The Director of Public Health will provide a general update.
Minutes:
Rob Howard, Consultant in Public Health (Medicine), was present at the meeting to provide an overview of the latest picture of ward trends, including Covid-19 infection rates and vaccinations. During presentation of the information, the following points were noted:
· Overall in terms of rates of infections, things were looking good. Since the summer Leicester had lower rates than national rates, but rates had started to go up slightly over the past few weeks as national rates had reduced, which had caused concern, particularly the rate in the over 60s.
· But the last week up to 4th November had seen a significant drop, and were currently at 297 per 100k per week, compared to the national rate of 372. The rate in the over 60s had come down significantly over the past week, and there were continued low rates in the 17-21 age bracket and secondary school children.
· The number of people being admitted to hospital was fairly steady with 39 residents admitted in the week up to 5 November 2021 having testing positive for Covid-19. The number of deaths was tragic but relatively small numbers, with 5 people dying week ending 29 October 2021.
· Highest rates of infection were in Hamilton, Abbey, Rushey Mead and Beaumont Leys wards, although not hugely higher than other ward areas.
· Overall in terms of age groups, highest rates were in secondary school age children, and the second highest rates in the 30-44 year old group, possibly the parents of the children, which had been a pattern seen over the pandemic, particularly in multi-generational households.
· In older people, the rates were coming down slightly, with a few cases in care homes but relatively figures currently.
· The highest rates for over 60s for the week were in Rushey Mead, Latimer South and Beaumont Leys.
· In terms of vaccination rates compared to statistical neighbours, overall the city was doing OK, but was not seeing the right sort of rates for school age programme, and the rates for the third vaccination (booster) were also low.
· Of particular concern were care home rates which should be priority for the CCG responsible for the programme, and was really chasing for information, and working with the City Mayor and Directors to put the pressure on to get the booster rates up, particularly into the care homes.
The City Mayor stated that he, the Consultant in Public Health (Medicine) and officers would meet with NHS colleagues on 12November 2021 to press for the concerted effort to ensure that boosters were taken up, children vaccinated, and care homes for the elderly were prioritised. There is clearly some work to be done but was a shared effort.
Members were given the opportunity to ask questions, and the following information was provided:
· For the 12-15 secondary school age vaccination programme, this was an age group that officers had been putting a lot of pressure on and numbers had improved, however, the uptake across the age range was very low at 16.5%, compared to Leicestershire up at 24.7% and Rutland 26.9% and England as a whole at 27.3%. One reason given was consent levels of parents of the school children was quite low. It was noted, however, that the consent form sent to parents was complicated and took little consideration of the fact many of the families had English as a second language, or consideration of literacy levels. It was not necessarily the fact that parents did not want their children vaccinated, but the process put in place was complicated, as the level of those who had rejected consent was very small. Different ways would be discussed with the NHS on alternative ways to get consent from parents.
· Not all GP practices were distributing booster vaccinations. Pfizer needed to be stored at an extremely low temperature, so specialist equipment and fridges were required which was a logistical and operational barrier to having every practice to deliver the booster. The NHS was trying to ensure there was a good offer of the booster across the city, from community pharmacies to pop in centres such as mobile buses that people would attend without booking an appointment. Officers would discuss with the CCG its operational plans and gaps across the city to improve rollout.
· The NHS was supposed to send out letters for people to have boosters at six-months from the last vaccination received, but there was slippage with some people not being invited until seven months. It was noted the booster could now be booked by people at just five months after the second vaccination, to receive the booster at six months. It was important to promote the pop-in centres, and as the booster take up was quite low, there were no queues being seen at various distribution points. It was further noted it was possible for people to book appointments online at venues other than GP surgeries.
· Information on the number of people in hospitals was not received as a matter of course but received when requested. It was known, however, that of the people with the most serious condition in hospital, the majority were unvaccinated. It was emphasised that it was still important for people to get the vaccination to protect them from serious illness, and for the City of Leicester it was important for people to keep pushing the message out to get vaccinated.
· People had been turned away because of mis-communication that they believed at the time of making the booking they could have a booster jab at just five months after their second vaccination, and that it should be made clear at the time of booking there needed to be a period of six months. The City Mayor commented that it was far more important for people to get the booster rather than turning people away because they were a few days early, and the NHS would have the question put if the timing could be more flexible rather than discouraging people from having the booster.
· Booster figures were at levels lower than needed. For care homes it was around 30% for residents, and a lot of care homes who had not had any offer of the booster at that point. Members found it concerning that a priority group had not been targeted and noted there would be fourth vaccination in April being delivered by a system that wasn’t working. Members also wanted information on the number of care home staff that had opted out of having the vaccinations. The latest data would be circulated to Members following the meeting.
· An issue with some GPs not seeing people face to face or being uncontactable was reported by Members. It was reported that many GPs were working incredibly hard and it was easy to criticise them. It was further noted that more people wanted to be seen by a GP, but there were still some people that wanted to continue to have appointments by phone. Members were informed if there are individual cases of urgency they could be picked up and referred through to the various complaint procedures available through the practice or CCG.
· Members thanked the City Mayor for the regular Covid-19 update circulated. They asked if vaccination booster rates could be included which would be helpful to Ward Councillors.
The Chair of Health and Wellbeing Scrutiny Commission informed the meeting the Commission had looked at booster vaccination rates. Noted was the issue of low rates which was a generic problem across the UK and not peculiar to Leicester. Of concern was the low take-up of the vaccine amongst 12-15year old children and care homes. Further noted was access to GPs had been in crisis in the city before Covid-19 and the pandemic had made the situation worse, with not enough GP hours in the city. A suggestion was made that technology could enable some GPs who were retired / semi-retired, on maternity leave etc. who could be given the option of doing online consultations which might provide those hours that the city badly needed.
It was also put to the meeting that it was the responsibility of the Overview Select Committee, Members, and specifically Health and Wellbeing Scrutiny Commission to push the issue of the problems with accessing GPs with the CCG, to get them to push Government to increase the number of GP hours in the city, and to express concern about school take up and care home booster rates.
The Consultant in Public Health (Medicine) said the issues raised would be picked up and discussed with the CCG. Top priority was vaccination booster rates in care homes and children.
The Chair in in summing up said it was clear members were in touch with what was going on in the community and was pleased the Health and Wellbeing Scrutiny Commission were looking into the issue of GPs and availability of hours. He added there needed to be clear a message sent out to get those young people in schools vaccinated, as the low rates were of huge concern.
Members of the Committee were asked to write to the City Mayor or Director of Health with details of any issues they wanted to bring to their attention.
The officer was thanked for the clear guidance and information.
AGREED:
That:
· A further update on Covid-19 be brought to a future meeting.
· Data on vaccination booster rates in care homes for the elderly and children age 12-15 be provided to Members of the Committee.
· Information on the number of care home staff who had opted out of having vaccinations be provided to Members of the Committee.
· Information on booster rates be included in the City Mayor’s Covid-19 information circulation.
· That the Commission express its concerns with the CCG over the problems experienced by residents in accessing GP surgeries, the low vaccination rates in 12-15 years olds, and the low booster vaccination rates delivered to care homes for the elderly.