(19:30 – 19:45*)
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 section of the presentation were as follows:
· Infection rates had continued to fall in the BCP Council area; lockdown 3 has been very effective at reducing transmission.
· The 7-day infection rate for BCP Council had fallen below the rate for England at 57 per 100,000 as of Feb 21 – 28.
· The transmission rate in Over 60s was also declining rapidly, with the current figure of 38 per 100,000. The South West regional rate for the same period was 44 per 100,000, with England standing at 81 per 100,000 population
· Testing positivity was 3% across BCP. This was an improvement on the figure in early January 2021 where positivity reached 19%.
· Although there had been improvements there was no room for complacency as some parts of the country, including the Midlands, North West and parts of London were showing increases in infections.
· More than 300,000 people in Dorset and BCP Council areas had received their first dose of the vaccine.
· Hospital admissions were reducing more quickly than predicted. The national evidence showed that the vaccination rollout was helping to reduce hospital admissions and reduce deaths; this was compared with modelled estimates.
· The Government’s roadmap provides a clear framework for how Public Health England will provide support whilst lockdown restrictions begin to ease.
· There is a national requirement to refresh the local outbreak management plan, as of 12 March.
· This revised plan will include preparations for how to live safely with COVID-19, providing assurance on local capability and capacity to respond to future outbreaks. This involves the mobilisation of rapid community testing and closer working with the Test and Trace scheme to identify contacts of those who are infected.
· Enhanced surveillance will be introduced to inform rapid suppression of cases.
· A vaccine coverage assurance was underway to close gaps in uptake among cohorts within the community that are as yet not taking up the vaccine offer.
· There were plans underway for surge testing of Variants of Concern.
· There was now also an opportunity to show learning from the past 9 months, with the ultimate aim to progress to a business as usual COVID mitigation strategy.
· Maintaining confidence in public adherence to social distancing and hygiene measures was imperative along with supporting schools to open safely which relied upon the lateral flow testing of secondary pupils and household bubbles.
· Clear communications around vaccination and rapid testing must be upheld. Neither receiving the vaccine or engaging in testing programs means that people can stop social distancing and practising good infection prevention and control measures.
· Getting infection rates down further would be key to prevent the risk of a resurgence.
· Public Health Dorset were monitoring the take up of community asymptomatic testing.
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:
• The service continued a focus on the hospital discharge program.
• There was now a lower demand for Respite Care, community based Domiciliary Care and Care Home placements from the community.
• There were certain challenges in accessing respite care for people with a learning disability and family carers and this was identified as a specific matter that needed addressing.
• Safeguarding concerns remain high with several groups. This was evidenced by volunteers reporting more concerns for their patients.
• Mental Health Act assessments and CMHT demand continued to be high which reflected the impact of the pandemic on mental health. Many residents were less able to access treatment services.
• Remote working continued to be successful and sickness absence was decreasing. Testing had begun taking place regularly among staff and many were being vaccinated.
• PPE continued to be a routine part of operational practice with staff being both well-equipped and trained.
• Flexibility remains in the closure of Day Centres.
• Reviews and the re-provision of services to patients discharged during the first phase of the pandemic, between March-August 2020 were now concluding.
• Recovery of paused Continuing HealthCare assessments from the first phase of the pandemic (March-August 2020) continues.
• The risk of staff absence because of Covid-19 related illness or self-isolation was now much lower, however many of the pandemic related pressures on carers continue and a backlog of non-urgent care demand was showing.
• In terms of support for care providers, grant funding to support infection control measures, workforce capacity and rapid testing ends on 31 March.
• Ongoing infection prevention and control training continued to be offered and taken up by staff. This was in conjunction with the Clinical Commissioning Group.
• Advice, guidance and weekly briefings were being given from the Director of Adult Social Services and Director of Public Health.
• Staffing shortages were being supported via work with the Local Resilience Forum. There showed to be a reduction in demand.
• The vaccination co-ordination continued and encouragement for all eligible social care workforce to take up the vaccination was offered. This was still very much a focus for the service.
• Dorset HealthCare Trust had been providing a service for staff in all social care and NHS organisations to support those who were experiencing high levels of stress and distress. It was found that social care leaders were reporting some high levels of emotional stress within the sector – particularly in care homes.
• There had been a visible reduction in the number of care homes with infection outbreaks but there still needed to be vigilance on the matter as the risk remained high.
• The availability of care provision was good, however costs are still rising which had been linked to additional requirements of COVID that was not covered by grants.
• Strategic commissioning activity was underway and developments of commissioning strategies for older peoples care homes and extra care housing was ongoing.
• National guidance on care home visiting would change on 8 March and would enable increased levels of visiting by relatives in order to support the well-being of residents.
The Committee asked several questions following the adult social care presentation. Answers were provided by the Director of Adult Social Care Services and the Director of Public Health Dorset. The questions and responses included:
· A member asked what the uptake amongst care home staff and carers had been. The Committee were told that up to 68.2% of staff had received their first vaccination. A number of staff had been absent due to COVID and therefore could not take vaccination at the time; several if not most of this number would be picked up at a date in the near future. A small number of the cohort had opted not to take the vaccine and work to support encouragement efforts in this area was ongoing.
· A member asked about demand for the BIC vaccination hub. The Members heard Primary Care Networks had been key in the first stages of the rollout and that the BIC hub would see demand rise when the younger age groups were called for their vaccinations.
· A member asked when teachers will be called for their vaccines. The Committee were informed that the vaccine rollout was a nationally-lead programme that was being delivered at a local level. Command and control around routes of vaccination and supply of vaccination and order of cohorts were all lead nationally and unfortunately there was no leeway for local determination.
There were no further questions and the Chair thanked those that had presented.