Agenda item

10:20

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

The Committee received a presentation on the system-wide response to the COVID-19 pandemic.  Ansaf Azhar, Director for Public Health, presented slides on the latest data which demonstrated a continuing drop in the number of new cases.  This he attributed to a combination of the vaccination programme, widespread testing, lockdown, social distancing and COVID-secure regulations.

The numbers in hospital from COVID had come down dramatically but there was still pressure on hospitals due to the long waiting lists that had built up for non-COVID issues.  The system was ready to respond if there should be another surge.

Ansaf Azhar responded to questions as follows:

·         Workplaces were the most common sources of new cases but numbers were low.  The return to school was well managed and there was only a small effect.

·         There was currently no intervention available that was guaranteed to achieve zero-COVID and the costs to people’s general wellbeing and the economy in trying to achieve that would be significant.

·         There was no measurement to document how many people were suffering from Long-COVID.  It was being studied closely but we were still learning about it.  Maintaining a healthy lifestyle was still the best way of recovering from COVID.

·         The number of new cases was back to where it was last summer but it never got down to zero then.  There were new more transmissible variants around this time and it was important that people continued to following guidelines and carry out the regular testing being offered.

·         The data was available on whether those who tested positive had been vaccinated but he couldn’t comment on specific cases.  The vaccine did not completely prevent infection but it would ensure that, if infected, the need for hospitalisation would be avoided.

·         In terms of excess deaths – which was a useful way to compare different regions – Oxfordshire was comparable to the national average in the first wave and below average in the second.

It was agreed to provide statistics comparing Oxfordshire to other counties that Public Health England group with us as similar counties.

Testing

Ansaf Azhar presented data on testing showing that the numbers of PCR tests were dropping as fewer people were presenting with symptoms.  There were now more sites open for LFD asymptomatic testing and kits could be collected from centres, including around 100 pharmacies.  The number of positive tests was very small but it was still important to detect them to stop the spread.

Ansaf Azhar responded to questions on testing:

·         The purpose of asymptomatic testing was to detect positive cases rather than give assurance from a negative result.  The figures showed that LFD tests, although less reliable, had detected 70 cases in Oxfordshire in one week.

·         Up to April 9 asymptomatic testing was focussed on the workplace but from that date the general public were encouraged to get tested twice a week.  He noted the feedback that this message was not widely understood and would look at new ways of communicating it.

·         Asked about people being reluctant to take the LFD test from a fear that they might lose their job by taking time off work to self-isolate – especially when this test was known to produce some false positives, he responded that those who tested positive could get a more reliable PCR test very quickly now.  Support payments were available to people who had to self-isolate.

·         The Pharmacy Collect system had only been put in place for a week or two and it was expected that the number of pharmacies participating would grow.

·         Mask wearing will need to be continued in schools and in general.  The advice was still to get a PCR if showing symptoms.  Testing kits are available from all testing centres.  He would take on board the comments about confusing signage at the Shippon test centre.

Vaccination

Jo Cogswell, Director of Transformation, Oxfordshire Clinical Commissioning Group, gave an update on the vaccination programme.  This had progressed very well thanks to the strong partnership across the system.  The top nine cohorts had been offered vaccination by April.  The focus was now on second vaccinations but in the last week over 45s had been offered first doses.  Three pharmacies were now operating as vaccination centres with five more soon to come online.  These have been targeted for market towns.

Tehmeena Ajmal, COVID Operations Director, Oxford Health NHS FT, described the work being undertaken to reach the 30,000 or so people in the nine cohorts who had not yet been vaccinated.  Pop-up clinics were being held in churches and mosques for example and sprinter vans were being acquired to service more rural areas.  Three different vaccines were available so that there were alternatives for those people, such as under 30s, who were not being offered the AstraZeneca vaccine.  Work was continuing to ensure that those who might not be registered with a GP get a vaccine, including people who are homeless.

The Chairman thanked all those working in the system for their work in ensuring that all people, all ethnicities were able to access the vaccine.  Officers responded to questions about the vaccination programme:

·         Not all GP practices took up the offer to be part of the vaccination programme but where they did not, other practices in their Primary Care Network covered for them.  Some practices will stop vaccinations after cohorts 1 to 9 and other centres will service cohorts 10 to 12.  The BOB-ICS which organised the vaccination programme across Thames Valley was conscious of travel difficulties in certain areas and the roll-out of new centres in pharmacies will give much wider coverage across the county’s towns.

·         It was acknowledged that there was an issue in relation to GP centres with people getting short notice of their second dose.  This was due to supply problems.  The mass-centres had regular delivery dates but this was not the case with GP centres.  Everyone should receive an invitation in the eleventh week after their first dose and should be offered the nearest available centre.  While 12 weeks was the recommended interval, anything up to 16 weeks still gave the required protection.

·         The vaccine supply was generally known about three or four weeks ahead and there was enough to meet the needs of the cohorts currently open.

Health and Social Care

Sara Randall, Chief Operating Officer, Oxford University Hospitals, described the longer waiting lists across out-patients, diagnostic and treatment phases, with just over 5,000 patients waiting more than 52 weeks.    

Patients were reviewed by clinicians including a psycho-social assessment.  One case of major harm had been identified and one of moderate harm.  Cancer patients were reviewed when waiting over 104 days and prioritised on urgency.  Some patients chose to delay – for COVID and other reasons – but they remained on the waiting list.

Diane Hedges, Deputy Chief Executive, OCCG, stated that three services were still closed to referral – Ear, Nose and Throat; Maxillofacial and Ophthalmology.  GPs could escalate cases and patients were being given options to travel to other areas for treatment.  A redesign of Ophthalmology was being examined to increase the staffing capacity.

It was agreed to come back to the next meeting with the plans for recovery based on the planning guidance that had just been published.  It was also agreed to circulate to the Committee data on the numbers who contracted COVID in hospital in comparison to other counties.

Officers responded to further questions as follows:

·         A staff wellbeing programme ‘Growing Stronger’ provided support to individuals and teams.  Vacancy and turn-over rates had dropped in recent months.  A lot of research funding which had been lost during the pandemic was coming back online.

·         Deaths in the community within 30 days of testing positive were all being notified and it will be possible to give more detail on that at the next meeting.

·         In ENT they were subcontracting in consultants, as well as referring out of county.  A group had been formed to work on reducing waiting lists.  Patients who did not turn up were been contacted.  It was agreed to provide data on audiology referrals which were not included in the ENT waiting list figures.

The Chairman thanked all officers across the system for a very useful update.