Agenda item

10:25

A presentation to update on the key issues for the Oxfordshire system on COVID-19 recovery.

Ansaf Azhar, Director for Public Health, updated the committee on the latest data around Covid-19.  As expected, the opening of schools in September led to an increase in infections.   That had started to come down again but we were entering a period of uncertainty as winter approached.

The vaccination programme had broken the link between infection and hospitalisation.  However, the acute hospitals were still under extreme pressure from non-Covid issues and we also faced the flu problem as winter approached.  It was still important to continue with safety measures such as masks and testing.

Ansaf Azhar summarised the Winter Plan.  We were still on Plan A which included continuing the vaccination programme and booster jabs.  If the situation deteriorated Plan B would be activated with further restrictions to reduce case rates.

Tehmeena Ajmal, Covid Operations Director, Oxford Health, spoke about the vaccine programme.  They were now more skilled at getting out and about with vaccinations rather than expecting everyone to come to the centres.  The booster programme was now live.  It was recommended that the booster jab be delivered between 6 and 8 months after the last vaccination.

The programme for 12 to 15 year olds was mostly delivered through schools.  No coercion was involved and the service was supporting schools in responding to concerns.

From Oxford University Hospitals, Lily O’Connor, Deputy Director of Urgent Care and Dr Larry Fitton, Divisional Director, Medicine, Rehabilitation & Cardiac, described how pressures on Urgent and Emergency Care were being managed so that elective surgery could continue.  More people were being supported at home when appropriate. 

It was expected that the next Covid peak was likely to be mid-October.  There were concerns of a negative impact on staff wellbeing if demand levels continued into Autumn.

The situation was being monitored seven days a week.  There were increased numbers presenting to Emergency Departments, especially in the evenings.  There were also increases in people presenting with eating disorders and in mental health crisis.  Lily O’Connor took the meeting through the surge planning with an example case.

Lisa Glynn, Director of Clinical Services, OUH, described elective care recovery.  The Trust had performed well coming close to the planned targets.  The total waiting list had been increasing since February.  The numbers waiting over 52 weeks had reduced but there had been a sharp increase in the numbers waiting over 104 weeks.

Three areas remained closed to referrals: Ear, Nose & Throat, Oral & Maxillofacial Surgery and Cataracts.  The plans to reopen will be discussed at the Executive meeting the following week.

Looking at cancer waiting times, the percentage meeting the two-week-wait standard for Breast Symptoms was in the low 20s in July but intensive efforts have seen that rise to the high 90s in September.

Planning guidance for the rest of the year was expected imminently and they would ensure that the local plans were updated to meet that guidance.

Members of the Committee raised issues which officers responded to as follows:

·         The number of PCR tests per week was increasing but the key figure was the proportion testing positive.  This had increased from around 4% in early summer to 7-10% lately.

·         Gynaecological referrals from primary care were being assessed on the community model and appropriate cases referred to secondary care.  It was expected that the screening programme will be back to a healthy state by January 2022.

·         Asked about a timeline for services that have not re-opened, there was a plan that was going to the OUH Executive the following week and it should be possible to give a timeline following that.  A report on that will be submitted to the Committee within a week of the Executive meeting.

·         Diagnostic testing was prioritised in the referral from primary care.  An urgent case should be progressed within 7 to 10 days, routine in 6 weeks.

·         There has been a significant number of young people reporting with breathlessness, often a couple of weeks after being diagnosed with Covid.  They can be referred to long-Covid clinics if the problems persist.

·         Oxfordshire Clinical Commissioning Group were working with primary care practices and Healthwatch to gather information on those who decline alternative providers and what can be done to assist them.

·         There was no specific threshold for schools to reach in order to call an outbreak control meeting.  It was context specific – depending on speed of spread and complexity.

·         At a national level around 20% of those admitted to hospital with Covid have been fully vaccinated.

·         Complex needs was an area where more could be done by an integrated approach between health and social care.  OUH and Oxford Health were also examining opportunities for community based support.

·         Work was ongoing on the governance and accountability of the Integrated Care System which was due to be up and running by April 2022.

·         There was government guidance for Covid-safety in various settings.  The County had a Covid Secure Team that visited settings to give more tailored advice.

The Chair thanked all of the participants for their contributions to the discussion.  In particular, the Committee congratulated Tehmeena Ajmal and Natasha Barnes of Cherwell District Council on their High Sheriff Awards for their work on the pandemic.

Action: the slide titled “Elective care RTT” had incorrect data and a correct slide will be sent for the record.