Presentation from the Director of Public Health.
The Sub-Committee received a presentation from Harrow Council’s Director of Public Health and NHS staff which outlined the current position with regards to Covid in the borough as well as updating the Sub-Committee on progress with the vaccination programme. The following key points were raised:
· The case rate for London had been generally lower than surrounding areas, with highest rates found in Cumbria, however cases were also high in parts of West England, Bedfordshire and St Albans. As of 5th of November 2021 654 cases had been reported in Harrow in the previous 7 days.
· The 11 – 16 age group continued to have the highest rate of cases; however, this had halved due to the half term break, this being said the number of LFD recordings had also decreased during this period. However, no significant rise in cases had been seen in any age group.
· Since the 1st of October 2021, 70 Harrow residents had been admitted to hospital due to Covid-19, 36 were vaccinated with the majority of the 36 vaccinated were 60 or older. This had shown that those unvaccinated were twice as likely to be admitted with covid. In addition, intensive care data had shown that only 1 in 5 were vaccinated.
· Those that lived in affluent parts of Harrow were more likely to be vaccinated compared to those that lived in the most deprived parts of Harrow, in addition, people of black heritage and people in white ethnic groups had remained the least likely to be vaccinated.
· A local consultation had been planned to find out why people had chosen to have their first vaccination now as opposed to when they were first eligible. The information gathered would be used to encourage uptake of the vaccine, particularly to areas that had a lower uptake.
· That 284,000 vaccinations had been administered within Harrow, where GP practices, pharmacies and vaccination centres had been used for the vaccine to be delivered.
· Primary, mental health and acute care systems had returned to business as usual with the backlog of cases to be addressed a key challenge, whilst the vaccination programme continued.
· A target had been set for community engagement over vaccination uptake to be improved and for a number of approaches to be used.
· More than 75% of Harrow’s population had already received their booster vaccination.
· Only 40% of children in north west London had been vaccinated.
The Chair thanked officers and NHS representatives for their updates and asked a number of questions, which were responded to as follows:
· Asked if contingency plans for local outbreaks had been planned as part of the winter plan and what additional ward space and equipment had been identified at Northwick Park Hospital. The Deputy Chief Executive of London North West University Healthcare NHS Trust explained that a winter and contingency plan had been made for the hospital, which included how additional ward space would be created. In addition, it was planned that some elective activity may be reduced for bed space to be created; for critical care capacity to be expanded and additional funding had been received. It was emphasised that the timely discharge of patients needs to be maintained for bed space to be supported, investment in the discharge team had been made.
The Member asked for further details on how the trust were balancing the demand for planned/diagnostic procedures and covid specific care. An NHS staff member noted that there had been a low number of patients with long-covid admitted and that efforts had been made for the patient waiting list to be reduced. The Chief Executive for London North West University Healthcare NHS Trust added that the workforces needed to be supported and for new staff to be recruited in order for elective activities to continue and to cope with winter pressures as it had been predicted that the situation would get worse.
· It was raised that residents potentially faced information fatigue regarding covid vaccinations and therefore asked NHS staff how this might be tackled such as using key community influencers. An NHS staff member explained that that had been a challenge, however, there were community champions who supported engagement with communities.
· It was asked by a Member if initiatives were undertaken to support recruitment, to which the Chief Executive for London North West University Healthcare NHS Trust noted that work had been undertaken the past 12 months to streamline the recruitment process. There had been a dependency on overseas recruitment, particularly in nursing had been negatively impacted during the pandemic.
London North West University Healthcare NHS Trust’s Chief Nurse added that the vacancy rate for trained health care support workers was less than 5%. This was due to a substantial recruitment drive. However it was the recruitment of a highly technical registered workforce. Significant vacancies included: qualified nurses and antitheists where recruitment drives had been planned at a national level and was considered a long-term issue due to the years required for qualifications.
In addition, a mapping exercise had been undertaken that looked at those who worked in healthcare support role who held a registered qualification in their country of origin. It was found that 96 people in the trust who held such qualifications. However, it had proven difficult for these staff members to provide evidence or obtain the nationally required qualifications in maths and English, a pilot scheme had been offered to 14 Afghanistani refugees with health qualifications.
· A Member asked if there were indications to suggest that face to face appointments would increase given that the current infection rate had still been worrying. The Borough Director for Harrow NWL CCG added that some residents welcomed the used of digitised consultations, however, there were residents who had preferred to see their GP face to face and that plans were underway to increase face to face consultations as the government had set a target of at least 50% of consultations to be in person.
The Member asked if the reduction of face to face consultations had raised the number of A&E visits, to which the Borough Director for Harrow NWL CCG noted that a lot of patients had not wanted to go in to either A&E or their GP practice and that more recently demand had risen in both care services.
· A Member asked why Harrow had not been tendering new agencies and what were the costs of this. London North West University Healthcare NHS Trust’s Chief Nurse explained that there was strict criteria in place in order for agencies to be on the NHS framework and that only agencies that had been approved were to be used.
· Concern was raised over the challenges for those who had learning disabilities and for those who were elderly faced when it came to accessing their GP digitally and asked if priority had been given to vulnerable groups when it came to face to face GP appointments. An NHS staff member explained that surgeries had asked residents who were able to book appointments online to do so in order for phonelines to be alleviated for those who were digitally excluded. A patient’s records would show if they were vulnerable and therefore the appropriate action could be taken. In addition, surgeries were now open to residents to walk and to speak to a receptionist.
This was followed by concern raised over the consistency of these procedures to support vulnerable patients across all surgeries within Harrow, to which the Borough Director for Harrow NWL CCG reassured that data had been utilised so that weak points of surgeries could be managed.
RESOLVED: That the report be noted.