Agenda and minutes

Board Members had no interests to declare.

The Board signed off the minutes as an accurate record of the meeting held on 24 August 2021.

Fiona Phillips, Assistant Director of Public Health, provided a presentation on the current Covid-19 situation in York.  She reported that the latest official validated rate of new covid cases per 100,000 people for the period from 17.9.21 to 23.9.21 in York was 226.5.  Cases had started to rise but this was happening nationally as well. Compared to regional and national rates, York’s local 60+ rate was lower and amounted to around 10% of the total cases. 

The NHS 111 service frequency had reduced as well, which was attributed to people becoming less sick when they contracted covid.  A similar picture was reported by the hospital, with 37 patients in general beds and another three in the intensive care unit.  Due to various mitigation measures the link between hospitalisation and deaths had been severely weakened.  Winter respiratory issues were happening earlier this year, which had caused our rates to be higher than those reported last year.

Fiona reported that the bulk of cases were amongst children, especially since they returned to school in September.  Cases had started to drop in this cohort at the end of last term and continued to fall over summer.  The rates had risen again before the current term started and had continued to increase.  The effect of the 18+ vaccination programme could be seen in the data, as eight weeks after the initial round of vaccines were administered rates had started to drop.

Given that footfall had fallen across all sites, only the sites at York St John University, University of York and Foxwood Community Centre would remain.  Tests kits could now be picked up from pharmacies and test sites or can be delivered to the home.  Fiona reported that the outreach team had delivered over 11,000 tests and handed out over 13,000 at the test sites.

Sharon Stoltz, Director of Public Health for the City of York, informed the Board that the majority of household cases were triggered by school aged children.  There was a risk that infection could be passed on to family members who were, or worked with, the clinically vulnerable.  She was continually working with local schools to achieve a balance between proportionate measures to allow children to attend school while also mitigating the risk of transmission.

Sian Balsom, Manager of Healthwatch York, raised a concern around parents being fined for not having their children in school even if there was a possibility of them being exposed to the virus. Sharon wanted to make the distinction between a parent keeping their child off school out of fear that was not borne out by the evidence base and a parent with genuine concerns about infection control.  The Corporate Director of People and the Director of Public Health had not received local reports of any cases where a fine had been imposed. Schools continue to work closely with children services and public health continued to deal with complex cases appropriately.

James Farrar asked for clarity of communication around the correct procedure for  ...  view the full minutes text for item 33.

Including:

·        Vaccine Take Up & Boosters & Flu Vaccine

·         Access to Vaccines and Addressing Vaccine Inequality

Stephanie Porter, Director of Primary Care at the NHS Vale of York CCG, gave a presentation on vaccinations and the overall picture across the Vale of York and North Yorkshire.  She reported that 89% of all first doses had been administered. The bulk of the centres’ activity was currently made up of second dose appointments.  All wards had achieved a minimum vaccine take-up of 60%.  The level of vaccination in York remained in line with the levels of the region and was slightly above the national level.  The city had also begun the delivery of the third dose programme.

Stephanie reported that the universal offer to 12-15 year olds had recently commenced and was being led by the School Immunisation Teams, not primary care.  They aimed to offer the vaccination to all 12-15 year olds before the next half-term break.

All York GP Practices had signed up to deliver the Seasonal Influenza Vaccination Programme.  Community Pharmacies were also mentioned as crucial partners for the delivery of the programme.  The School Immunisation Teams planned to deliver an expanded flu programme to 15 year olds.  Stephanie also confirmed that the primary care flu clinics for priority groups had commenced.

Councillor Douglas asked whether the flu programme was expected to be unpredictable or whether it would have a straight trajectory.  Mike Holmes assured the Board that Nimbuscare were prepared to reorganise appointments if there were problems with the vaccine supply.  Councillor Douglas also asked if there were any issues with the delivery of the vaccine to housebound patients. Mike assured the Board that Nimbuscare continued to support and consult community nurses over vaccinating housebound patients. 

Mike Holmes informed the Board of a pilot scheme around managing children with a respiratory virus.  The scheme had arisen because of a surge of viral illnesses in children.  The rate in children had since settled but was expected to rise again. Respiratory viruses contracted by children under two years of age could cause more serious respiratory problems, like bronchiolitis. In order to reduce the risk of further health complications, children who had contracted a respiratory virus were put into the green, amber or red category.  If a child was in the amber category they would require a period of observation.  The scheme aimed to help improve capacity at the hospital through a collaborative approach.

Gareth Wilce, Senior Communications Manager at City of York Council, gave a presentation around the key messages and four phases of the Outbreak Communications Plan. The volume of regular communications had reduced, enabling the team to resume their business as usual.  All communications were prepared to be resumed or extended whenever it was appropriate.

Gareth reported that the Return to Education Campaign was in full flow.  The campaign focused on supporting parents, carers and pupils to return to school safely.  Every school received a resource pack with key messages tailored to the younger population.

Gareth also reported that there was a national push for the 18-29 cohort to get vaccinated.  National resources had been shared with the relevant organisations.  Behavioural research had found that convenience and removing barriers were the main factors to persuade this cohort to get vaccinated.  Employers who hired younger staff had also been consulted.  Social media platforms had been commissioned to encourage peers to share their vaccination stories and normalise the conversation around vaccination.

Sharon Stoltz informed the Board of the increasing levels of complacency around covid seen in the community.  As the pandemic continued it became increasingly challenging to ensure messages were received in the right way.  The next phase of communications would need to focus on infection prevention control (IPC) steps to protection, and practical messages around covid.

Sharon asked the Board whether local advice around face coverings should go further than that advised by the national government.  Face covering provided a level of protection against all seasonal respiratory viruses.  Although York as a local authority was not in a position to mandate face coverings, given the recent evidence about how people feel safer with face coverings, the Board endorsed the suggestion.  Sharon informed the Board of a letter that was being developed to remind residents of IPC measures and how to remain safe.  The letter could be an opportunity to advise residents to wear face coverings where appropriate.  The letter would be signed by the Clinical Chair of the CCG, the Medical Director of the Hospital and the Director of Public Health.  Charlie Jeffery agreed that a clear citywide message around face coverings would help with what the universities were trying to achieve.  James Farrar asked whether the business community were being engaged to support this, as a consistent message from all partners was necessary.  Sharon agreed that communications between the business community needed to be strengthened.

The Board noted the update.

Mora Scaife, Principal Neighbourhood Management Officer reported that she was working with colleagues in public health to develop the community hubs and support the outreach work.  Since the start of the pandemic the hubs had supported the community through food distribution, shopping, prescription collection and delivery and provided support for those identified as clinically extremely vulnerable.

By working on a grass roots level on the frontline with the community, more of an insight into the local barriers was gained. Mora reported that most of her team had been upskilled to enable them to have conversations around vaccine hesitancy and financial/technological inclusion.  She added that these types of skills had been carried over into their usual work and not just used in the covid response.  Mora also suggested her team as a good resource to disseminate messages at a local level. 

The Board noted the update.

Alison Semmence, Chief Executive of York CVS, informed the Board that, even though there had been a significant decrease in income for charities over the pandemic, the picture was starting to look better, with 76% thinking they would be okay for the next 12 months.  Alison reported that those charities with a diverse spread of income had been the worst hit compared to the charities that were solely funded from grants.  The Third Impact Survey had found that 33% of organisations had used their reserve funds.

The pandemic had caused an increase in frequency and reliance across most support services.  With fewer staff and volunteers available, most services were at capacity.  Alison assured the Board that this problem was being addressed through the Volunteering Centre established to help replace volunteers that had been lost.  To ensure the centre continued to operate, further funding would have to be identified, as it had only been agreed to run up until March 2022.

Alison made a request for the Board to reflect on how their organisations could help with the sustainability of the voluntary sector.

The Board noted the update.

Professor Charlie Jeffery, Vice Chancellor and President of the University of York gave an update on the current position of universities and higher education establishments.  He informed the Board most of the new students had arrived last weekend. Freshers’ week had begun this week and teaching would start next week.  He reported that he was working with colleagues in public health to establish risk assessments and scenario planning for the 40,000 students currently studying at universities and colleges.

The universities had been encouraging bi-weekly testing and had continued to support self-isolations with digital vouchers, entertainment and IPC guidance.  The University of York had re-surveyed their students to get a better understanding of the current landscape.  It was found that 91% of students had been vaccinated and 71% had received their second dose of the vaccine.

Stephanie Porter thought it would not be unreasonable to estimate the general population of the 18-29 cohort to be around 50-60% vaccinated if 91% of university students had been vaccinated. Sharon Stoltz suggested that the JSNA carry out a piece of work to separate the university cohort from the rest of population.  Fiona Phillips explained that the data received did not include an individual’s occupation or education; she advised that some proxy estimates might be drawn from the university’s survey.  James Farrar suggested exploring the younger cohort in the behavioural insight work that was carried out.

Action: Gareth Wilce agreed to provide a behavioural insight report on the younger cohort at a future meeting.

Action: Fiona Phillips to investigate whether proxy estimate could be drawn from the university’s survey.

The Board noted the update.

The Chair confirmed that there were three standing items for all future agendas:

·        Current Situation in York

·        Communications and engagement

·        Updates from Sub-Group/ Task and Finish Groups.

The Board agreed to add the following to the agenda for the next meeting:

·         Economy and building back fair – Simon Brereton.

The Board agreed to reduce the frequency of the meetings to one meeting every two months.  Should the situation change, an additional meeting would be called if it was viewed as necessary.

The agreed dates of future meetings were as follows:

·        24 November 2021

·        26 January 2022

·        23 March 2022

·        25 May 2022

The Board recorded their thanks to Amanda Hatton, who would shortly be leaving City Of York Council.

The Board had no other business to discuss.