Agenda item

(Verbal update)

The Director of Public Health updated the Board on the Covid-19 situation in the borough. She stated that the infection rate in the community was slowly falling due to lockdown. Currently, Croydon was the 6^th highest rated borough and the 20^th local authority in the country. She told the Board that the latest variant of Covid-19 was disproportionately affecting the south Asian community.

Dr. Agnelo Fernandez, NHS CCG and Vice Chair, addressed the Board and stated the following:

• At least 15,000 people had been vaccinated in Croydon.
• There were six new GP community sites that had gone live based in Old Coulsdon, Purley, Valley Park, New Addington, Thornton Heath and Fairfield Halls.
• The vaccinations were focused on the over 80’s and those in care homes, including staff, and next age would move onto the vulnerable/shielding group.
• A limiting factor was transporting the Pfizer vaccines. This made it difficult to deliver into care homes, which was why they had to administer that vaccine in a centre.
• The AstraZeneca vaccine was easier to transport which enabled it to be administered in care homes.
• GP Surgeries that were offering vaccinations had been given permission to reduce some of their other services due to a shortage of staff.
• In February 2021, sites would open in central Croydon and Crystal Palace, which would speed up the vaccination programme by providing a good coverage of the borough.
• There were issues in vaccine supplies, with some sites stating that they were not receiving the supplies to meet demand.
• The army were also providing assistance and were posted to support different sites.
• There were issues in relation to staff absences due to shielding or because they contracted Covid-19.
• An issue with the vaccination programme was hesitancy. The vast majority of residents who were over 80 years of age gladly received the vaccine, however, there had been reluctance amongst some groups particularly in the black and Asian community which included care home and practice staff. There needed to be more information circulated to enable people to make informed decisions in regards to taking the vaccine.

The Executive Director for Health, Wellbeing and Adults informed the Board that the information being circulated locally was likely to be the most accurate data because there had been an error in national data recording. Whilst attending the Health and Resilience meeting, noting care homes submitting data, a technical issue in how that data was processed was discussed.

In response to a question regarding vaccine shortages, the Vice Chair stated that patients were able decide whether they go locally or to attend the mass vaccination sites.

The Director of Public Health informed the board that the priority in terms of vaccination had been decided nationally based on clinical risk and stressed that social distancing measures had to remain in place despite the vaccine roll out in order to minimise risk of spreading the virus.

In response to a question from a councillor, the Vice Chair informed the Board that, despite the lack of available data, he estimated that each site had given 1,000 vaccines a week therefore at least 17,000 vaccines administered to date.  He stated that information would be made available in the near future.

It was noted that there was work being carried out to tackle the challenge of invalidated data being spread throughout the country. The hope would be to produce more up to date data with more granular information about both the localities and the demographic data around populations.

The Chair of Croydon Health Services NHS Trust, Michael Bell, provided the Board with an update on the Covid-19 situation within the hospital. He stated that the numbers in hospital had increased quite dramatically from the middle of December onwards. There were roughly 20 to 30 new admissions every day and he anticipated that these numbers would stay relatively stable for the next 3-5 weeks. He informed the Board that the hospital was not offering the full range of planned care that it would normally be providing in terms of outpatients and non-urgent operations. All emergency and urgent operations were continuing in a Covid secure space and diagnostic procedures such as cancer diagnosis would continue to be provided.

In response to a question relating to vaccine roll out, the Chair of Croydon Health Services NHS Trust informed the Board that there had been careful planning of the programme of work in accordance with government guidelines. The general practice prioritised older people in care homes in the first few weeks of the vaccine rollout. In the past week, they had begun a programme, which focused on younger residency care homes, particularly those which housed residents with learning disabilities.

The Executive Director for Health, Wellbeing and Adults the followed up by stating that both he and the Director of Public Health had met with the Department of Health & Social Care Covid-19 regional support team and they were pushing for a focus on ‘Care Settings’, rather than just care homes. There were vulnerable residents in Croydon that live in other types of accommodation (such as hostels).

Councillor Hopley informed the Board that a resident had mentioned to them that people were being discharged from hospitals, if they were to capacity, back into care homes without being tested. The Member asked whether staff would be mandated to have vaccinations in order to take care of vulnerable residents in the hospital and why the allocated beds in the nightingale hospital may not be used as previously planned.

The Chair of Croydon Health Services NHS Trust informed the Board that the mortality rate was lower for the number of inpatients than in the first wave, which was likely a result of better treatments and practice as a result of learning from the first wave. He stated that he was not in favour of making it mandatory for staff who cared for vulnerable people to take the vaccine.

The Executive Director for Health, Wellbeing and Adults informed the Board that he had no reports of people being discharged into care homes without being tested. He said in his opinion that it was not beneficial to release staff into the Nightingale hospitals as they had managed to keep a steady flow of patients being admitted and discharged from hospitals, so there was no real need to use the Nightingale hospitals because they were able to manage the pressure.

In response to a question regarding caring for patients at home, the Vice Chair informed the Board that there were more patients recovering from Covid-19 outside of hospital than there were inside. A new pulse oximetry service went live earlier in January 2021 which measured people's oxygen and was supported by the GP collaborative. This would help with early detection in patients and allow treatment before deterioration. He also stated that despite Croydon having more residents with Covid-19 complications than other boroughs, Croydon had been able to respond rapidly due to the good systems that were in place. This had been seen by clinicians and feedback from a number of patients indicating that the quality of care had been excellent.

In regards to the mandated vaccine, the Vice Chair stated that there were cohorts in general practices, hospitals and care homes that were either anti-vaxxers or were hesitant to receive the vaccine. According to GP’s, one of the most important factors in whether residents were willing to take the vaccine was the prospect of vaccine passports and whether it would affect their ability to travel.  He stated that while the vaccine would not be mandated in this country, there were instances where private organisations may require their staff to be vaccinated or where there may be a requirement for a Covid-19 vaccine certificate someone wanted to travel and request permission to enter another country. He also informed the Board that the CVA (Croydon Voluntary Action) had been co-ordinating the effort for all of the vaccine centres and thanked them for their contributions.