Agenda item

The Board received an update from the Director of Public Health for South Tees on Covid.  The Board heard that the rates of Covid infection across Redcar and Cleveland had flattened and had dropped dramatically from around 500 cases per 100,000 to around 140 cases per 100,000 however the rate of decrease has flattened.  In Middlesbrough cases are starting to increase which is driven largely by 25-34 year olds which is a concern that it escalates through to older age groups and can have an impact on the hospitals.   The Board was advised that activity within the hospitals had reduced and was flattening.  It had reduced from 20-25 new cases per day to around 10 people who had been admitted to hospital with Covid or diagnosed in the hospital.   It is significantly lower than what it was but is still providing pressure on the NHS.  It was advised that there is 10-11 people in the Intensive Care Unit at James Cook Hospital.

The Board heard that the rates had fallen very rapidly but unfortunately they had not fallen far enough from the perspective of the Director of Public Health for the easing of restrictions over the Christmas period when more families will be mixing and staying overnight which could amplify the spread of the virus and there is concern that we could see a rate of increase to that of before the national lockdown which was around 500 cases per 100,000.  It was advised that January is a busy period for the NHS and the impact of the easing of restrictions over the 5 day Christmas period will be critical.

It was advised that work is being undertaken on Communications and amplifying the messages of the national communication around Covid to ensure that people enjoy Christmas as safely as possible.  There is a pilot community led testing taking place in Grangetown running until 18 December to see what the demand for testing is.  The pilot will test asymptomatic residents using the lateral airflow tests and will determine what communities think of this testing.

Both Middlesbrough and Redcar and Cleveland all looking at opening up a larger testing regime around mid-January which will give both local authorities time to plan and allow for learning from other areas that have carried out mass testing as the financial modelling relies on numbers tested for the income that would be received to support the costs.

The Board also heard that both local authorities had signed up to the local tracing partnership which will look at contacting residents that the national scheme has been unable to contact this went live on 9 December 2020 and both local authorities a part of a pilot to get those cases sooner than 32 hours and get access to them immediately which will have an impact as residents will be informed of support that is available to them.  There is a drive between Christmas and New Year to have as many contract tracers in place as possible in case of a rise in numbers.

Members raised grave concerns over the relaxing of rules over the Christmas period and also if both areas are reduced from Tier 3 to Tier 2.  A member queried the rates of cases in schools and was advised that the rates of cases in Redcar and Cleveland schools had decreased slightly but they were rising in Middlesbrough schools which reflects the rates of community transmission.  There has not been an amplification of numbers through schools as generally when a case is identified the bubbles isolate.       

The Board also heard about the work being undertaken at James Cook Hospital regarding the vaccination programme.  The hospital had vaccinated around 400 members of staff, patients and care home staff each day since the arrival of the vaccine.  It was advised that approximately 400 care home staff had been vaccinated between Tuesday and Friday.  A member queried about the Oxford vaccine it was advised that there had been no further information on when this vaccine would be available.   Alan Downey acknowledged the phenomenal effort being made at James Cook Hospital.  It was advised that the hospital are waiting on a daily basis for the vaccine to arrive.  Concerns were raised by members about the time it was taking for the vaccine to arrive and the short supply of the vaccine.  Alan Downey stated that they were awaiting the next batch of the vaccine at James Cook Hospital.  Following the meeting it was confirmed that the latest batch of the vaccine had arrived and there had been no interruption in the vaccination programme at James Cook.  A member queried how many employees of James Cook Hospital had been infected with the virus it was advised that the level of infection amongst staff was approximately 3 times the average of the population at large.  It is closely monitored and a significant number of staff are absent through isolating due to coming into contact with the virus or they have the virus themselves.  It was advised that this is currently manageable.  It was advised that there has been a drop in the number of patients being admitted with the virus and this had flattened however there is a nervousness in what will happen following the Christmas period.  The Board heard that the morale of staff had been boosted due to the arrival of the vaccine.

Systematic approach to consider policies and their impact against Marmot Recommendations:

●     Give every child the best start in life

●     Enable all children, young people and adults to maximise their capabilities and have control over their lives

●     Create Fair employment, good work for all and a healthy standard of living for all

●     Create and develop healthy and sustainable places and communities

Whole System Monitoring: Inequalities Focus

●     Identifying inequalities for the patient groups - access, stage of presentation, processes and outcomes

●     Identifying patient groups with unequal access and experiencing the greatest inequalities in access to diagnosis and treatment, and /or inequalities in outcomes

●     Carefully design and monitor implementation of digitally enabled care pathways to ensure they do not exclude people due to barriers in access, connectivity, confidence or skills.

●     Inequalities further upstream on the pathway

●     Identify inequalities in preventative, early detection and diagnosis, primary care management, community management and other parts of the pathway

●     Why do some patients present early/late and what can be done to support this?

●     Social factors associated with access to services that could widen inequalities

●     Are there going to be social barriers to accessing services e.g. finance, transport, health literacy, cause barriers to accessing treatment?

●     How can we understand the wider pathway and interface with other services and agencies