To receive a report and presentation from the director of Public Health.

The Director of Public Health presented the COVID 19 figures across Trafford. Trafford had high levels of testing and 12.5% of tests were coming back positive. Feedback received showed that the majority of people who were receiving tests said that they had symptoms. All of Trafford’s figures were well above the England average but the positive aspect was that there were low rates among school aged children. The highest rates of infection were amongst 18 and 19 year olds and the most worrying aspect was that there had been a rise in cases among the over 60 population, who were of the highest risk from COVID 19. The second highest rates of infection were among 45 – 64 population and then the 34 – 44 population. Spread among these ages groups was concerning as they were more likely to come into contact with the older population.

Although many cases had been linked to schools it was believed that these were due to community transmissions and it appeared as though there was very little spread within schools.  There had been some outbreaks in care homes but it appeared that the measures taken to protect care home residents were working could change.  The main message was the importance of self-isolation if you have been contact with someone who had COVID 19.

The public health team had divided their work into sections which was reflected within the plan. Trafford had increased the levels of testing available, the local test and trace system was working and supporting the national system, and the team had been working closely with care homes and businesses to make them COVID safe. There had also been an increased focus on community engagement to find out what people were struggling with to ensure there was adequate messaging and support available. Following the introduction Board Members were given the opportunity to ask questions.

Councillor Blackburn noted that if one child tested positive then their whole bubble was sent home but their siblings were still able to go to school and asked the Director of Public Health to explain that approach. The Director of Public Health explained that in early years if a pupil or teacher tested positive then the whole bubble was sent home. In secondary schools it was just the close contacts who had to isolate. The practice was one step of separation between anyone who had been infected and those who were required to isolate. So if a child or teacher tested positive anyone who had direct contact needed to isolate but the siblings of those who had been in contact with the infected person would not need to isolate.

Councillor Blackburn noted that a testing facility was to be set up at the Soccer Dome in Trafford Park and asked what publicity and signage was in place. The Director of Public Health responded that publicity and signage was due to be set up as soon as the facility was running.

The Vice Chair raised concerns about the health impacts of the restrictions on the public’s health due to people not seeking medical advice and mental health due to increased isolation. The Chair responded that those concerns had been picked up within messaging going out to the public. The Director of Public Health added that there was a need for more positive messaging about what you were able to do such as going out to meet friends and family as long as they arrange to do so safely.

The Corporate Director for Adult Services then gave an overview of the Winter Plan which had been circulated with the Agenda. This year’s Winter Plan was longer than in previous years as it covered the NHS Wave Three Guidance in addition to the Adult Social Care Winter Plan and both parts needed to be completed for submission by the 31^st October. The plan covered a number of core issues including the flue, increased admissions, falls, and respiratory problems.

The Outbreak Management Plan covered Trafford’s response to the second wave of COVID 19.  Modelling had been completed utilising data on activity since the first outbreak to identify the likely impact of the second wave. There was a single plan for Trafford bringing all aspects of Health and Social Care together. The plan detailed the pathways that had been refreshed from the lessons learned over the course of the pandemic. The pathways covered discharges from hospital, respiratory support, support into homes, support into care homes, end of life support, and the long term impacts of COVID 19.  The recovery and reform group were tracking the work and all partners across the health and care sectors were involved in bringing the plan to fruition. The operating model for the system was in place and had been enhanced in line with the most recent guidance. The Hospital discharge guidance was still in operation which required patients be discharged within three hours of becoming fit to leave and to be tested prior to discharge to a care home. The Urgent Care Control room tracked all patients who were discharged and ensured that follow up support was put in place. 

The Corporate Director for Adult Services informed the Board that a different pattern was emerging in the second wave. In the first wave the majority of those who were admitted to hospital were very ill and it was between six to eight weeks before they were ready to be discharged. In the second wave the people being admitted were younger and were recovering faster. In response to this the government had released new guidance on having a designated site for anyone who was COVID positive and an agreement had been reached to have joint provision between Manchester and Trafford.

Discharge to assess beds had been utilised throughout the pandemic and the Council were renewing those contracts. The rapid discharge homecare services were also being renewed for the next phase along with the therapy provision to support discharges into the community. The required capacity was being tracked on a daily basis to enable action to be taken swiftly if additional capacity was required. Digital support was being used to deliver as much support as possible. The latest guidance switched the sourcing of PPE equipment to a national portal, which was to be free to both registered and unregistered services. The hub that had been set up by Trafford and Manchester would continue for the foreseeable future to support the national process and act as a back-up option if required. 

All care homes were contacted twice a week which would continue throughout the winter period. All outbreaks were being tracked and the infection control team responded quickly to any outbreaks. Weekly testing was in pace for Care Home staff with monthly testing for residents. There were an increased number of risks during the winter months and the Director of Adult Services was confident that the risks had been identified and with plans in place. The main risk was the cost of the second wave which would put all services under significant pressure. There had been a change in the funding of support with the NHS providing funding for the first six weeks following discharge then the cost would move to social care and place additional strain on the Council’s budgets. The financial impact was being monitored and work was ongoing nationally to manage those risks.

Following the overview Board Members were given the opportunity to ask questions. The Mental Health Lead for Trafford Housing Trust informed the Board that there had been some issues with accessing therapy provision at the One Stop Resource Centre and asked when it was likely to go back to normal levels. The Corporate Director of Adult Services responded that this had been discussed at the Local Care Alliance and guidance was due to be reissued across the system in relation to the contact and service offer for all services. The Corporate Director of Adult Services requested that the details of any particular service issues be sent to her so they could be addressed. 

The Chair of the Trafford Strategic Safeguarding Partnership welcomed the information and assurance provided by the Corporate Director of Adult Services but raised concerns around Children’s Services especially around mental health support in the wake of the pandemic. The Chair of Health Watch Trafford responded that some deep dive exercises on children’s services had been conducted by the Quality, Finance, and Performance Board and an update was due in December. 

The Mental Health Lead for Trafford Housing Trust raised that a lot of the outdoor play equipment was in need of maintenance across Trafford. The Chair responded that she was aware that work was ongoing at Longford Park following an accident. The Chair assured the Board that the One Trafford Partnership were working on improving the outdoor play facilities across the Borough. The Chair asked that people contact Councillor Patel with the details of any specific issues so that she was aware and could address them.

RESOLVED:

1)    That the COVID 19 update be noted.

2)    That the Winter Plan be noted.

3)    That the COVID 19 Outbreak plan be noted.