(18:30 – 19:00)*
For the Committee to receive an update from Adult Social Care Services on COVID-19, to enable the Committee to monitor the ongoing pandemic and scrutinise the ongoing response to COVID-19.
Minutes:
The Director of Public Health for BCP Council introduced the progress report on Public Health and Adult Social Care Response to the COVID-19 Pandemic. The main points raised during the Public Health part of the presentation were as follows:
• Since the start of Spring 2020, BCP saw 18,000 cases in total. More than 6000 of these cases had occurred in the most recent two-week period.
• The 7-day infection rate for BCP Council stood at 881 cases per 100,000 between 3 January and 9 January. On the 18 January, the figure had reduced to 831 per 100,000.
• The rate of infection in Over 60s was at 641 per 100,000. This figure had increased to 691 per 100,000 between the period of 8 January to 14 January. This was because of current outbreaks in care homes, which accounted for between one third and one half of all cases in Over 60s.
• The South West regional rate throughout the same period was 385 per 100,000. This was less than the English national rate of 609 per 100,000.
• The epidemic curve of case numbers showed a sharp increase from the week commencing 7 December 2021.
• The infection rate per 100,000 of the population for neighbouring councils, such as Dorset, Southampton, Hampshire, appeared to reach their peak sooner than BCP’s, which continued to increase for up to a week. BCP were now seeing a steady fall in case rates, however it was hoped that the reduction in cases would speed up as the lockdown measures took effect.
• On supporting the wider system, Public Health Dorset were evaluating and planning with the NHS the healthcare capacity required to deal with the number of cases in hospitals. On this, EpiCell modelling was assessing the critical care capacity required for the next 2 – 3 weeks.
• It was believed that the peak impact on hospitals would not to be seen until 24 January 2021. Infections that occurred a week to ten days ago are currently manifesting as hospital admissions at present.
• Media briefings were held to stress the urgency of the issue with the public and communications were of great significance during this latest wave of infections. Therefore, a postcard, agreed with the local outbreak engagement board, was circulated to every household across BCP, advice was given to care homes to encourage family visits only to be enabled in exceptional circumstances such as end of life, and transparent information continued to be published on the Public Health Dorset website and across the social media channels. Signposting to the Public Health England daily updates also occurred as often as possible.
• Testing of Frontline Council employees would start on 18 January 2021 and this would extend to those working in the community who are not covered by other offers.
• The virus seems to now be more transmissible, as observed in care homes and hospital wards. It was stressed that behaviour and adherence to public health measures was of vital importance at this stage.
• Communication around vaccination and rapid testing needed to be clear. People must understand that social distancing and practising good infection prevention and control measures are still highly important throughout the duration of the pandemic.
• There is a real risk of infection rates increasing if lockdown ends before the rates are sufficiently reduced.
• There had been a shift, following behavioural insight and the development of content for younger age groups, to emphasise praise for compliance to prevention measures.
• The roll out of community testing was underway. The purposes of this was to find cases in the community, not to release from isolation or reduce restrictions.
The Committee asked several questions following the public health presentation. Answers were provided by the Director of Public Health. The questions and responses included:
• A Member asked how many of the people admitted to hospital with COVID had recovered. The Committee heard that of the 2488 that were admitted to hospital with COVID, 1102 had recovered and been discharged from hospital. Of those admissions, 458 had died in hospital.
• A Member referred to the opening of the BIC vaccination hub and asked if there were a possibility of extending the opening hours of the hub. The committee heard that the NHS vaccine delivery model was reliant on the workforce who were on hand to staff the centre and that at present, they were working as fast as vaccine supply would allow. It was also highlighted that the primary care networks were also vaccinating and were doing so at a very good rate. The Chair raised the point that voluntary roles were required for the vaccination process, be that vaccine training or other supporting roles.
• A Member stated that the Public Health England updates on social media were extremely informative and were a great way to disseminate the information to others.
• A Member asked for clarification on the daily case figures and heard that the daily case rates fluctuated every 24 hours. Therefore, the 7-day rate was a much clearer and more reliable data on the rate of infection.
• A member asked a question on the increasing rate among over 60s and how this would potentially have great impact on hospital admissions. The Director of Public Health explained that models on potential hospital admissions depend on various factors and are remodelled often by EpiCell.
• A member asked if the latest wave of cases was due to the new strain from Kent and the South East. Members heard that it was difficult to tell from local testing as genetic testing was not available on majority of community cases. The assumption is that the new variant is in BCP and is playing a role in transmission rates.
• The Portfolio Holder for COVID Resilience, Public Health and Education emphasised the point that BCP hospitals had not yet seen the peak of admissions and that key messages of lockdown and preventative measures continue to be crucial.
The Director of Adult Social Care Services introduced the social care services aspects of the presentation. The main points of the update were as follows:
• Very significant levels of the Adult Social Care resources were going toward the rapid hospital discharge process.
• The number of safeguarding concerns and Mental Health Act assessments were increasing again, which was to be expected, as was the case during the first national lockdown.
• There was lowered demand for respite care due to people wanting to prevent transmission of the virus and not mix with other people if possible.
• There was an increase pressure on family carers for people with a learning disability.
• Remote working was increasing between field workers and clients, such as the use of telephones.
• 25 of the Adult Social Care staff were currently away from work with COVID or suspected COVID.
• Staff testing was up and running and allowed those who were a-symptomatic to isolate as appropriate. This could lead to a greater number of staff sickness.
• Service has looked at alternative delivery methods, such as providing alternative day-time opportunities and supporting carers to form online groups via teleconferencing.
• In-house care services were running almost as normal. The Start service was mostly focused on discharge. Priority was on protecting and emotionally supporting service users in the Supported Living ahd Shared Lives services.
• Adaptations to people’s homes had reduced where they are not high priority due to the risk connected with entering people’s homes.
• Between March and August, people who left hospital did not have to pay for care, since August leavers are receiving up to 6 weeks of care without charge to enable recovery and reablement. The revised finance model for provider payment and billing has been very complex to implement at fast pace.
• In partnership with CCG, the service is having to assess and reassess clients who are eligible for healthcare. These were paused between March-August 2020.
• The resilience and wellbeing of staff was vitally important as they have worked tirelessly for months throughout the pandemic.
The Committee asked several questions following the adult social care presentation. Answers were provided by the Director of Adult Social Care Services. The questions and responses included:
• A member asked whether there were any funding or resource issues in mental health services. The Committee heard that it was difficult for hospitals to assess people who needed help, treatment or admission. BCP only has limited Approved Mental Health Professionals and there was concern that if these workers went off sick, the service may not reach all those who have acute needs. The service was looking at bringing in locum staff to prevent people from needing to wait for an acute mental health assessment.
The Director for Adult Social Care Commissioning explained the social care commissioning aspects of the presentation. The main points of the update were as follows:
• The Council had continued to distribute grant, with a total of £16 million funding to support infection control measures.
• A weekly Communication has been circulated to all Adult Social Care providers by the Corporate Director of ASC and the Director of Public Health.
• Staffing shortages were occurring, particularly in care homes. and work was ongoing with the Local Resilience Forum to continue supporting care providers.
• Vaccination of staff was taking place at the Royal Bournemouth Hospital and the BIC hub.
There were no further questions and the Chair thanked those that had presented.