Agenda item

The Director of Public Health will provide the Commission with a verbal update.

The Director of Public Health provided the Commission with an update of the latest position of health protection, and it was noted that:

·       Rates for TB had risen in Leicester in recent years and the city currently had the 2^nd highest rate in country which raised significant concerns.

·       Leicester is a complicated area due to issues of migration, travel, country of origin, poverty, homelessness, and substance misuse.

·       TB kills around a million people a year globally. It is entirely preventable; however, it requires an extremely long and hard treatment over 6 months often with side effects.

·       There had been lots of work in the city including the development of a new strategy and an action plan. A presentation was provided at Health & Wellbeing Board and discussion at the ICB clinical executive meeting enabled people to discuss how to resource and improve screening and treatment.

·       There have been some unusual strains in the county which have been more infectious and have had more severe outcomes. These strains have been around for decades but being monitored as if were to transmit to the wider community it would be concerning.

·       The outbreak of whooping cough had also raised concerns although there were more cases in the county than the city. The lower uptake of vaccinations particularly by pregnant women as newborn babies are most vulnerable was noted of particular concern. Another concern is the limited protection of the vaccine as it reduces over time and is less effective than other vaccinations.

·       Close attention to monitor the situation will continue moving forward with the incident management team, ICB and UKHSA. Partnership working is required to overcome the hesitancy amongst communities.

·       There had been a measles outbreak across East Midlands and the highest rates were in the city. There had been lots of work on this with health partners for focused efforts on communications, a roving mobile unit for vaccinations and working with communities to overcome vaccination hesitancy and this had made a real difference as there had been hundreds vaccinated since the campaign started. Rates had reduced with no new cases reported in recent weeks for the first time since the outbreak began.

·       The national issue of an e-coli outbreak associated with lettuce was highlighted. There had been only one case in the city but Public Health, the Food Standards Agency and Environmental Health were continuing to monitor.

·       The identification of a couple of salmonella cases was also highlighted which was also being monitored by Environmental Health and Regulatory Services.

·       During the pandemic there was a significant drop in the screening programme, with cervical screening rates much lower than the national average and lots of work with partners around this issue.

In response to questions and comments from Members, it was noted that:

·       The Deputy City Mayor for Social Care, Health and Community Safety is writing to the Secretary of State to request funding to tackle TB in Leicester as the city has the second highest prevalence in England. The highest prevalence area received funding.

·       The effectiveness of health protection so far has demonstrated the benefits of partnership working.

·       The data on screening uptake needs to be analysed to identify barriers that are preventing uptake and how they differ between communities. These could be due to cultural sensitivities or practical factors. It was highlighted that cost-of-living crisis may have worsened practical barriers preventing uptake.

·       Responsibility for screening lies with NHS England, however from next year it will lie with the ICB.

·       The pandemic was the largest factor in vaccination and screening decline and poor re-uptake.

·       The biggest challenge in addressing TB rates had been that many cases are latent (No symptoms and not infectious but with potential to become ‘active’ TB). However, it was found that there was not a good correlation between areas affected with TB and the GP surgeries offering screening.

·       The exemplary response demonstrated in Leicester during the pandemic should be built upon, allowing best practise to be applied to health protection or in the event of another outbreak.

AGREED:

·       The Commission noted the report.

·       The draft TB strategy and updated action plan to be added to the work programme.

·       Screening to be added to the work programme.