confirmed that there had been a small number of COVID-19 outbreaks within care homes, but these had not developed into serious illness and advised that deaths had been extremely low.

With regards to the flu vaccination, Councillor Jopling asked if this vaccine was widely available. The Director of Public Health confirmed that a different model was to be used this year and informed that priority was to be given to care homes and those that were house bound. She advised that the level of supply for vaccinations was sufficient, and that people should wait until they are called.

Colin Stephenson, Primary Care lead, North East and North Cumbria ICB suggested that he obtain a list to identify all sites within County Durham that were administering vaccinations for COVID-19 and flu and agreed to share this with the Committee.

Councillor Hovvels expressed concern regarding the level of supply of the COVID-19 vaccine as she was aware of areas within County Durham that were short. With regards to cold winter deaths, she noted that were many vulnerable people with some that would struggle to get to a warm hub. She asked for assurance on how these people would be cared for and requested further information regarding the warm hubs.

The Director of Public Health confirmed that any shortages needed to be communicated to the team so that these issues could be addressed. She accepted that this winter was going to be challenging but explained that a range of plans were in place to help and that these included information on warm spaces. She advised that support would be given to the local community response and that vulnerable people would include those who suffered from a health perspective and those that struggled financially. She explained that the team were working closely with Mary Readman and were hoping to join up areas to ensure a proactive approach moving into winter. A challenge currently faced was the sharing of data sets and she advised that permission for access to these had been requested. 

Cllr Jopling advised that some residents were getting called for their vaccination but had to travel to receive it. The Director of Public Health confirmed that all GP surgeries should have the vaccines and that they were reaching out to care homes and to those residents that were housebound.

Michael Laing, Director of Integrated Community Services, County Durham Care Partnership advised that residents who were housebound would be vaccinated by community nurses. He stated there would not be a mass vaccination centre this year but that vaccinations at community pharmacists had increased. He accepted that the delivery of the vaccines had not always been consistent, and this explained the delay for some GP surgeries.  In terms of vulnerable people who were housebound, he noted that the district nursing team was a good resource as they carried out frequent visits and knew people well. He advised that there were plans for the team to receive additional training and to ensure that information and advice about keeping warm was communicated to residents including information on grants that were available.

Councillor Earley referred to the Health Protection scorecards and asked if it was possible to obtain a list of local areas within County Durham where screening was higher or lower to address any issues with inequality.  The Director of Public Health advised that screening programmes were led by NHS England and that it was difficult to obtain data that was lower than local authority level but advised that they would continue to seek this data and provide interventions to ensure fair access to screenings. In addition to this, she advised that this data would also provide clarity on what prevented people coming forward for their appointments.

Councillor Quinn supported care homes being a priority for vaccinations noting this helped staff and visitors. She agreed that COVID-19 related deaths in care homes had recently been low and had great praise for the work that had been done in County Durham.

Councillor Higgins also supported the targeting of vaccinations to care homes and to residents who were housebound. With regards to vaccinations at GP surgeries, he gave examples of residents who had to travel a considerable distance to get their vaccination which was difficult due to the rising costs of living. He informed the Committee that those who were diagnosed with COPD were advised to have an emergency pack within their house but was aware that these packs were no longer being supplied.  Whilst appreciating the benefits of the warm hubs, people then had to return to a cold environment, and he suggested whether social services could provide feedback if they had visited a home that was cold.

Councillor Sutton-Llyod commented that the information was reassuring but felt work could still be done around community centres and could connect with various programmes to provide education and advice. With regards to the topic of vaping, he expressed that more education and awareness needed to be promoted. 

The Director of Integrated Community Services, County Durham Care Partnership indicated that the vaccinations for residents who were housebound would start within the next two weeks and would include both the COVID-19 and flu vaccination. He stated that there were approximately 12,000 visits to make and the target date for completion was the end of November 2022.

Resolved

The Committee agreed:

      i.         That the content of the report be noted;

     ii.         That the performance in County Durham for all childhood immunisation programmes exceeds both national standards and national averages be noted;

   iii.         That the report provided broad assurance that effective processes are in place for each of the key strands of health protection activity be noted;

   iv.         That a further report be presented to a future meeting of AHS OSC which provided further assurance in respect to flu and COVID-19 vaccination, the ongoing work with CDDFT in relation to Infection Prevention and Control (IPC) be requested;

    v.         That the development and delivery of the transition plan to ‘Living with Covid’ capturing the learning from Covid be supported;

   vi.         That the review of the health protection governance arrangements aligning the robust Covid assurance arrangements with wider health protection governance be supported.