Ruby Bhattal – Steve Thorne attended as a substitute

Alison Challenger – David Johns attended as a substitute

Steven Cooper – Paul Winter attended as a substitute

Andrew Errington

None

To confirm the Minutes of the public section of the meeting held on 18 December 2020

The Board approved the minutes of the public section of the meeting held on 18 December 2020 as an accurate record.

David Johns, Consultant in Public Health, gave an update on the Outbreak Control Plan.  He highlighted the following information:

a)  There have been 1,651 cases of Covid-19 in the City in the last seven days, which equates to a rate of 495.9 per 100,000 population. 

b)  This compares to a rate of 391.4 per 100,000 for the preceding seven days; a rate of 166.1 per 100,000 reported to the last Board meeting on 18 December; and a rate of 1,300 per 100,000 at the peak in October.

c)  The current rate in Nottingham is below the national average of 622.3 per 100,000 population, however over the last week England has seen a 1% rise in cases compared to a 26.7% rise in Nottingham.

a)  NHS update

b)  Schools update

c)  Universities update

Amanda Sullivan, Chief Accountable Officer Nottingham and Nottinghamshire Clinical Commissioning Group (CCG), gave an update from the health perspective.  She highlighted the following information:

a)  There are significant pressures on the NHS both in hospital settings and community services.

b)  There are currently over 600 people in hospitals, which is twice the amount in hospital during the first wave of the pandemic.  50-60 of these patients are critically ill with Covid-19 in intensive care.

c)  GPs are also busy and approximately 50% of their appointments are taking place face to face.

d)  Due to current pressures, hospitals are having to prioritise emergency care over planned routine care.  Some planned routine care has been stepped down and citizens may experience delays.

e)  The independent sector is being used to increase capacity and keep waiting lists down.  This is being negotiated nationally. 

f)  Work is taking place with social care colleagues to enable people to leave hospital as soon as they are able and this is working well.

g)  The 111 First approach is now in place and that should help to ease pressure by ensuring that people access the right service in the right place first time.

h)  In the week to 13 January there were 63 deaths in all settings linked to Covid-19, which is slightly lower than the previous week.

i)  It is anticipated that hospital admissions will continue to rise until at least the end of January and then may level off.

During subsequent discussion the following points were made:

j)  It is important that everyone continues to follow the lockdown rules and requirements to minimise any opportunities for the virus to spread.  It is acknowledged that fatigue may be setting in and therefore it is important for all partners to keep refreshing the same key messages.

k)  The independent sector was used during the first wave of the pandemic, with sites such as Woodthorpe, The Park and Spire being used to carry out operations and provide routine care in a Covid-safe environment.  There are discussions taking place about whether the independent sector can be used more widely over the next few months.  In some areas staff work across both sectors so part of the consideration is how best to deploy staff.

l)  The CCG is working with the hospitals on raising awareness of what it is currently like in hospitals, which may include photographs of the inside of hospitals. The Chair welcomed this approach, noting that a question had been raised about this issue at the meeting of the City Council on 11 January. 

m)  There have been reports in national media about patients being discharged from hospital into care homes without prior testing.  It was confirmed that testing is taking place before individuals are discharged to care homes in Nottingham.

Nick Lee, Director of Education Services, gave an update on schools.  He highlighted the following information:

n)  Schools are in a challenging situation at the moment.  Although it was known that there would be  ...  view the full minutes text for item 153.

Amanda Sullivan, Chief Operating Officer Nottingham and Nottinghamshire Clinical Commissioning Group gave an update on the Covid-19 vaccination programme.  She highlighted the following information:

a)  Vaccinations commenced before Christmas and there are now nine vaccination sites, including hospitals, with more planned.

b)  The vaccination programme started with delivery at hospital sites due to the nature of the Pfizer vaccine but it is recognised that these are not necessarily the most accessible locations and additional, more accessible, sites are becoming available.  This will be supported by a patient transport service and a roving service visiting people in their homes.

c)  There is national guidance to prioritise the most vulnerable groups as these are the most vulnerable to Covid-19, including care home residents and staff, those aged over 80 years and the frontline health and social care workforce.  Priority will then be given to those aged over 75 years, those aged over 70 years and the clinically extremely vulnerable.

d)  Progress is on track to vaccinate all those in care homes and those over 80 by the end of January and all those in the top priority groups by mid-February.  Many of those aged over 80 should have received their letter by 15 January and reminders will be sent out the following week and everyone aged over 80 years should have received their letter by 19 January.

During subsequent discussion the following points were raised:

e)  The new Kings Meadow site is a local site and the Medilink buses can provide transport to it if needed.

f)  The first vaccine available for use (the Pfizer vaccine) had a lot of requirements for its storage and this influenced decisions about sites for vaccination.  The new Astra Zeneca vaccine is more flexible in how it can be transported and stored and this should enable a more flexible delivery model.

g)  Nationally work is taking place on using more GP sites for vaccination and also the use of community pharmacies, which are familiar sites for delivery of the seasonal flu vaccination.  The use of pharmacies is being piloted nationally but the findings of these pilots is not yet known.

Mandy Clarkson, Consultant in Public Health, gave an update on local testing sites.  She highlighted the following information:

a)  So far most testing has been through the NHS Test and Trace Programme, based on symptomatic testing.  As rates of Covid-19 are increasing, the use of asymptomatic community testing is becoming more important.

b)  There are three main purposes for carrying out asymptomatic testing: ‘testing to protect’ by preventing further transmissions in high risk settings e.g. care homes; ‘testing to enable’ people to carry out essential business (but this is less supported given the current national lockdown); and ‘testing to find’ asymptomatic cases that might otherwise not be known and break chains of transmission.  ‘Test to find’ is the primary function of asymptomatic testing.

c)  Lateral flow technology is available but although this gives a rapid result and does not require the use of a laboratory it is not a perfect test as it does not pick up all positive cases.  However, regular testing is likely to pick up those with high viral loads.  It then adds to information and informs decision making.

d)  The national policy position is to encourage all local authorities to deploy lateral flow testing for those who have to leave their homes/ cannot work from home.

e)  In the City it is intended to have testing in neighbourhoods, closer to households with a ‘test to find’ approach; ‘test to protect’ the homeless and those at risk of homelessness; and also target frontline workers in essential keyworker groups using a ‘test to find’ approach.

f)  There will be a similar approach in Nottinghamshire so that there is a co-ordinated approach across the City and County, recognising that people need to cross boundary lines and ensure a good network of coverage.

g)  There will be a focus on getting working age people tested, and also those in areas of high positivity but lower levels of testing, and where people might face barriers to testing.

h)  Asymptomatic testing will start week commencing 18 January.  The first phase will be the opening of a site at Djanology Leisure Centre, the second phase will be a site in the City Centre/ Trent Bridge area and consideration is also being given to St Anns.  The third phase will consider other options in the City and possibly a mobile unit.

During subsequent discussion the following points were raised:

i)  There is a communications plan with a very targeted approach towards relevant local communities.  This will include leaflet drops, information on local radio stations, posters in shops and information on roadside lamppost banners.  Local faith and community leaders will be engaged with communication activity and consideration is being given to providing information in different languages.

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 18 December 2020

See Confidential Minutes

See Confidential Minutes

See Confidential Minutes

See Confidential Minutes