Agenda item

Councillor Shah MOVED and Councillor Fielding SECONDED a report which provided an update on how the Council and its partners continued to monitor and manage the impact of COVID-19 in Oldham.

 

COVID-19 was still circulating across the UK and new cases continued in Oldham every day. The report provided a summary of activity and demonstrated how the Council collectively managed and prevented the spread of COVID-19 across Oldham’s communities.

 

The report detailed the four key themes which were: Test and Trace; Vaccination; Enforcement and Compliance; and Community Engagement and Communications. Test and Trace included local testing door-to-door testing, mobile testing units, care home testing, contact tracing and tracing in schools.  With regard to vaccinations, the United Kingdom had become the first country to approve a COVID-19 vaccine and the NHS was currently offering the vaccine to those people most at risk from coronavirus. Oldham was preparing to deliver the programme starting with the most vulnerable segments of the population. Pop-up mass/community vaccination sites would be established in each of the five Primary Care Network areas of the locality supported by mobile arrangements to ensure equitable access to vaccination. 

 

Enforcement and compliance included support to businesses, support grants and the Coronavirus Job Retention Scheme. The Enforcement Team (Environmental Health, Licensing, Community Safety and Greater Manchester Police colleagues) were working seven days a week visiting premises, responding to complaints, attending gatherings and serving fixed penalty notices. 

 

Community engagement and communications included public health messaging, self-isolation payments, winter grant payments and work was ongoing to ensure mechanisms were in place to support the distribution of vouchers.

 

Question received from Councillor Sykes:

“I welcomed the recent news that Oldham will soon be one of 67 areas to be the location of mass testing.  Mass testing enabled Liverpool to detect asymptomatic carriers of Covid-19 and to move from Tier 3 to 2. I hope that it will start soon and be placed in the hands of our armed forces who have done such a sterling job in Merseyside, rather than incompetent private sector companies.

My question is in two parts, relating to the priority that will be given to certain groups of individuals and the testing timetable.

Front line health, care and key workers leading the fight to save lives, alleviate suffering and deliver core services should be an absolute priority group in a mass testing programme, both for moral and practical reasons, but I would like to make a plea for a third category of our residents not be overlooked. 

In this pandemic, one of the greatest tragedies has been seeing the forced separation of the residents of our care homes from their loved ones.  For the residents of the care homes in our borough who have waited many months to finally meet up with family a visit cannot come soon enough.

According to a recent survey carried out by Age UK, seven out of ten people with a close relative in a care home have not seen them since the start of the pandemic in March; so can I make a plea tonight to the Cabinet Member and ask her to ensure that the relatives of the residents of care homes are also given priority so they can arrange to visit, hopefully by Xmas? And can I also ask her to she can confirm tonight when the mass testing programme will start in Oldham?”

 

Councillor Shah, Deputy Leader of the Council and Cabinet Member for Covid-19 Response responded that the mass testing in Liverpool may have helped reduce the transmission rates but this was not the only factor driving down their infection rates. In Oldham we had been planning our approach to using the same type of tests as used in the Liverpool pilot in a targeted way for those most at risk of getting and transmitting the virus, and those most at risk of experiencing harm from the virus. This included care home staff, residents and visitors.

We were working with the military to plan the set up of testing site and had already started providing training to some of the groups we wished to prioritise, for example schools.

We were working hard to ensure that loved ones could visit their relatives in Care Homes prior to Christmas. By 18th December all care homes should have received testing kits to enable them to offer visitor testing. We wanted to make sure that visiting was carried out as safely as possible and had worked with other Councils across Greater Manchester to agree guidance for care homes. This guidance was being shared with care homes this week and training was being offered to support them to undertake testing.  We were also offering testing via a central testing site to support care home visiting in homes that were not yet able to offer testing themselves.

 

Question received from Councillor C Gloster:

“Anecdotal evidence, particularly from the Liverpool mass testing programme, suggests that people, particularly those from deprived backgrounds, are deliberately avoiding taking a Covid test as they cannot afford to not work due to lack of government support.

I would like to ask the Cabinet Member how are we encouraging our vulnerable residents to take a test without the fear of deprivation? And additionally, what are we doing as a local authority doing to support those that have a positive test result and then cannot work?”

 

Councillor Shah, Deputy Leader of the Council and Cabinet Member for Covid-19 Response responded that in Oldham, we had tried to make sure that access to COVID tests was as easy as possible. In addition to our 3 static testing sites we had 2 mobile testing units that moved around the borough every few days to reduce journey times to local testing sites, we also ensured that most of the sites had a walk through access in recognition that many of our residents do not have access to, or drive, a vehicle.

We regularly examined our local data to identify areas with the highest rates of infection, the number of tests being undertaken and the proportion of people testing positive in each ward. Where testing rates were low or rates of infection were particularly high, we were able to deploy our door step engagement team to help explain COVID restrictions and to offer COVID-19 tests to residents.

To promote the availability of tests and testing sites we published details of schedules for testing at the permanent, as well as mobile sites every week. This was done through a range of channels, including our social media, local ward councillors and district teams. We also promoted the financial support available to people who needed to self-isolate.

In the new year we would be increasing access to testing for people who did not have symptoms. We were keen to learn from Liverpool to ensure that fears about losing income did not act as a disincentive to testing, and would continue to work with local organisations and communities to understand the barriers to testing and try to design the local testing offer in a way that was easy for people to access and reduced these disincentives.

 

Question received from Councillor Hamblett:

“A recent disturbing report from Public Health England found that people with learning disabilities were up to six times more likely to die from Covid-19 during the first wave of the pandemic, and the death rate for those aged 18 to 34 was THIRTY times higher than the average. 

The study found that there were 451 deaths per 100,000 people registered with a learning disability between 21 March and 5 June, but that this was thought to be an underestimate due to gaps in the data. Researchers estimated that the real figure could have been up to 692 per 100,000 – over 6 times the national average.

Can the Cabinet Member please tell us what is being done to support, test and treat Covid-19 patients with learning disabilities, and will Oldham residents with learning disabilities be prioritised in the proposed mass testing programme?”

 

Councillor Shah, Deputy Leader of the Council and Cabinet Member for Covid-19 Response responded that

Shielding

•     Early in lockdown it was identified that there was some confusion about shielding for people with LD. A protocol for Oldham GPs was developed that outlined requirements for:

       o          Highest risk people with LD and/or autism who need to shield

o          At risk/Vulnerable people with LD and/or autism who need additional support

•     All practices within Oldham CCG received guidance from the Primary Care Team on 27/3/20 on how to identify, from their registered patient list, those patients who had the clinical conditions as set out in the NHS England guidance dated 22/03/2020 defined as at the highest risk of severe morbidity and mortality from coronavirus.

 

Annual Health Checks

•     Pre Covid-19 57% of the people on Oldham LD registers were receiving an annual health check, however as anticipated this had been greatly impacted by Covid-19 as patients were unable to go into practices. To address this issue, we had piloted remote health checks.

•     We had secured regional funding to develop the role of an Outreach LD RGN who would work with practices to ensure processes were established to book health checks while adhering to any reasonable adjustments as well as performing health checks in the community. The role was in the recruitment process and we anticipated this would greatly increase the uptake of annual health checks by people with a learning disability.

•     GM guidance had been shared with preferred model including both virtual and face to face options. Oldham was looking to progress with the model shared by GM due to the following benefits:

o          This would save GP time and enable more AHCs to be completed

o          Face to face required only if necessary

o          Reduced stress of going into a surgery

o          Reduced the need for people to use public transport

o          Enable people with complex needs and their carers to receive an AHC who previously may not have been able to go into the surgery

o          Increased likelihood of greater uptake if people receive AHCs from their own home in a comfortable environment

 

Testing

The LD Covid-19 testing plan had been worked up reviewing the following cohorts of people:

•     Testing for people living alone with low needs not accessing services but registered as a patient with an LD with their GP

•     Testing for people living with family with low needs not accessing services but registered as a patient with an LD with their GP

•     Testing for people who are registered with the LA who are not receiving services

•     Testing for people who receive services from the LA but live at home with family

•     Testing for people in supporting accommodation or who have a PA

•     Testing for people with complex needs either at home or in supported living

Covid testing, including daily monitoring checks and Covid swabbing approaches, had focussed on supported living settings in the first instance. We were working with colleagues in Public Health and with specific providers to develop a person centred approach to the most appropriate way of testing and consent to testing, which included our response to Track and Trace for those settings. The focus was on supported living for adults with LD and/or autism and how we supported tenants and those supporting them at home with oversight and monitoring of oxygen levels.

From recent LeDeR rapid reviews and themes from LeDeR in general relates to pneumonia as a leading cause of death in adults with LD, but the rapid reviews had also shown significant concerns relating to silent hypoxia (no obvious concerns of the usual indicators, e.g. breathlessness, cough, blue skin tone, increased confusion etc). In these instances people had gone to bed appearing well, and died in the night. More work was required to understand the impact of Covid19 on deaths in our LD and autism population which would be picked up through LeDeR and the ADASS work on rapid reviews

 

LD Mortality Reviews (LeDeR)

There was a currently a backlog of LD mortality reviews and this was likely to increase as a result of Covid19. This was due to a number of Covid-related deaths of people with LD, but also because of the practical issues that impeded the reviews.

•     The KPIs for LeDeR reviews were as follows:

•     For the CCG to have an identified lead

•     For the CCG to provide an annual report (complete and presented to LDPB in November)

•     For reviews to be completed within 6 months of being reported

•     For the learning from the reviews to be distributed and embedded into practice.

•      The CCG is exploring options to recruit to a dedicated clinical post that will support with undertaking the reviews as well as embedding the learning from the reviews

 

Question received from Councillor Al-Hamdani:

“Mental health services in the UK are “overflowing” with patients, with growing numbers struggling to cope with anxiety, psychosis and depression, according to the Royal College of Psychiatrists.

New data shows that the number of people needing support and advice because of suicidal thoughts has tripled, with similar trends being seen among those with anxiety disorders.

Please can the Cabinet Member tell us what is being done in Oldham to support local people reporting mental illness since the start of the during the current crisis?”

 

Councillor Shah, Deputy Leader of the Council and Cabinet Member for Covid-19 Response responded that the following actions were put in place in response to the Covid19 crisis across the mental health system:

•        Established a 24/7 helpline with the Trust initially to support people known to services, which was later expanded to support the people who may be coming through 111 requiring mental health support

•        Community hubs had a direct pathway to a Tameside Oldham & Glossop Mind practitioner where there were identified mental health or wellbeing needs

•        Crisis Safe Haven at Royal Oldham Hospital was repurposed as a ‘MH A&E’ to reduce numbers of people attending ED with updated urgent and crisis pathway at the start of the pandemic. Last month the Safe Haven had been reinstated as originally intended as support for people following A&E assessment and/or for people under care coordination with Community Mental Health Teams.

•        Risk stratification process undertaken for patients across teams to identify where face to face contacts still required. Face to face contact with patients had continued throughout where necessary.

•        Coordinated work to overcome barriers to discharge and reduce Delayed Transfers of Care on adult and older adult acute wards – the number of MH DTOCs had stayed at a minimum

•        Developed dedicated inpatient Covid pods to ensure compliance with IPC guidance

•        Developed and implemented updated Covid pathways for Memory Assessment, IAPT, Safe Haven/Home Treatment and Liaison MH in hospital teams

•        Provided a bespoke care home staff support offer through the helpline and Care Home Liaison Team (now working with the STICH team)

•        Rolled out Silver Cloud online therapy universal support offer for Oldham population, with targeted modules available for health and social care front line workers

•        Established a weekly Mental Health System Support call including all partners across CCG, Council, Public Health, primary care, providers and third/voluntary sector

•        Outlined the Oldham bereavement support offer from immediate support to longer-term counselling offer provided by Healthy Minds

•        Progressing with development of the ‘Dementia Hub’ which had been planned in response to changing carer support needs since Covid, providing much needed respite to carers and therapeutic/social opportunities for people with dementia. The service would run initially from a community centre and follow council approved guidance for day services to ensure safe delivery

•        Collaboration across Clinical Psychologist, Senior Educational Psychologist, Specialist MH School Advisor and Emotional Wellbeing Team had worked together to support schools during lockdown and recovery, and acted on the concerns and anxieties young people shared about the safe return to school/college.

•        Healthy Young Minds staff were approved to support the acute paediatric ward to assess children admitted with emotional wellbeing symptoms and to support early discharge planning, as well as offer additional 7 day follow up support to 16-17 year olds who had either been admitted or referred through the MH Liaison team in A&E

•        Over the next few months we would be implementing winter pressure MH schemes – for Oldham we had submitted a proposal for additional mental health nursing support in Butler Green and Medlock Court

 

Question received from Councillor Murphy:

“In the Middle of November, it was reported that payments made against fixed penalty notices issued under coronavirus laws have yet to reach local authorities. Apparently, an organisation called Acro, the criminal records office, has been processing the fines given by English and Welsh police forces and the money remains in an Acro bank account, rather than being disbursed.

Acro told the national press that the money had not yet gone anywhere as it was still trying to locate payment details of local authorities.  I am assuming that in the month that has passed this authority has been in touch with Acro to ensure they have the correct details to ensure this unsatisfactory situation can be resolved.

If this is so could the Cabinet member please tell me whether this Council has now received the money it is owed from Acro, and how much this is? Alternately if this is not so can the Cabinet Member tell me how much is owing and what action we are taking to get paid?”

 

Councillor Shah, Deputy Leader of the Council and Cabinet Member for Covid-19 Response responded that the Council had contacted Acro and supplied the correct details to enable payment against fixed penalty notices issued by the police under coronavirus laws. An initial remittance had been received from Acro and a payment of £610 had been received by the Council.  This payment covered fixed penalty notices issued in May and June for 15 offences recorded in April and May. Information for later penalty notices had been requested.

The payments only related to fixed penalty notices issued by the police. Fixed penalty notices issued by Council officers were processed direct by the Council and were not affected by the arrangements with Acro. 

 

Question received from Councillor H Gloster:

“The NHS is establishing specialist units to treat “long Covid” patients with persistent symptoms such as breathlessness, chronic fatigue, brain fog, anxiety and stress. Apparently up to 500,000 people in Britain are living with the long-term effects. I understand that three of these units or mini- hospitals will be in the North West of England. Does the Cabinet Member know where these will be located?”

 

Councillor Shah, Deputy Leader of the Council and Cabinet Member for Covid-19 Response responded that the precise location(s) of these specialist facilities for ‘long Covid’ was yet to be determined. Work was currently taking place to develop and agree a specification. It was the intention of the Greater Manchester Health & Social Care Partnership that, following agreement on the specifications and the associated scoping exercise, a decision would be made with regard to the location prior to Christmas by the appropriate Greater Manchester Board.

 

Question received from Councillor Harkness:

“In early November, economist Douglas McWilliams, founder of the Centre for Economics and Business Research, warned that the four-week lockdown in England would wipe £1.8bn off the value of the economy for every day it lasts.

Can the Cabinet Member please tell me if there is an estimate of the loss to the Oldham economy every day during Lockdown, and if so, what this is?”

 

Councillor Shah, Deputy Leader of the Council and Cabinet Member for Covid-19 Response responded that unfortunately, the Government did not measure economic gains or losses at a local authority level. It as not possible to provide a direct response to the question.

However, it was clear that the economic impact has been significant in Oldham. Unemployment and Youth Unemployment levels increased by 101% and 132% respectively.

Between 55 - 62% of businesses had reported reduced sales over the last two months across all sectors, however this was significantly higher for the Hospitality, Leisure and Tourism sector and Creative and Cultural industries which had seen 76% of businesses declaring decreased sales persistently for the last 2 months.

Businesses on average reported that they had less than 6 months sustainability dropped from 23.5% in early September to 9% at the end of November, however for Hospitality, Leisure and Tourism were reporting around 40% declaring less than 6 months of sustainability (with cash flow being a key problem for 49%).

The Council had focussed effort on prioritising grant support providing £51.974 million of grant support alongside engagement with businesses to ensure that they were aware of business support programmes delivered by the Growth Company.

 

Question received from Councillor Williamson:

“In early November, around 12 Covid-19 deaths per day were reported to be happening at the Pennine Acute hospitals, which includes the Royal Oldham Hospital. This is the highest number of daily deaths of any hospital trust and over the preceding month the number was 197 of the 600 Covid-19 deaths in Greater Manchester. The data could indicate the trust has struggled to cope with ‘probable healthcare-associated infections’, which means an outbreak or outbreaks of Covid-19 within the trust’s hospitals.

Can the Cabinet Member please tell us what steps are being taken to control and prevent further outbreaks at our hospital in the future?”

 

Councillor Shah, Deputy Leader of the Council and Cabinet Member for Covid-19 Response responded that the Pennine Acute Hospitals NHS Trust did have the highest mortality for COVID-19 across Greater Manchester. The mortality figures detailed in the question represented the total number of deaths in the 5 Hospitals which constituted the Trust. These deaths were generally evenly distributed between NMGH, FGH/RI and TROH. However, there was no evidence to indicate this was being driven by in-hospital nosocomial transmission of COVID-19. It should be referenced though that at the peak of activity PAT had 424 patients with COVID-19 in hospital indicating there were approximately 40% more patients at this time in hospital with COVID-19 compared with comparable size organisations in GM. Considering the  Pennine Acute Hospitals NHS Trust had the highest levels of COVID-19 admissions during the second wave of the pandemic (40% more COVID admissions than the second highest Trust with Covid admission activity in Greater Manchester) there was a likely correlation with this activity and the reported increased mortality rate.

SitRep data used by NHS England and NHS Improvement on their daily infection dashboard to identify any possible in-hospital transmissions of COVID-19  in the in-patient setting did not evidence special cause variation at the Royal Oldham Hospital nor at the Pennine Acute Hospitals NHS Trust.

It was acknowledged there was a spike in nosocomial transmission at the beginning of the second wave (end of October- mid November) but this was observed across all Trusts within Greater Manchester at similar levels.

 

Work has been ongoing across the NCA to prevent nosocomial infections. There had been an Infection Prevention Control Collaborative running across the NCA which had now become an IPC cell.

The cell had used The Healthcare Safety Investigation Branch (HSIB)report “COVID-19 transmission in hospitals: management of the risk – a prospective safety investigation” to form a hierarchy of priorities for the care organisation to work through. This group met three times a week and had enjoyed participation of NHSI/E who attended to observe and provide input and guidance when necessary.

Nosocomial infections for Oldham for w/c 26th October totalled 27 the height of the COVID19 admissions peak compared to 6 for w/c 30th November a reduction of some 78%.

 

Question received from Councillor Phythian:

“I have recently received enquiries from a ward constituent who works for the DWP benefits office on Union Street in the Town Centre.

The enquiry was to do with free parking for key workers in the Town Centre during the continuing pandemic. In light of the Government’s pay freeze for public service workers does the council have any plans to introduce such a scheme?”

 

Councillor Shah, Deputy Leader of the Council and Cabinet Member for Covid-19 Response responded that in order to help support Oldham’s key workers - free parking was introduced on all Council car parks in the town centre at the start of the March lockdown period. While this had been reviewed periodically with the various changes to tiered restrictions further lockdown periods, the Council decided to retain the free parking arrangement for keyworkers – and this remained in place to this day. 

Anyone designated as a keyworker, supporting communities in Oldham had the privilege to park for free on Tommyfield market car park, subject to displaying the correct Government issue key worker permit on their dashboard. 

In the event that a Penalty Charge Notices was issued by mistake to a key worker, it would be cancelled once evidence of keyworker status had been confirmed and verified. 

 

RESOLVED that:

1.         The update on Oldham’s response to the COVID-19 pandemic be noted.

2.         The questions and responses provided be noted.