Minutes:
The LBB Director of Public Health provided Board Members with an update in regarding COVID-19 in Bromley. Weekly reports containing data relating to COVID-19 within the borough had been provided to Board Members, however it was noted that the structure of these report would be changed as more information of interested was being provided.
The LBB Director of Public Health highlighted that incidents of COVID-19 were increasing across London, nationally and internationally. The figures for Bromley provided in the latest report looked better than they truly were due to issues with testing in London, and nationally. As fewer people were being tested than required, not all cases would be identified – other data sources and modelling suggested that the actual figure of cases in the borough was likely to be significantly higher.
Over the summer, the Public Health team had been focussing on prevention and working with communities. In the last few weeks, the emphasis had shifted towards more work on contact tracing. It was noted that there had recently been a lot of media coverage which suggested that the NHS Test and Trace was not as efficient as it should be, and how some of the functions should be transferred to local Public Health teams. This had happened in areas with high incidents, giving the teams priority access to the Test and Trace database and training. The LBB Director of Public Health advised that preparatory work relating to this had been undertaken in the borough, and an ‘Expression of Interest’ would be submitted shortly. The team were now at the point where the system could be set up, and a local two-week pilot would start the following week. It was hoped this would provide an indication of anything that needed to be adapted or changed, prior to taking on the ‘locally enhanced’ contact tracing at the beginning of October. Additional work undertaken had included preparatory work on outbreak management plans, and regular updating of protocols and regulations as national guidance changed. It was noted that more and more functions were being passed on to local Public Health teams from Public Health England (PHE) – significantly in relation to work with schools and care homes. There was an indication that work relating to single outbreaks would be passed on too, and therefore training was being delivered to others, such as school nurses so they could take on some of the functions to support schools, as well as schools themselves for when incidents started to increase.
The Chairman noted that Bromley started in a good place and recognised that Test and Trace had been difficult here, as it had been across the country. However, it was encouraging that going forward there would be three testing centres located in the borough.
In response to a question, the LBB Director of Public Health advised Board Members that the transfer of the Test and Trace function to local Public Health teams was based on the national model and was led by PHE. A large amount of work had been undertaken in preparation to express an interest, including setting up a system to cross-reference the data and recruiting contact tracers. Those recruited would be required to undertake a three-day training course delivered by PHE. The Chairman requested that the full evaluation of the local two-week pilot be shared with Board Members.
In response to a question, the LBB Director of Public Health confirmed that social workers and health care workers were priority groups for access to testing – this testing was through a different system to that used for the general public. The Chairman noted that around 110,000 test slots were being reserved for key workers. The Test and Trace app had launched earlier in the day, which was a step forward, however testing was still currently difficult.
The Vice-Chairman noted the importance of keeping schools in the borough open and asked if anything could be done to increase the number of COVID-19 testing kits available to them. The LBB Director of Public Health said that information provided by PHE advised that schools were provided with 10 testing kits per 1,000 pupils a week, which were for emergency use only. If there was a single case, parents could request a test via the national portal – it was noted that there had been problems with testing in general, however this week there had been some increase in the provision for London. If there was an outbreak in a school, PHE would manage it by testing those involved separately. The Chairman highlighted that some schools had not received these emergency tests from PHE.
The LBB Director of Children’s Social Care advised Board Members that the LBB Director of Education and herself met with the Department for Education (DfE) on a weekly basis and had been pushing them on a number of issues. This had included the problems faced by schools that used a testing kit when trying to obtain a replacement. The DfE had given assurances that schools were now able to order replacement kits via the portal. Another issue raised had been proportionality, as there was a number of large schools in the borough, and this would be closely monitored.
The One Bromley Programme Director – South East London Clinical Commissioning Group (SEL CCG) informed Board Members that, as part of the One Bromley local care partnership, work had been undertaken locally on a recovery plan. This was being developed using the lessons learnt from the last six months, both positive and negative, to transform services and prepare for winter and a potential second wave of COVID-19. A comprehensive programme of work would be established over the next few months, which also looked forward into next year.
A number of priorities had been set out in the Winter Plan, including how community services would continue to be developed to support COVID-19 patients. Other priorities were to assist with hospital discharges and further develop the Single Point of Access (SPA); provide additional capacity in the system around primary care; and working with colleagues in the Local Authority regarding how best to support their schemes. It was noted that further details were provided in the Bromley Winter Assurance Plan 2020/21 update that would be presented later in the meeting.
The GP Clinical Lead – SEL CCG noted that during the COVID-19 pandemic, many people would have experienced a sudden transformation in the way services had been delivered. Going into recovery it was important to get as many services open and running as possible; catch up on waiting lists; and encourage residents to access health services. It was a difficult time for primary care with COVID-19 rates increasing; the need to maintain social distancing; and making sure services were safe to access. There was a need to ensure that communications relating to this were sent out to patients. The One Bromley Programme Director – SEL CCG advised Board Members that a public document was being finalised as part of the recovery plan, to address lessons learnt as well as managing expectations. It was agreed that this document would be shared with Board Members once finalised.
The Portfolio Holder for Adult Care and Health expressed thanks, on behalf of herself and the Leader, for the excellent work undertaken by Chloe Todd, LBB Consultant in Public Health, to produce statistics and reports on COVID-19 trends within the borough. This was echoed by the Chairman, who advised that a letter of thanks would be written to the LBB Consultant in Public Health on behalf of the Health and Wellbeing Board.
RESOLVED that the COVID-19 Update be noted.