Agenda and draft minutes

Board Members had no interests to declare.

The Board signed off the minutes of the meeting held on 26 January 2022 as an accurate record.

Fiona Phillips provided a presentation summarising data from York through the pandemic period since late February 2020. In that time there had been 59,026 positive cases of Covid in York, which equated to a lower rate per 100,000 of population than the regional and English averages. There had been almost 80,000 positive tests in the population, mostly through Pillar 2 testing (lateral flow and PCR tests), with over 70,000 testing appointments attended across seven CYC-run testing sites to February 2022. Although cases remained high, York was moving out of the outbreak response phase.

Fiona noted that the Delta and Omicron BA.1 variants accounted for 40% and 48% respectively of all cases in York across the pandemic, with most current cases involving the Omicron BA.2 variant. Peaks in hospital bed occupancy had occurred in January 2021 and March 2022, although in the present peak the figures for Intensive Treatment Unit bed occupancy were very low. To date 469 York residents had died from Covid, with peaks occurring in May 2020 and January 2021; the success of the vaccination programme had ensured that there was no corresponding peak in deaths during the current phase. The vaccination programme was ongoing, with over 85% of the 16+ population having received both doses of the vaccine to date and work being done to target low-uptake wards. The contact tracing service had now concluded, with over 80% of referrals actioned being successful.

Fiona also noted that over 3,000 Test and Trace Support Payments, over 800 Hospitality and Leisure Grants, and over 5,200 Additional Restrictions grants had been paid by the Council over the course of the pandemic and highlighted the scale of the effort made across the city over the period.

The Chair expressed the Board’s thanks for the efforts of public health teams, volunteers, NHS and primary care staff, the community and voluntary sector, and businesses in pulling together across the pandemic.

Alison Semmence echoed the Chair’s comments, highlighting the work of the Public Health team and asked about the drop-off in uptake of the booster vaccination. Fiona noted that this was partly due to timing, with high rates of Covid delaying when people could have their booster, but messaging was still needed to emphasise the importance of vaccination, which was the reason why people with Covid were not becoming more unwell.

Siân Balsom also echoed the Chair’s comments and enquired about the messages Public Health wanted emphasised going forwards in weathering the Omicron BA.2 strain. Fiona confirmed that a focus on vaccination was a key element; many would be nervous about the next phase so it was important to help give people confidence that monitoring of the disease would continue and that local measures could be introduced if needed.

Jamaila Hussain asked whether there would be any further guidance around testing for both internal and external care providers. Fiona noted that this was expected to be published on 1 April, addressing the next phase including testing in high-risk settings.

The Board noted the update.  ...  view the full minutes text for item 65.

Mike Holmes provided an update on the vaccination programme to date, noting that since December 2020 a multi-sector offer had been provided, with Nimbuscare working from Askham Bar to deliver local and national vaccine services, alongside GP practices, York Hospital and community pharmacies. Pop-up sites had been established in areas of low take-up, as well as at the universities. Over 600,000 vaccines had been delivered at Askham Bar alone, with particularly good uptake among older and higher-risk cohorts. Although some were still unvaccinated a drop-in service would remain available to them. Despite short notice there had been a strong response to the December booster campaign. The spring booster programme was now underway and vaccines were also being offered to the 5-11 age group; discussions were taking place with NHS England about the ongoing commissioning of local and national vaccination services at Askham Bar until March 2023. Preparations were being made for a further booster campaign later in the year and for potential surges.

Cllr Kilbane asked about comparative vaccination levels across wards. Mike confirmed that pop-up services would continue to be delivered in areas of low uptake when needed. The response to pop-up services suggested that access issues were not always the cause of low uptake. Cllr Kilbane also enquired about work with ward councillors to encourage vaccine uptake in these areas, and Fiona Phillips confirmed that contact had been made with relevant councillors and the Public Health team were willing to try new ideas to encourage people to come forward.

The Board noted the update and offered its thanks to all involved in delivering the vaccination programme.

The Board received a presentation on the Public Health and Partner Response to living with Covid going forward, including outlining ongoing work, acknowledging potential risks, and the question of continuing with the current Board or using other mechanisms for oversight.

Fiona Phillips outlined the Public Health perspective, noting that the Director of Public Health had been responsible for leading the response to the pandemic under seven themes outlined in the Outbreak Management Plan. The Board had been established to oversee the implementation of this Plan. This enhanced pandemic response would come to an end at the end of March.

Fiona noted that the Public Health team would continue to act as local experts for schools on any public health issues and support care homes, where full guidance was expected soon, as well as continuing to work with partners to identify specific risks for particular locations and communities. The last symptom-free testing sites would close this weekend, with symptomatic PCR testing sites operating until 30 March, although symptomatic testing would remain available for the over-80s and the immunocompromised. The local contact tracing service had already ceased to operate on 24 February, and any future need for contact tracing or testing for future outbreaks would be arranged through UKHSA. Case data would no longer be published although the national ONS Covid infection survey would continue. The need to support people to isolate through local community hubs had ended with the end of the legal duty to isolate for Covid cases.

With reference to the Outbreak Management Advisory Board, Fiona noted that the Board had played an important role in providing local political ownership and public-facing communication through the pandemic, but that it was now proposed to stand the Board down. The Joint North Yorkshire and York strategic health protection board and a local York-only health protection group would continue to oversee Covid-related work. She also highlighted risks including the potential for future variants of concern, the impact of health inequalities including around vaccination, the ability to stand back up an outbreak response locally which would entail scaling back other Public Health work given limited resources, and the long-term impacts of Covid in health, education and the economy.

Mike Holmes provided an overview from the perspective of Primary Care and Out of Hospital Services. He drew attention to lessons from the pandemic experience which could be carried forward, including practices working together to deliver at scale through Nimbuscare, risk stratification of patients, co-design of services being delivered outside hospital, outreach services and remote working. Continuing use of e-consultations and telephone triage could potentially help address health inequalities by freeing practice capacity for in-person appointments. There was a backlog in general practice and ways of reducing waiting lists were being looked at, including using Askham Bar for other services. The principle of transactional care to deliver at scale was being developed to allow practices to focus on relational care to better help patients with complex needs. However, there were significant pressures, with continuing staffing  ...  view the full minutes text for item 67.

Fiona Phillips thanked Board members for their acknowledgement of the work done by the Public Health team, and offered thanks to colleagues in the Council, the NHS, the voluntary, education and business sectors, and the former Public Health England (now UKHSA) for their support across the pandemic.