Agenda and minutes

Councillor Rebecca Langton

Carolyn Kus – Steve Oakley attended as a substitute

None

To confirm the Minutes of the public section of the meeting held on 15 January 2021

The Board approved the minutes of the public section of the meeting held on 15 January 2021 as an accurate record.

Alison Challenger, Director of Public Health, gave an update on Nottingham’s Outbreak Control Plan highlighting the following information:

a)  There is an improving picture in relation to infection rates, with 1,342 positive cases in the last seven days, which is a rate of 403.1 per 100,000 population.  This is a 6% decrease compared with the previous seven days.  However, this reduction is starting to plateau, which is concerning.

b)  This rate is similar to the England average of 403.9, however rates in England are reducing at a faster rate than in Nottingham. 

c)  While there continues to be high rates in all adult age groups, the highest rate is in the 23-59 year age group.

d)  It takes a few weeks for changes in the number of positive cases to impact on pressures in hospitals, so it will be some time until hospital pressures ease.

David Johns, Consultant in Public Health Nottingham City Council, provided the following information about work to support care homes in responding to Covid-19:

a)  The Care Homes and Home Care Cell supports a system and partnership response including the City Council, Clinical Commissioning Group and NHS providers.  There is a robust governance structure in place that enables issues to be appropriately escalated for a strategic level response to supporting care homes.

b)  A daily taskforce meeting is held.  The meeting is multi-disciplinary involving partners such as Adult Social Care, Commissioning Teams and Public Health Teams.  It looks at issues such as outbreaks, workforce challenges and quality issues, identifying how best to support care homes on current issues.

c)  The Incident Management Team meets weekly and draws together themes from outbreaks to either deal with directly or escalate to the LRF or nationally, as appropriate.

d)  Outbreak Control Teams are put in place if required.

e)  There has been a huge amount of guidance for care homes.  On issues such as arrangements for visitors, there is national guidance and Directors of Public Health are able to provide information on the local position in line with that national guidance.  While acknowledging the risks, the aim is to keep care homes as open as possible.  Care home managers know their homes best and are best placed to make the necessary risk assessment, and they are being supported with the tools to do this.

f)  The Infection Prevention and Control Team provides advice on testing.  There have been recent changes in guidance and care homes are being helped to work through the implications of these changes.  New national funding is being passed on to care homes to support them with putting the new testing guidance into practice.

Steve Oakley, Acting Director for Procurement and Commissioning Nottingham City Council, provided the following information about the work of his Team in supporting care homes:

g)  The Team has been in contact with care homes throughout the pandemic, initially on a daily basis although this has reduced now.

h)  Care homes are operating in a very challenging environment, but have mostly coped well with the challenges and the changing guidance. 

i)  Testing has led to issues with staffing capacity, but care homes have generally managed this well so far. 

j)  Care homes have managed the best they can in terms of meeting reporting requirements.  It is important that relevant information is reported and recorded but the Team acknowledges that those required to complete reporting requirements are the same people providing frontline care, especially when there are staffing pressures. 

k)  One of the challenges for care homes is coping with the number of ill residents and deaths.  The inability to hold face-to-face staffing meetings etc reduces opportunities for staff to share, and be supported during these difficult and emotional times. 

l)  It is important to remember that care homes operate as private businesses and have to make decisions on this basis. 

Fiona Branton, from the Infection Prevention  ...  view the full minutes text for item 166.

a)  Environmental Health

b)  Nottinghamshire Police

c)  NHS

Paul Dales, Safer Business, Food and Health and Safety Manager Nottingham City Council, gave an update on work to look at compliance by supermarkets and min-markets.  He highlighted the following information:

a)  Visits are being carried out over 2-3 weeks to look at compliance and how compliance can be improved.  This will include 27 supermarkets/ local versions of national supermarket chains and 35 independent outlets.

b)  Customer behaviour impacts on the measures put in place and perceptions of safety.

c)  For the national chain outlets, visits include looking at company standard procedures, an on-site inspection against those standards, an assessment of the local management attitude towards compliance, a review of front and back of house checks and a reality check on customer compliance to see how things are working in reality.

d)  For local independent stores, visits include completion of an inspection check form (based on national regulations), a check for Covid-secure measures, provision of a free information sheet and provision of free posters for display to customers. 

e)  The main issues identified in relation to local independent stores are a lack of available hand sanitiser, not having a maximum capacity set, a lack of signage and a lack of floor markings to help with social distancing and one way systems.

f)  The main issue identified with stores of national supermarket chains is the difficulties of challenging and enforcing customers for not wearing face coverings.

Steven Cooper, Nottinghamshire Police, gave an update on the work of the Police, highlighting the following information:

g)  The Force has continued to follow the national approach, with a focus on engagement and then enforcement as a last resort. 

h)  Most incidents reported to 101 currently relate to social gatherings and supermarkets, particularly in relation to their enforcement of wearing face coverings.  The Police also take a proactive approach if there is intelligence from social media, neighbourhood teams etc about a potential incident.

i)  Since 1 October 2020 there have been over 6,000 Fixed Penalty Notices (FPN) issued, 80% to people aged under 30, and 62% to men.  Most of these are single incident offenders but there are a number of repeat offenders, with one individual found to be breaching the rules 5 times.  This has resulted in a significant fine for that individual.  68 FPNs have been issued to people from outside of Nottingham and Nottinghamshire.  12 fines of £10,000 have been issued in the City.  Data shows that the level of enforcement mirrors infection rates. 

j)  The Police are also supporting the vaccination programme, with staff and officers at vaccination centres to be able to respond if needed.  Response Plans are in place for all centres.

k)  Changes are coming into force soon, enabling those present at gatherings of over 15 people to be fined £800, which is a significant increase from the current fine of £200.

Amanda Sullivan, Nottingham and Nottinghamshire Clinical Commissioning Group, gave an update on the position in the NHS.  She highlighted the following information:

l)  There were  ...  view the full minutes text for item 167.

Mandy Clarkson, Consultant in Public Health Nottingham City, gave an update on the Local Testing Strategy.  She highlighted the following information:

a)  As infection rates increase, asymptomatic testing is becoming an increasingly important part of the strategy.

b)  There have been changes in the national emphasis on asymptomatic testing, prioritising those unable to work from home and the programme has been extended to all local authorities. 

c)  There are a range of national testing programmes for the NHS, care homes and domiciliary staff, with pilots for other settings such as prisons, asylum centres and food manufacturing plants.  Workplaces with under 250 key workers are the responsibility of local authorities.

d)  In Nottingham and Nottinghamshire there is a co-ordinated programme, focusing on more testing closer to where people live; frontline workers; and homeless people. 

e)  Work is taking place to look at waste water extraction to inform the triangulation of knowledge and help to focus efforts.

f)  The first asymptomatic testing site in the City opened in Forest Fields on 22 January.  It has had a slow start and it is hoped that interest will build.  It was originally thought that the site would only target people living in that area but everyone is welcome to attend that Centre to get tested.  If it gets too busy then the position will be reviewed and it may be necessary to set up other sites.  Two further sites are planned for Mansfield and then Worksop. 

g)  There will be close focus on the Forest Fields site to try and increase the number of people getting tested.  This will be supported by targeted communications.  The next steps will then be to look at setting up other sites in the City.

Sarah Carter, Nottingham and Nottinghamshire Clinical Commissioning Group, gave an update on the Covid-10 Vaccination Plan.  She highlighted the following information:

a)  95% of older adults living in care homes have been vaccinated.

b)  As at 24 January, 95,000 vaccinations have been delivered.

c)  There has been a significant improvement in uptake by those aged over 80 years, although some population groups have lower uptake than others.  The Integrated Care Partnership is reviewing local data to identify groups with lower uptake to identify how this can be addressed.  Work is taking place with local faith leaders groups and in areas of high deprivation to encourage and support people to book appointments.  Establishing ‘pop up’ sites and using GPs and pharmacies is being explored to try and provide hyper local solutions for particular population groups.

d)  Local letters have gone out to those aged over 75 years inviting them to book a vaccination appointment and appointments are now bookable. 

e)  People aged over 70 years should get their local letter tomorrow and the online booking link will be shared.  National letters are going out to this cohort on Friday.

f)  Letters are being sent out to housebound individuals with details of the roving service that can visit their house and transport to vaccination sites.

g)  The key messages are:

  i.  The NHS is confident that vaccination is very safe and highly effective.  Vaccines are highly regulated products.

  ii.  Evidence shows that the vaccine is effective for black, Asian and ethnic minority communities.

  iii.  Neither of the vaccines currently used contain any animal products.

  iv.  Vaccination appointments are available seven days a week into the evening and transport is available to take people to appointments if necessary.

  v.  Everyone’s support is needed to improve uptake.  If people have elderly relatives they can help them to book and attend appointments. Trusted community leaders are needed to help target messages towards specific communities and help is also needed to counter non-evidence based and non-scientific anti-vaccination messages.  Any ideas on how to improve uptake are welcome.

  vi.  Vaccinations are only available from the NHS and are free.  The NHS will contact individuals when it is their turn to book a vaccination appointment. 

During the subsequent discussion the following points were made:

h)  Nottinghamshire County Council Customer Support Line can answer questions about the vaccination process, including booking transport.

i)  It was suggested that community leaders could be recorded receiving their vaccination for circulation.  Medics and nurses have been recorded but it would be good to broaden this out.

j)  It would be helpful to have regular published data on the number of vaccinations to help build confidence in the programme.

k)  There is sufficient capacity in Nottingham and Nottinghamshire. The Forest Fields site is extremely well used and capacity will look to be uplifted in response to demand.   

l)  A hyper vaccination site has opened in Derby and people living 30-40 minutes drive away from this site will be sent a national letter inviting them  ...  view the full minutes text for item 169.

The Board agreed to exclude the public to move into the confidential section of the meeting.

See Confidential Minutes

To confirm the Minutes of the confidential section of the meeting held on 15 January 2021

See Confidential Minutes

See Confidential Minutes

See Confidential Minutes