Agenda item

For the Sub-Committee to receive an update on the ongoing response in Croydon to the Covid-19 Pandemic, including progress made on the vaccination programme. 

The Sub-Committee was provided with a number of presentations on the response to the Covid-19 pandemic in Croydon for its consideration.  Copies of the presentations delivered at the meeting can be found along with the agenda papers on the Council’s website at the following link:-

https://democracy.croydon.gov.uk/ieListDocuments.aspx?CId=168&MId=2163&Ver=4

In addition to the information provided in the slides, the following points were noted:-

·      The Director of Public Health thanked everyone for adhering to the lockdown, which had led to the infection rate in Croydon reducing significantly. The seven day infection rate currently stood at 48.4 infections per 100,000 people in Croydon compared to a rate of approximately 250 infections per 100,000 at the peak of the pandemic.

·      Going forward, it was possible that there would continue to be different variations of the covid-19 virus. With the two recent surge testing programmes in New Addington and Fieldway linked to the South African variant. There had also been surge testing in South Norwood and Thornton Heath as a precaution following a case of the Brazilian variant. It was likely that surge testing would be the way forward for the longer term management of covid-19 outbreaks.

·      The health system in Croydon had seen a declining rate of covid-19 infections, with 74 in-patients at the Croydon University Hospital since the start of March. The hospital had cared for approximately 2,500 covid patients since the start of the outbreak, with 580 lives lost.

·      The hospital continued to manage its non-covid care, with two thirds of its wards now covid free. Both urgent and cancer care had been maintained throughout the pandemic, and the focus was now turning to non-urgent care.

·      Regarding the vaccination programme, it was confirmed that a different approach would be needed to target young people. The approach would need to be nuanced and informed by people from that cohort. Targeted work was underway to dispel some of the myths that had arisen around the vaccine such as its effect on fertility. Thanks was given to local faith leaders for helping to dispel these myths.

·      The Social Care team had been working seven days a week to provide support with hospital discharging throughout the pandemic. At the same time work had continued on its business as usual, with waiting lists remaining stable. There were some outstanding reviews to be completed, but these were in the process of being picked up.  The service was now starting to focus on its roadmap for the recovery of services such as Active Lives, Dementia Day Services and Extra Care Housing.

·      Mental Health services had continued to run throughout the pandemic and a mental health summit had been held on 8 March.

·      It was confirmed that most front line council workers had now been vaccinated.

Following the presentation, the Sub-Committee was provided the opportunity to question those in attendance on the information provided. The first question raised concerned the difficulty for residents in obtaining lateral flow tests, with a request for an update on the local availability of these tests. It was advised that the availability of lateral flow testing had been limited before Christmas, with availability restricted to healthcare workers and school staff. Currently all schools in Croydon received a supply of tests to ensure they were able to remain open and all care homes were tested on a weekly basis. Public Health tried to make sure that information was made available about the availability of testing for the general public, but lateral flow testing was not controlled by the Council.

As a follow up to this response, it was questioned whether the availability of lateral flow testing could be communicated more effectively. It was advised that communication on the availability of testing was complicated due to the changing advice given. Although Public Health made sure its own communication was clear, as the supply of lateral flow testing was not managed by the Council, people should be directed to the national website in the first instance.

In response to a question about how the pandemic had impacted upon the provision of mental health services and the availability of care beds, it was confirmed that there had not been a reduction in mental health provision. Covid had impacted upon the capacity within acute hospitals, but the social care service had supported patient discharge. The service had also ensured that support for infection control was available for mental health service providers.

It was highlighted anecdotally that there may have been confusion over the logging of vaccination data. As such it was questioned whether there was a wider issue with data collection and whether data was being used to target those who were vaccine hesitant. It was confirmed that the health care system did not hold a list of the vaccine hesitant, but worked with everybody to try to encourage vaccine uptake. Information was held on the amount of people vaccinated in care homes, with it confirmed that all residents and staff had at least been offered a vaccination. It was confirmed that ward level data was available on the take up of the vaccine amongst the general public and this would be shared with the Sub-Committee.

In response to a question about whether there was a backlog of patients waiting for elective surgery, it was confirmed that the hospital did not have a back log. The waiting list had been reduced from 2,500 to 2,200 patients since March 2020, but the wait time had increased. The key focus was on addressing clinical priorities and the patients on the list with the longest wait. The creation of the elective centre had ensured there was a good mechanism in place to ensure that patients could be treated quickly.

It was confirmed that availability of the different vaccines tended to fluctuate, but overall the UK had performed well in terms of vaccine supply. The CCG was able to work across Croydon and South West London to smooth out any supply issues that did arise.

In response to a question about how long-covid had impacted upon planned care and mental health services, it was advised there had been an increase in the amount of mental health disorders and other associated symptoms related to long-covid. Much of the support for those experiencing long-covid symptoms was managed through GP surgeries, but for more severe cases there was a specialist clinic with a multi-disciplinary team in place to provide additional support. Work was underway to understand the potential economic impact upon patients who were experiencing long-covid.

It was confirmed that PCT testing had initially only been available in a hospital setting and was only available in the community from June 2020. The PCR test would normally only be used on people displaying symptoms of covid-19. Lateral flow tests worked in a different way, which was why they were used on people who were asymptomatic. 

It was questioned whether either the health or social care representatives had any additional concerns about the move to open up care homes for visits from residents families. It was advised that the Council was in daily contact with the majority of homes, who were providing information on their vaccination numbers. An additional nurse was being recruited to help homes with infection control in relation to these additional visits.

The final question for this item asked what was being done to communicate with the transient population in Croydon, which was significant, about the availability of the vaccine. It was confirmed that the CCG had a specific work stream to establish the scale of this issue, as it was important no one was left behind. Once this was completed, individual mechanisms based on the roving model would be used to engage with these populations.

At the conclusion of the item, the Chair of the Sub-Committee thanked those in attendance from health and social care for all their hard in delivering the vaccination programme.

Conclusions

At the conclusion of this item, the Health & Social Care Sub-Committee reached the following conclusions:-

1.    The thanks of the Sub-Committee was given to all the health and social care professionals for the support provided to vulnerable residents throughout the pandemic

2.    The thanks of the Sub-Committee was also given to those involved in delivering the vaccination programme and surge testing.

3.    The offer to share Ward by Ward data on vaccination with the members of the Sub-Committee was welcomed.