Minutes:
The Borough Based Director – SEL CCG informed Board Members that currently, very few cases of COVID-19 were being seen in the Borough, with just a handful of positive cases through the testing arrangements in place. In total there had been in excess of 1,300 confirmed cases in Bromley, and 337 deaths. 73 deaths had taken place in care homes, 239 in hospitals and the remainder in the community. There had been no deaths within recent weeks. Work was being undertaken to ensure the LBB Public Health team were provided with all the data available to populate the information.
The system of testing currently in place was antigen testing, to see if a person had the disease. This was ideally done during the first few days of having symptoms, after which there was a high probability that the test would come back negative. Antibody testing had also been launched, mainly for those working in health and social care settings. 1,500 tests had been carried out in Bromley, and as the test involved a sample of blood, additional phlebotomy services had therefore been arranged.
In response to a question, the Borough Based Director – SEL CCG said that in relation to the antibody testing for health and social care staff, between 17 and 18% had returned positive tests. However it was noted that the antibody disappeared very quickly, so it could not be stated that only 17-18% of these staff had been infected with COVID-19. The Chairman highlighted that some evidence suggested that the antibodies only remained present for around five weeks.
In relation to care homes, testing for residents and staff, both symptomatic and non-symptomatic, had been established early on in the pandemic. Over 5,000 tests had been carried out, with a proportion of both residents and staff testing positive and support had been provided to care homes to help segregate patients and ensure that the correct infection control measures were in place. It was noted that having a single General Practice for all Bromley care homes had made it easier to provide this support. Testing was also continuing to be offered to other residential settings, such as mental health and learning disability homes, and other environments where there were groups of residents and staff.
In response to a question, the Borough Based Director – SEL CCG said that the figures relating to the antibody testing could be circulated to Board Members following the meeting.
Antibody testing was not generally available to patients. There had been a number of people who had tested antigen positive, but were then testing as antibody negative. Therefore it could not be assumed that if you had the antibody, you would be immune to getting re-infected. It was highlighted that PPE should be worn as recommended, and that infection control measures must be followed. It was emphasised that it was not known how long the antibody lasted in those that returned a positive test.
With regards to recovery planning, work was being undertaken to look at getting service ‘back to normal’, as well as preparing for phase two. Some NHS services had been paused during the pandemic, such as cancer screenings. Another important piece of work would be to restart the immunisation programme, and services such as endoscopy and diagnostics. It was noted that immunisations had not ceased during the pandemic, but many people had not received them. They were also working with colleagues to identify what could be done differently in phase two to be “on the front foot”. They were looking at a more strategic plan covering the next twelve to eighteen months, which involved partners across the health service and third sector.
Initial discussions regarding the recovery plan would take place the following week at the Bromley Borough Based Health Board. It was highlighted that the new SEL CCG had now been formed, within which there was a Bromley team. The Bromley team would work to ensure services for patients were as robust as possible. In terms of governance, a Place Based Board was to be established which would be co-chaired by Councillor Colin Smith, Leader of the Council and Dr Andrew Parson, SEL CCG Clinical Lead – Bromley.
A Board Member noted that there had been a lot of media attention regarding death rates, and how it could be proved if someone had died from COVID-19, rather than having COVID-19 but dying of another condition. The Borough Based Director – SEL CCG responded that there were some clear clinical cases of COVID-19 deaths, but it was noted that the figures provided included both confirmed and suspected COVID-19 deaths, based on clinical decision making. In some cases, where a patient had a terminal illness and contracted COVID-19, it was often hard to distinguish, but it was quite probable that COVID-19 was what caused that death. In care homes, as well as testing, they had asked about symptoms. It was considered that a broader approach needed to be taken with regards to symptoms in older people.
RESOLVED that the NHS Update be noted.