Agenda and minutes

Outbreak Control Engagement Board
Tuesday, 22nd September, 2020 10.30 am

Venue: Remote - To be held remotely via Zoom - View directions

Contact: Jane Garrard  Senior Governance Officer

No. Item


Apologies for absence


Clive Foster

Councillor Rebecca Langton

Catherine Underwood – Terry Dafter attended as a substitute


Declarations of interests for agenda items 3-8




Public minutes pdf icon PDF 237 KB

To confirm the minutes of the public section of the meeting held on 8 September 2020


The Board approved the minutes of the public section of the meeting held on 8 September 2020 as an accurate record.


Nottingham's Outbreak Control Plan update


Alison Challenger, Director of Public Health, gave a presentation updating on the Outbreak Control Plan.  She highlighted the following information:


a)  The Alert Level across the country has changed to Level 4, which means that cases of Covid-19 are high and rising.


b)  There is regional variation in the number of cases and rate of increase, with higher number of cases in the north-east and north-west, but all areas are seeing higher numbers of positive cases.


c)  The highest numbers of cases are currently mostly in those under 60 years, who are not presenting with symptoms but getting identified through testing.


d)  It appears that much of the spread relates to households and that is the rationale for greater restrictions on households mixing.


e)  The number of Covid-19 related deaths has slightly increased nationally and more people are being admitted to hospital for related issues.


f)  The data suggests that the country could be moving into a ‘second wave’ of the outbreak.


g)  In Nottingham there had been an additional 102 cases over the previous week and numbers appear to be holding at this higher level although there are daily fluctuations.  This is far lower than worst affected areas but locally work is focused on taking as much action as possible to minimise spread and everyone needs to remain vigilant.


h)  Since February, to date there have been 1568 cases of Covid-19 identified in the Nottingham and 239 deaths related to Covid-19.


During the subsequent discussion the following points were raised:


i)  There are issues nationally with testing.  While in many areas there is testing capacity available to meet demand, the challenge is insufficient laboratory capacity to process tests.  The Government has said that it expects this situation to continue into October and has issued new guidance that individuals should not get tested unless they have symptoms or are specifically asked to do so by an appropriate authority.


j)  Cases of Covid-19 have been reported in small numbers in all wards in the City, spreading through community transmission rather than related to specific outbreaks.  Due to the small numbers, it isn’t possible to identify particular ‘hotspots’.


k)  There has been a lot of learning in relation to reducing spread of cases in care homes and it is one of the City’s priority areas.  Care homes have worked really hard and they are currently well-protected and therefore in a good place to prepare for a potential ‘second wave’ of cases.  The Care Home and Home Care Cell continues to meet because protection of staff and service users is critical.  Regular testing of both staff and residents is taking place.  Small number of homes have been affected but it appears that this is primarily from community transmission.  The Cell is looking at workforce resilience to ensure the sector is prepared to deal with any increased levels of sickness and/or shielding.  Care home issues are reported on daily to the Daily Covid-19 Briefing. 


Board member updates


Updates were provided by Environmental Health (minute 71), Nottinghamshire Police (minute 72) and health colleagues (minute 73).


Environmental Health


Paul Dales, Safer Business, Food and Health and Safety Manager, gave an update on work that has been undertaken on environmental health issues since the last meeting.  He highlighted the following information:


a)  Over the last four weeks, there have been 300 inspections or revisits carried out, mainly in relation to hospitality and close contact businesses.  There have been some issues with continued non-compliance with the regulations and 15 health and safety improvement notices have been issued, mainly for staff not wearing the required face coverings. 


b)  Enforcement has to be taken under health and safety legislation and this can be challenging because it is not always the most effective way of achieving the desired outcomes.


c)  Complaints and concerns from the public are being raised through the new portal system and to the traditional email address.  The most common concerns are a lack of social distancing by customers queuing outside bars; shop staff not wearing face coverings (although they have not been required to); ‘pinch points’ at tills and entrances/ exits; and noise issues at hospitality premises. 


d)  Community Protection colleagues have delivered approximately 200 leaflets to shops in targeted areas requesting that they are displayed to remind customers about complying with Covid-19 requirements, and more leaflets are due to be distributed.


e)  Environmental Health Teams are supporting work on local tracing following specific outbreaks by contributing ‘on the ground’ intelligence.


During the subsequent discussion the following points were raised:


f)  Local authorities have powers to fine businesses for failing to collect required contact details from customers.  Businesses have a duty to display the new QR code but can also collect contact information in different ways if customers are unable/ unwilling to use the QR code.  There are risks that some businesses may find the change in requirements confusing and checks on compliance will be carried out. 


g)  There needs to be clear messages for businesses about the implications of failing to comply with requirements. 


h)  In the majority of cases, businesses are doing all that they reasonably can to meet the requirements and one of their biggest challenges is the behaviour of customers.  Businesses try to gently encourage compliance by customers but it can be hard and there is a role for the Police and Community Protection to support businesses in doing this.




Nottinghamshire Police


Kate Meynell, Assistant Chief Constable Nottinghamshire Police, gave an update on the work of the Police since the last meeting.  She highlighted the following information:


a)  The Police have been given additional enforcement powers in relation to the ‘rule of 6’.  There has been information in the media about what this means and the Police are working with local communities to help people understand what their responsibilities are so that enforcement only has to be used if necessary.


b)  Additional patrols have been added but so far the number of reported incidents has been quite low.  There have been 9 calls in relation to breaches of the ‘rule of 6’ and 2 of those have related to individuals self-isolating.  There have been 5 calls about licensed premises and in many cases this has related to customer behaviour.


During the subsequent discussion the following point was raised:


c)  The universities are working hard to get messages across to students but there are still local reports of parties and groups gathering in streets.  Advisory patrols are taking place in those areas.





Andy Hayes, Nottingham and Nottinghamshire Integrated Care Partnership, and Amanda Sullivan, Nottingham and Nottinghamshire Clinical Commissioning Group, gave an update from the health partners’ perspective.  They highlighted the following information:


a)  All of the primary, community and acute sectors are busy and there is particular pressure on the 111 and 119 Services, with higher than expected demand.  Work is underway to look at capacity in these services.


b)  The system is starting to see an increase in hospitalisation of patients but this is still currently at low levels.  Preparation work is taking place in case numbers of patients requiring hospital care increase.


c)  Work is continuing to support care homes taking people discharged from hospital to maintain hospital flow.  Patients are tested when they are discharged from hospital to a care home and this testing capacity is protected.


d)  Local capacity is being used to help testing issues where possible.


e)  There is the potential for staffing challenges due to numbers of people isolating, childcare issues if children are sent home from school and general staff sickness and therefore keeping staff in work is a current focus.  Health partners are aiming for a high uptake of flu vaccinations by staff.


f)  There has been media coverage that some GP surgeries are not open and seeing patients.  All practices in the City are open and activity levels are about normal, although patients may see some changes in service delivery.  In most cases a telephone triage is carried out initially to determine whether face to face contact is required.   


Rule of 6


Kate Meynell, Assistant Chief Constable Nottinghamshire Police, gave an update on the new ‘rule of 6’, highlighting the following information:


a)  There were suggestions that the previous guidance was complicated and the ‘rule of 6’ is intended to make requirements more straightforward to understand and, where necessary, enforce. 


b)  The Police have enforcement powers in relation the ‘rule of 6’ and can issue fixed penalty notices (FPNs) of £100, rising to £3200 for repeated breaches.  The Police will be monitoring the issuing of FPNs to ensure that they are proportionate and consistent.


c)  Although the intention is that the ‘rule of 6’ is straightforward and simple, there are a number of exceptions including groups that are part of the same household/ support bubble; planned events by businesses or charities that have been risk assessed in line with Covid-19 guidelines; certain activities such as elite sports training, childcare and providing emergency assistance.


d)  The Police do not have enforcement powers in relation to social distancing.


During the subsequent discussion the following point was raised:


e)  There could be challenges in determining the size of households, for example, and it will require people to behave with honesty and within the spirit of the legislation.  In the first instance, the Police will take information about household size on face value but if repeated concerns are raised then they will investigate further.


Test and Trace Overview


Mandy Clarkson, Consultant in Public Health, gave an update on Test and Trace, highlighting the following information:


a)  Nationally there are capacity issues with testing due to the high levels of demand, largely as a result of the more widespread return to schools and workplaces.  It is understood that, across the country, there have been incremental increases in capacity but every increase is immediately outstripped by demand.  The Government has said that improvements should be seen by the end of October.


b)  There are frustrations amongst members of the public about problems in accessing testing especially when it looks as though testing centres aren’t being fully utilised.  While there is capacity to take tests, there is insufficient laboratory capacity to process all of them.


c)  National priorities for access to testing have been set out and prioritised groups include hospital patients, hospital and care home staff.


d)  Testing Cell colleagues are having some success in securing some additional capacity and work is taking place on prioritising access to that additional capacity.


e)  It is important that members of the public only book tests if they have symptoms and/or are told to do so by an appropriate authority.


f)  A national self-isolation package has been created to support those in vulnerable employment/ low incomes to be able to isolate if necessary.  There is no firm evidence, but anecdotally it has been reported that some employers do not want their employees to take tests because they would then be required to isolate and not be available for work.


g)  Lots of new cases of Covid-19 are from community transmission and likely to come from social settings.  It is now mandatory for businesses to collect information on who has visited the premises to support test and trace activity.


During the subsequent discussion the following points were raised:


h)  Locally cases of Covid-19 are monitored daily and where there are higher numbers in a particular area local intelligence is used to support contact tracing and an Incident Management Team stood up if necessary. 


i)  Local contact tracing is carried out in parallel with the national system and discussions are taking place as to how to pick up cases locally that the national system has been unable to contact.  Local contact tracing can be more effective because communities are better understood.


j)  Work is taking place with Public Health England to manage tracing capacity.


k)  Some people do not want to be traced and won’t willingly engage with the process.  Therefore different tactics, such as calling at different times of day, door-knocking and if necessary escalating to the Community Protection Team are used.  The Outbreak Control Cell brings together expertise on doing this but it has to be recognised that it won’t always be possible to identify 100% of contacts.


Exclusion of public to move into confidential section of the meeting


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


Declarations of interests for agenda items 10-14


See Confidential Minutes


Confidential minutes

To confirm the minutes of the confidential section of the meeting held on 8 September 2020


See Confidential Minutes


Situational round up


See Confidential Minutes


Local arrangements for testing and contact tracing


See Confidential Minutes


Communications update


See Confidential Minutes


Any other business


See Confidential Minutes