Agenda and minutes

There were no declarations of interest.

The minutes of the meeting held on 1^st February, 2021 were agreed as a true record. There were no matters arising.

Presentation from Nina Morgan, University Hospitals Coventry and Warwickshire, Melanie Coombes, Coventry and Warwickshire Partnership Trust and Jo Galloway, Coventry and Warwickshire CCGs

The Sub Group received an update from Elaine Clarke, University Hospitals Coventry and Warwickshire, on the NHS Covid Capacity and Recovery.

Elaine Clarke referred to January/ February as the most challenging time at the hospital with the highest numbers of Covid cases along with the winter pressures. The key priorities now were to support the health and wellbeing of staff and the resetting of services. In relation to patients, and working with the links with Virginia Mason, there was a focus on improvements for patients including communication to keep patients informed including details of new initiatives. Consideration was being given to a new organisational strategy to meet future challenges, strategies were being re-evaluated to support alignment and change.

Staff continued to work closely with partners on integrated care to help address inequalities. Reference was made to the hospital’s profile as both national and international leaders on the healthcare journey with details of individual pathways being highlighted.

The Sub Group were informed that all elective theatre surgeries were up and running although there was now a significant backlog of cases. Staff were working to prioritise cases in line with national guidance and maximum day surgeries were being undertaken to reduce waiting lists. Outpatients services had been fully restored with 25% of appointments being held virtually. The hospital site at Rugby was being reconfigured and the green pathway was continuing but would reduce in due course.  

In response to a question about the past year leaving staff emotionally challenged and very tired, further information was provided on support being given to employees. Significant investment had been made in this area. Lots of Listening Events had been organised to understand staff needs and facilities for enhanced break areas had been introduced with emotional / psychological support also being provided. Facilitators were touching base with staff to see how they were coping.

RESOLVED that the update on the NHS Covid capacity and recovery at the hospital be noted.    

Presentation from Liz Gaulton, Director of Public Health and Wellbeing

The Sub Group received a presentation from Liz Gaulton, Director of Public Health and Wellbeing which provided an update on the Covid-19 situation in Coventry including data information and the testing results in the city. An overview of Coventry Outbreaks was also provided.

The presentation detailed Coventry’s rolling 7 days Covid-19 rate per 100,000 residents which was now 25, a considerable reduction since the peak of 585 in January. It was noted that this rate had now plateaued over the past three weeks. A comparison of regional trends which compared the West Midlands with other areas of the country was set out. A similar plateau was being seen nationally, with Yorkshire and The Humber having the highest rate at the present time.

Key metrics for the city at 25^th April showed there were currently 7 Covid-19 cases in the 60 plus age group over the last 7 days. 280 daily individual tests per 100,000 residents were being carried out, with the weekly percentage of positive individual tests being 1.2. 5 people were admitted to hospital with Covid-19 the previous week and there were currently just 9 residents in hospital with Covid. The Sub Group were informed that, to date, 152,916 first vaccinations had been administered.

The presentation concluded with a summary of key messages as follows:

·  Coventry rate was 25/100k, with 93 cases in last week. The West Midlands Region rate was 24/100K

·  West Midlands rates were 4th nationally

·  The highest rate was in 40-49 year olds

·  Covid rates north of the city centre remained high

·  Vaccination uptake in Foleshill and St Michaels was lower than the city average 

·  Increasing in rates was a possibility this week as the impact of recent lock-down easing started to show

·  Hospital Covid beds were reducing, there were 5 admissions at UHCW in the last week, compared to 7 the week before (median age 46). 

·  New variants from returning travellers posed a considerable risk, local numbers were small and surge testing plans were in place. 

Additional information was also provided on the Public Health priorities to reduce Covid transmissions.

The Sub Group noted that outbreak management in the city continued to be effective. There had been 3 cases in school settings which would close next week as long as there were no more cases. The Director of Public Health and Wellbeing thanked local communities for coming forward for testing.

RESOLVED that the contents of the presentation be noted.

Document attached. Liz Gaulton, Director of Public Health and Wellbeing will report at the meeting

Liz Gaulton, Director of Public Health and Wellbeing introduced the Local Outbreak Management Plan (LOMP), which detailed the city’s Covid journey to date and described Covid defences going forward. The purpose of the plan was to take a whole system, One Coventry, approach to reducing Covid-19 transmission whilst mitigating, where possible, against the socioeconomic and health inequalities the pandemic had exacerbated.   

In June 2020, Local Authorities were tasked by Central Government to produce specific local outbreak control plans in response to the ongoing Covid-19 pandemic. The Coventry Local Outbreak Control Plan had now been refreshed into a Local Outbreak Management Plan (LOMP). The LOMP reflected local and national developments since the original plan was produced, and included changes in local roles, responsibilities and resources, as well as incorporating the learnings of the past nine months and plans for the next phase of the response, as the city moves towards recovery. The current plan included key metrics and the incentive dates within the national roadmap on easing lockdown. The plan also considers scenarios, should case numbers not continue to improve as expected.

At the time of producing the plan, Coventry had sadly seen 636 deaths as a result of Covid-19. This figure emphasised the importance of continuing to invest resource and capacity in the LOMP - to prevent infections via non-pharmaceutical interventions (NPIs), manage outbreaks and encourage vaccination uptake across all Coventry’s communities. This activity would need to be maintained alongside the recovery programmes.

As a Marmot City, Coventry was committed to tackling health inequalities. The LOMP focused on supporting the vulnerable communities. The city was aware of which communities were disadvantaged due to structural inequalities in social, health and economic terms prior to the pandemic and work was ongoing to redress these issues. Unfortunately, these inequalities had deepened and widened during the past year and the LOMP was designed to ensure that the vulnerable, disadvantaged and hard-to-reach communities were supported to stay safe within the remit of the plan.

The Department of Health and Social Care and the Local Government Association had identified the following six key critical themes in outbreak plans for this phase of the pandemic, all of which were interwoven throughout the Coventry plan:

Theme 1: Governance: Our ways of working

Theme 2: Preventing infection in high-risk settings, communities and locations: preventing and managing outbreaks

Theme 3: Communications and Engagement: working with our communities

Theme 4: Vulnerable and hard to reach communities: working with, and supporting, our most vulnerable communities

Theme 5: Resourcing: How we resource our Covid work

Theme 6: Data integration and information sharing: How we use data.

RESOLVED that the Local Outbreak Management Plan be noted.

Presentation from Valerie De Souza, Consultant Public Health

The Sub Group received a short presentation from Valerie De Souza, Consultant Public Health, which provided an overview of Covid-19 testing in the city.

The Sub Group were informed that residents were still going for PCR testing when showing any symptoms of Covid. There were 5 sites available across the city, four of which were open every morning and the Moat Street facility operating all day. Once a positive test was identified, this was immediately entered into the Test and Trace system and the individual would be phoned straight away and told to isolate. There were likely to be changes in terms of demand as the numbers of cases reduced. It was noted that any surge in demand would require additional facilities which would have resource implications.

Regarding travellers returning from abroad, two PCR tests had to be booked in advance for days 2 and 8 following return to the UK. The details were checked by border control. These measures were very important in supporting the rapid identification of any new variants.

The take up of lateral flow tests for people with no symptoms was still being encouraged. As one third of Covid positive people had no symptoms, these tests were key to stopping transmission, especially as the city was opening up with more residents returning to the workplace or going out as restrictions eased. Residents were being encouraged to test twice weekly. There were 7 sites available across the city which offered on the spot testing. Residents also had the option of home test kits which were readily available. Mobile units were being used to focus on hot spots and were being set up at venues with good public access such as shopping centres.

Workplace testing had been expanded to include any business with 10 or more employees.

In response to questions, additional information was provided about whether the numbers of test results were increasing following the increase in availability of tests, and how people got their test results.

RESOLVED that the testing overview update be noted.

Presentation from Alison Cartwright, Coventry and Warwickshire CCGs and Nadia Inglis, Consultant Public Health

The Sub Group received an update from Alison Cartwright, Coventry and Warwickshire CCGs, and a presentation from Nadia Inglis, Consultant Public Health on Covid-19 vaccinations in Coventry.

Alison Cartwright informed that over 85% of over 60s had now received their first vaccination. Work was continuing on cohorts 9 and 10 with appointments now being offered to the 40-49 year age group. There was still a limited supply of first doses currently but enough for cohort 10. It was anticipated that by mid May vaccinations would start for cohorts 11 and 12. Good progress was now being made on second vaccinations. Residents were being contacted at week 11 about their second dose. As before care homes were being prioritised. Where there were lower uptakes to offers of vaccinations, solutions were being put in place to increase uptake such as using pop up clinics and local pharmacies.

The presentation provided information on vaccination uptake by Ward, with Foleshill and St Michaels showing the lowest uptake across all cohorts. Work was ongoing in these areas to encourage residents to have their vaccinations. A map was shown which detailed all the vaccination stations across the city. To improve access to vaccinations, Vaccinating Coventry – a multi-agency group involving Council and NHS and partners – was working to increase the number of delivery sites.

In response to questions, additional information was provided on vaccine type and the issues arising following the reporting of blood clots post vaccination.

RESOLVED that the vaccinating Coventry update be noted.   

Liz Gaulton, Director of Public Health and Wellbeing will report at the meeting

The Sub Group received a brief presentation from Liz Gaulton, Director of Public Health and Wellbeing which provided an update on the easing of restrictions.

The presentation detailed the restrictions/ measures that had been eased on 8^th and 29^th March and 12^th April and detailed the following which were to be in place when further restrictions are eased:

·  Low rate of Covid-19 transmission including decrease in hospitalisations and deaths

·  Continued vaccination rollout/supply/uptake

·  Vaccination Performance

·  Confidence in control measures for new variants.

The next date for the further easing of any restrictions was 17^th May. It was highlighted that small surges were anticipated at each key date. Medical treatments were continuing to evolve and residents were being encouraged to take up the option of twice weekly testing. Plans for scenarios which required a surge in testing had been included in the Local Operational Plan. It was noted that the NHS were now having to deal with the wider impacts of the Covid pandemic including domestic abuse and mental health. Partners were all working to mitigate as much as possible.

In response to a question, it was clarified that there had been no national guidance as to avert over reaction to any increasing infections once indoor mixing was allowed.

RESOLVED that the update on the easing of restrictions be noted.

Any other items of public business which the Chair decides to take as matters of urgency because of the special circumstances involved.

There were no additional items of public business.