Local Outbreak Control Plan for Covid-19 infection - Last Update : 21st August 2020 - Barking ...
Page content transcription
If your browser does not render page correctly, please read the page content below
Contents (cross linked to the Local Outbreak Control Plans seven areas) Glossary Supporting Vulnerable People 2 6 • Barking and Dagenham’s support offer Introduction • Specialist support hub What are the key components Methods for Testing 3 • National portal & MTU arrangements Guiding Principles • Additional testing capacity Local Outbreak Control Plan seven areas Data Integration 5 • Local reporting arrangements Governance 7 • GDPR & Data Security • National governance • Roles & Responsibilities • Role and responsibilities in London • Local governance Communications & Engagement 1 2 3 4 5 6 7 • Escalation Criteria • Build on prevention messages • Range of levers available to encourage • Raise awareness of NHS Test & Trace compliance locally • Support area outbreak plan • Local lockdowns Risk Matrix Settings 1 2 4 • Setting specific action cards • Surge capacity planning
Glossary BAME: Black, Asian and Minority Ethnic LOCP: Local Outbreak Control Plan CCG: Clinical Commissioning Group LCRC: London Coronavirus Response Centre CQC: Care Quality Commission MDT: Multi-Disciplinary Team DPH: Director of Public Health MTU: Mobile Testing Unit GDPR: General Data Protection Regulation MSOA: Middle Layer Super Output Area HMO: House of Multiple Occupation PCN: Primary Care Network HR: Human Resources PHE: Public Health England IMT: Incident Management Team PPE: Personal Protective Equipment JBC: Joint Biosecurity Centre SPOC: Single Point of Contact LBBD: London Borough of Barking & Dagenham UTLA: Upper Tier Local Authority LA: Local Authority
Introduction This document is intended to outline seven steps in local preparedness to prevent, control and manage Covid-19 incidents and outbreaks, if and as when they emerge. It describes our local whole system response and it has been developed with a wide range of stakeholders and overseen by the Health Protection Board. It is signed off by the Recovery & Legacy Group and approved at the Health and Wellbeing Board on 28 July 2020. This Plan is iterative and will be regularly updated, as further evidence and guidance emerge. London as a global city, with celebrated diversity and numerous ports of entry has an established ‘world class’ health protection system. The local and London public health response will be designed around these responsibilities and existing health protection good practice. Together with our partners we will utilise local governance and partnership arrangements to ensure the design of our Local Outbreak Plan Control Plan for Covid-19 infection is developed and delivered to meet local needs. Within these plans we will need to consider what preventative measures are required, how the situation in schools and care homes are monitored, possible scenarios and what strategies are needed to manage an outbreak in these settings (such as temporary closures to allow the deep cleaning of facilities). As part of our local response, will be able to draw on the expertise and support of the London Coronavirus Response Centre (LCRC). The main aim of the Plan is to: Build on existing plans to prevent and manage outbreaks in specific settings, ensure the challenges of Covid-19 are understood, consider the impact on local communities and ensure the wider system works together to contain the spread of infection locally.
What are the key components of our Local Outbreak Plan? A document, easily understood & shared to provide assurance in preventing & managing outbreaks • Practical and in simple language and clear objectives • Likely to have a web based version for easy access and sharing • Primary audience include local decision makers, advisors and stakeholders most likely to be affected by the plan. It should be accessible to the general public to build confidence and trust Content developed to enable day to day working & rapid escalation of actions if / when required • Detailed governance arrangements with clear roles and responsibilities • Mapped interfaces with key stakeholders and flow of information day to day and in case of outbreak • Trigger points for escalation outlined • Key processes to be followed proactively day to day (e.g. infection control) and in case of outbreak • Develop or plug into existing plans for high risk locations / vulnerable people • Summary of risks associated with each theme, and suggested mitigations • Proactive and reactive communications and engagement plans including pre-prepared / example materials, and usage of data to tailor messaging to clusters Supported by key tools • Templates e.g. SITREP, readiness, tracing data to receive • Checklists and other proformas • National assurance and support framework
Guiding Principles Barking and Dagenham’s Local Outbreak Control Plan (LOCP) is guided by the principles and legislative framework specified in the document below and signed by Association of Directors of Public Health, Faculty of Public Health, Public Health England, Local Government Association, Solace and UK Chief Environmental Officers Group. There are four principles for the design and Operationalisation of LOCPs arrangements, including local contact tracing, if needed. They are stated below: 1. Be rooted in public health systems and leadership 2. Adopt a whole system approach 3. Be delivered through an efficient and locally effective and responsive system including being informed by timely access to data and intelligence 4. Be sufficiently resourced Read the document here
Our Covid-19 Local Outbreak Plan builds on existing plans to manage outbreaks in specific settings, ensure the challenges of Covid-19 are understood, considers the impact on local communities and ensure the wider system capacity supports the Director of Public Health Capacity Stakeholders Scale Integration & Delivery Communication & Engagement • Increased capacity • Significant and sustained • Plans must be able to • Requirement to integrate with• Requirement for comms requirements for: increase in number of deal with outbreaks at new bodies, including: o Community campaign, with more stakeholders, including: an unprecedented scale o NHS Test & Trace inc JBC frequent and consistent engagement o Residents across multiple o Testing o Support and Assurance messaging & broader o Contact tracing o Employers locations and facility teams o PHE types simultaneously scope and channels o Infection control • Requirement to integrate multi- (e.g. The leader, cabinet o Support for o NHS source data to support local vulnerable members, Director of o Facilities e.g. schools, • Some plans will involve decision making people hospitals coordination across Public Health, CEO o Enforcement • Requirement to collaborate school leaders,) • Specialist expertise o LRFs other London boroughs with PHE Health protection • Requirement for required o National government and in some cases teams, MDT LA, CCGs, o Local & national media proactive comms and • Mutual aid London as a whole hospitals, GPs, around arrangements o Community, faith and comms plans infection control, advice on available voluntary sector ground, delivery etc.
Local Outbreak Control Plans seven areas 1 2 3 4 5 6 7
Lead Agency Contact details Responsibilities The Director of Public Health Spokespeople is the lead officer for communications regarding Director of Public Health – Matthew Cole local outbreaks Email: Matthew.firstname.lastname@example.org Tel: 07734 716972 In the event of an outbreak, the DPH will inform the group and the communications team Chief Executive will co-ordinate initial media The Leader response both with other lead Councillor Worby agencies, partners and any other statutory agencies if Communications Contact: Von Edomi relevant. The DPH will ensure Von.Edomi@lbbd.gov.uk that the daily lines to take are Duty phone: 07968 511859 distributed to all partners through established channels until the incident is over
The Director of Public Health is the identified Barking and Dagenham 7 NHS Test and Trace Programme single point of contact (SPOC) The Director’s primary role is to give assurance that the key organisational elements outlined below are aligned and functioning effectively.
Who are the key decision makers? Level Decision maker(s) Co-ordination, advice and engagement Individual Individuals or bodies responsible for that setting • London Coronavirus Response Centre setting (e.g., Head Teacher, restaurant owner) • Director of Public Health and team • Multi-functional Silver Groups London Depending on the specific action required • Covid-19 Health Protection Board (Local Borough of decisions may be taken by the: Outbreak Control Board) Barking & • Acting Chief Executive • Barking and Dagenham Strategic Gold Dagenham • Director of Public Health Command • Acting Deputy Chief Executive/Monitoring Officer/Gold Commander London Agreed cross-boundary decisions will be • Local Resilience Forums implemented at London system level through the • GLA London Coronavirus Response Centre • New Contain/Joint Biosecurity Centre Support and Assurance Teams National Under specific escalation scenarios
Roles and responsibilities in London 1 2 3 4 5 6 7 A Joint Agreement between the LCRC and the London boroughs Directors of Public Health for supporting the management of Covid-19 outbreaks and complex settings has been agreed. This Joint Agreement provides a framework for joint working between the LCRC and the public health structures in the London boroughs (LA) for managing Covid-19 outbreaks. Details the following: • Summarised roles by setting (LAs and LCRC). • Brief Standard Operating Procedures/Roles and responsibilities for London boroughs and LCRC, by setting type This Agreement will be kept under monthly review initially due to the rapidly changing regional situation and guidance, and fluctuating capacity across the system. This document is therefore intended to be flexible and adaptable for local operation due to the different support and capacity arrangements available in local systems in London. Read the document here.
Local Governance 1 2 3 4 5 6 7 • Chaired by Director of Public Health and include • Chaired by Cabinet Member for Social Care & the whole system membership including PHE, Health Integration and includes Chief Officers, EHOs, PCN/GP, HR, B&D Collective Met Police, Healthwatch, DPH, CCG, GP Governing Body members, elected members. If • Oversee development of and provide assurance local lock-down needs to be imposed, Leader will that there are safe, effective and well-tested chair the Board; Local Outbreak Plans in place to protect the health of local population during Covid -19 • Political and partnership oversight of strategic pandemic. response and proactive engagement with the public. • Read the Terms of Reference here Covid-19 Health • Read the Terms of Reference here Health and Protection Wellbeing Board Board • London boroughs of Barking and Dagenham, Redbridge and Waltham Forest and includes all Category 1 responders; Supported at a national level by Government Tri Borough Departments (CCS/RED), TTCE programme and Resilience • Responsible for determining Council’s overall proactive management and emergency response, Joint Biosecurity Centre and at a Forum deployment of local resources and escalate need regional level by Local Resilience Forums and for mutual aid, if needed. Integrated Care Systems (e.g., for mutual aid and escalation) • Read the Terms of Reference here
Covid-19 Health Protection Board Incident Management Team In case of local complex settings outbreak or community cluster that needs investigation, LCRC or Director of Public Health will convene an Incident Management Team (IMT) that will report to Covid-19 Health Protection Board. The purpose of the IMT is to agree and coordinate the activities of the key stakeholders involved to manage the investigation and control of an individual outbreak situation. This includes assessing the risk to the public’s health and ensure control measures are implemented as soon as possible. Notification of an incident or outbreak will come via various sources (e.g. LCRC, Enforcement, local schools etc.) and this will trigger data flow. Incident Management Team meeting may be convened when there are: • 2 or more cases in a setting • A single case in complex setting Cases in three household at an MSOA level (Director of Public Health likely to be the main lead for IMT) Read the IMT meeting Terms of Reference and Agenda here
Escalation criteria Setting Criteria for escalation Escalation to: Covid-19 Health Protection Group Strategic Gold Command (Recovery & Legacy Board) Events /gatherings (any setting ) - Death of a child Yes - immediate Yes - immediate briefing needed - Outbreak linked to a major public Yes – immediate Yes – immediate briefing needed building, faith gathering or event in the borough Schools/Childcare/Early Years - More than one case in a school/EY Yes Yes – routine reporting only setting - Setting not able to contain outbreak - School closure Yes – immediate Yes – immediate briefing needed - Media interest in outbreak/cases Yes Yes Adult social care/Supported Living - More than 6 cases in ASC setting Yes Yes – routine reporting only - Setting not able to contain outbreak - Cases linked to a hospital outbreak Yes Yes Large employers - More than 6 Cases in setting Yes Yes Homeless setting - More than 6 cases in setting Yes Yes – routine reporting only - Setting not able to contain outbreak Yes Yes Council as workplace - Any outbreak Yes Yes Local businesses - More than 6 cases in setting Yes Yes – routine reporting only - Setting not able to contain outbreak Yes Yes
The five steps for introducing a local lockdown: ü Monitoring. PHE will work with the joint biosecurity sector by looking at data on the spread of coronavirus and people's behaviour across the country. They will look for emerging trends, rising cases and other indicators, while taking into account local factors. ü Engagement. If monitoring identifies local problems, NHS Test and Trace and PHE will work with the relevant local authority to develop a deeper understanding of the problem and identify solutions. They will work with local agencies to keep the local community informed at every stage, so they know what they need to do. ü Testing. Testing at a local level will then be scaled-up, combined with contract tracing through NHS Test and Trace to try to control the virus at that stage. ü Targeted restrictions. If the virus continues to spread, activities at particular locations will be restricted and individual premises will be closed. Hotspots will have access restricted, with people who have spent time there tested and contact tracing carried out for anyone who tests positive. ü Local lockdown. If the previous measures do not stop the spread, local lockdowns will be extended across whole communities, with businesses and schools shut down as people are urged to stay at home.
If collaboration and co-ordination efforts are insufficient, established pathways may be used to escalate decision making to higher levels National National level1 London London Coronavirus Response Centre London borough level Deep local infection UTLA control expertise C-19 Health Protection Health & wellbeing Lead public communications Board Chief Board Council Chief Exec. DPH Exec & Ultimately accountable for Public facing oversight DPH Sub-UTLA escalation Strategic Co- Liaison with Ministers as needed Rapid deploy resource ordination Group (Gold) Setting Individuals or bodies responsible for that setting (e.g., Head Teacher, restaurant owner, Care Home manager, faith leaders etc) 1. National level may include NHS Test and Trace service (including Contain/JBC), Chief Medical officer, Test and Trace Whitehall, Cabinet Office Briefing Office (COBR) etc.
National governance & responsibilities Group Attendees Frequency Remit ● Relevant Secretaries of As needed ● Cross government consideration of Examples of additional national Covid- Operations State situation and actions required in the support: Committee extreme cases where local lockdown is a consideration. • Increased access to testing Local Action ● Secretary of State for Weekly, at a ● Brief ministers on latest national Committee Health (Chair) minimum and local epidemiological picture resources & contact tracing data (GOLD) ● Ministers and Senior Civil ● Review and evaluate responses in • Additional communications and Servants This group can key areas and further action or ● Chief Medical Officer be convened escalation to other government engagement materials & ● PHE CX, Senior officials rapidly as departments or Covid-O translations from DHSC, NHS Test required and Trace, and PHE • Deep dive epidemiological Weekly ● Chief Medical Officer Weekly, at a ● Assess latest national and local reports Containment (Chair) minimum epidemiological picture ● Senior officials and PHE This group can ● Review and evaluate local outbreak • Access to surge resources via the Group (SILVER) colleague be convened responses and consider further JBC eg behavioural science & rapidly as action or escalation required project/incident management Daily ● NHS Test and Trace Daily ● Provide situational awareness on support & capacity planning Containment Executive (rotating) latest outbreaks and (Chair) This group can epidemiological picture • Facilitate liaison with OGDs as Group (BRONZE) ● Senior officials from be convened ● Review and evaluate local outbreak needed – e.g. Home Office/HSE range of govt depts rapidly as response and action extra support required ● Decide whether a situation needs etc further investigation and action ● Determine escalation
Covid-19 National monitoring Extensive approach using range of data to understand progression & inform • Cases - individual case categorisation of areas on Contain Watchlist with higher & rising levels: • Clusters - 2 or more • ‘Business as usual’ – where the majority of areas will be operating most of the time cases with no evidence of link • Area(s) of concern – eg areas with the highest prevalence, where the local area is taking targeted actions to reduce prevalence – for example additional testing in care homes and increased community engagement with high risk • Outbreaks - 2 or more groups cases with evidence of a link • Area(s) of enhanced support – eg areas at medium/high risk of intervention where there is a more detailed plan, agreed with the national team and with additional resources being provided to support the local team (eg • Community spread - epidemiological expertise, additional mobile testing capacity) sporadic or linked cases • Area(s) of intervention – where there is divergence from the measures in on a limited or extensive place in the rest of England because of the significance of the spread, with a basis detailed action plan in place, and local resources augmented with a national support
Local and ü Wherever possible, actions to address outbreaks of COVID-19 will be undertaken national powers in partnership with local communities, on the basis of informed engagement and consent ü UTLAs will have powers to close individual premises, public outdoor places and UTLAs & Ministers will have prevent specific events, without making representations to a magistrate in order to additional powers to deal close a premises with restrictions to help ü These powers will be used with the advice of the DPH, with the Secretary of State informed when they are used, and with the decision reviewed every 7 days. There stop the spread – if needed will be an appeal process – to be determined – to SoS and/or magistrates ü Premises which form part of essential infrastructure will not be in scope of these The Health Protection powers (Coronavirus, Restrictions) ü A non-exhaustive list of the types of categories of infrastructure will be set out in (England) (No.3) Regulations government guidance 2020 ü Ministers have similar powers to take action against specific premises, places and https://www.legislation.gov.uk/ events, as well as a power to direct UTLAs to act and to consider whether a local uksi/2020/750/contents/made authority direction is unnecessary and should be revoked (including in response to representations from those affected by it) ü In addition to the above powers, local authorities may also seek support from Read the document here ministers to use powers under the Coronavirus Act 2020 to close schools or limit schools to set year groups attendance
Prevent and manage outbreaks – NHS Test and Trace The London Coronavirus Response Centre working with the London boroughs provides an integrated Covid-19 Test and Trace service, designed to control the virus and enable people to live a safer and more normal life Test Rapid testing, at scale, to identify and treat those with the virus Test Trace Integrated tracing to identify, alert and support those who need to self isolate Enable Trace Contain Identify outbreaks using testing and other data and contain locally and minimize spread Contain Enable Use knowledge of the virus to inform decisions on social and economic restrictions Continuous data capture and information loop at each stage that flows through Joint Biosecurity Centre to recommend actions Underpinned by a huge public engagement exercise to build trust and participation Note: Test, Trace, Contain, Enable diagram is illustrative only
The table below summarises the role of the Council and LCRC in managing local outbreaks as part of the Test and Trace system:
Range of levers available to encourage compliance locally The Health and Wellbeing Board has a mandate to … and are well-placed to encourage provide public communications and provide local compliance accountability… Behavioral nudges • Social media • Tailored local marketing Health and Wellbeing • Local champions Board will: Resource Comms. • Provide public-facing Active communication Deployment delivery oversight of NHS Lead • Public Q&A forums Lead Test & Trace locally • Press calls • Provide timely communications to the public Political engagement • Act as liaison to Ministers • Possible option for Ministers to chair Public combined Local Outbreak Control Health Lead as needed Boards until legislation is approved
What is our approach to local containment? ● It is of utmost importance that we understand the geographic spread of the virus and take rapid steps in order to contain any potential outbreak and keep our communities safe. ● In order to do that, we need to know what is happening, and have robust principles for decision making, co- created and agreed by all stakeholders. ● These principles are set out in the Contain Framework (previously called the playbook/toolkit). ● We will then ensure that decision makers have the guidance they need via the Action Cards. Contain Framework Action Cards
Prevent and Manage Outbreaks in various settings 1 2 3 4 5 6 7 Setting Schools & Care Hospitals Places of Workplaces Community Early Years Settings Worship Clusters Action Card Read the Read the Read the Read the Read the Read the document document document document document document here here Here and here here here here Plans/Risk Read the Read the Read the Read the Read the Read the assessment document document document document document document tools here here here here here here
1 2 3 4 5 6 7 Surge Capacity Resource Plan From September onwards into the winter months we will be managing the usual winter pressures, other communicable diseases along with Covid-19. We have been advised that no modelling of demand has been done. Therefore, our services will have to flex to meet the peaks and dips in demand over the next 10 months. The Covid-19 Health Protection Board will need to consider where additional surge resourcing will be needed across the Council as part of the business continuity planning process. The Board will recommend to the Recovery & Legacy Group the use of the £1,566,647m Local Authority Covid-19 Test & Trace Service Support Grant Determination 2020/21. The purpose of the grant is to provide support to local authorities in England towards expenditure lawfully incurred or to be incurred in relation to the mitigation against and management of local outbreaks of Covid -19. The majority of the Grant will be held as a contingency and will be deployed based on need as it arises or is anticipated on a case by case basis. Actions • Mutual aid plans are developed by LCRC and London boroughs • Discussions between Tri-Borough Resilience Forum and at the London level are taking place to agree escalation points/mutual aid mechanisms • Director of Public Health and Consultants may be required for surge capacity for BHR wide local outbreak investigation and contact tracing • Escalation points for surge capacity/large outbreak plan to be developed and agreed including recovery process.
Supporting Vulnerable People
Supporting vulnerable residents 1 2 3 4 5 6 7 Supporting vulnerable residents through our front line services is core Council business. Our Community Solutions Service will be ensuring that a comprehensive system of support is and remains in place as we all respond to Covid-19 at the individual and at the community level. Working together with our partners, we want to ensure that no one becomes more vulnerable or is left without appropriate support as a result of the rollout of the national Test and Trace service. Where the contact tracing process identifies a complex case or one involving a high-risk location, the case will be referred to LCRC and the Director of Public Health and his team to deal with. These teams have worked in this way for many years and have tried and tested ways to deal with such complex cases. All referrals from the LCRC for the supporting vulnerable resident pathway will come to the Director of Public health as the Council’s single point of contact. The Public Health team will undertake their normal health protection practice which is: • Check the resident is not known to council services in respect of safeguarding. If known the case is directly referred to social care as per existing protocol • If the resident is not known to services, the Public Health team will refer the resident to the Adult Intake Team in Community Solutions. The intake team will assess the residents needs and put a support package in place for the duration of the isolation period Contact: email@example.com or phone 020 8227 2915 if you would like further advice or support.
Recap…support offer support offer Barking and Dagenham’s • Barking & Dagenham Citizens Alliance Network 1 (BD-CAN) – generalist support for vulnerable members of the community who lack support networks and need help with simple, practical tasks • The Specialist Support Hub – specialist support for 2 our vulnerable residents, including anyone who currently receives adult social care services or who has been identified as extremely vulnerable by the NHS • Community Solutions – integrated front door support 3 on issues ranging from homelessness, debt advice, benefits support, job support, food, early help • Central food hub – coordinated access to food supply managed across a network of distribution sites
Specialist support hub Main community partners are the ILA and DABD: Supports the following residents: 1 • Anyone who is shielding – who has received a letter from the NHS telling them they are extremely vulnerable • Anyone who receives adult social care, whether arranged • Food shopping (the resident pays for by the Council or arranged privately the food shopping but not the service) • Anyone living in specialist Council accommodation such 2 as sheltered housing, a hostel or a domestic violence • Medication refuge • Gas and electricity top up • Anyone who has recently come out of hospital and needs • Referrals on to other partners including support Reconnections • Anyone who is not known to social care, but who is 3 believed to be especially vulnerable due to additional needs
Supported access pathway for vulnerable residents 1 2 3 4 5 6 7 A supported access pathway is also under development to address some of the risks with applying the national model locally. This approach is based on Community Solutions, B&D Collective, NHS and other colleagues working together to support our most complex and vulnerable residents by using relationships of trust, wherever they may exist. We recognise that in order to support people best we need to take a person-centred approach which builds on existing relationships. This means that in developing a pathway for ‘supported access’ we recognise that the initial referral point could come from a variety of locations depending on who the resident feels most comfortable with for example: GP, pharmacist, faith leader, food bank, other B&D Collective organisation, social worker, local public services (like mental health, SEND etc), housing officer, Facebook, mutual aid provider etc. Residents who go through the supported access pathway is also intended to put in place the support the resident might need to enable them to participate in testing and possible 14 day self isolation (e.g. translation, food and supplies, financial support etc. The supported access pathway will evolve from our learning from the BD-Can programme and Community Solutions Specialist Support Hub.
Local Testing Capacity
Access to Testing 1 2 3 4 5 6 7 This section outlines arrangements for local testing to ensure rapid access for residents and settings. Whilst, in the majority of cases it is expected that testing will be done through the national testing process, localised capacity has also been created as we recognise that many of our residents will struggle to engage for a variety of reasons with the national testing system. Since May 28 2020 anyone (including the under fives) with symptoms can get a test via a the NHS portal https://www.nhs.uk/ask-for-a-coronavirus-test Most testing is via self-test swab kits either from home delivery, fixed or mobile drive thru or for whole home testing. There are a range of online portals for key workers, care homes, employers of key workers There is also a North East London local offer which offers individual home or drive through tests to essential workers and has also been focussed on care settings, using a self-test model by staff who then test residents. This model, using the capacity at the Barts Lab, is being flexed to support other local settings to target and proactively test in possible hotspot locations, like care homes unable to access the care home portal (non CQC registered, non-elderly population), hostels and temporary group housing for the homeless, and similar locally identified locations. In the event of an outbreak we will draw on this local testing capacity if necessary to expedite access to testing in the borough. Information on Local Test sites can be find here. Where appropriate the Director of Public Health may need to arrange for the rapid deployment of mobile testing units to assist in the management of a local outbreak. A response of this or a similar nature may require activity across a range of local partners, and the Covid-19 Health Protection Board will provide the means of coordinating that action.
Methods for testing 1 2 3 4 5 6 7 The primary method for testing is the national testing portal. Key workers (inc. teachers and Residents directed to Residents social workers) directed to testing testing via comms via comms Key workers Residents who have Key workers access priority symptoms access testing testing through dedicated Care settings online or by calling 119 website Book testing via following options Care settings directed to national testing portal for that setting Mobile testing Drive through Home test kits unit testing Care setting access testing for National testing should symptomatic and non-symptomatic residents via a national care home offer a 48-72 hr turnaround testing portal
Additional Testing Capacity 1 2 3 4 5 6 7 In the case of large outbreaks we may need to expedite testing. Access to these tests will be determined on a case by case basis, requiring a specific request from Director of Public Health LCRC LCRC identifies a situation MTU cell Intelligence data where enhanced investigation Notified by DPH London Borough is required. of Barking & Dagenham Standard MTU LA/LCRC identifies need for operating procedures local testing at scale are followed. Can LBBD DPH notifies MTU cell Yes. support scale of No. and confirms number of testing required? tests needed and day of testing (as early as next Read the document here day). Setting lead or LA notifies all people who need to be tested.
Data Integration and Joint Biosecurity Centre Arrangements
Data sharing and reporting In the context of Covid-19 this means: • Timely data flows from testing to be able to predict and intervene in outbreaks • Updated evidence on spread of infection and control measures; latest available data can be found here Daily data reports will be provided at regional level for London on numbers of cases and contacts successfully traced and numbers escalated to the LCRC. Weekly epidemiology and quality monitoring reports will provide further granularity on programme effectiveness. Scoping work with London stakeholders across the NHS, local government and Directors of Public Health have highlighted the need for borough level data to identify individual support needs, track local disease transmission and inform testing capacity. This will be provided by the Joint Biosecurity Centre. Additional epidemiological modelling will be provided by PHE London to further understand disease transmission at borough level. Alongside this the Director of Public Health will need to work closely with the Joint Biosecurity Centre, which has the role of bringing together data from testing and contact tracing, alongside other NHS and public data, to provide insight into local and national patterns of transmission and potential high-risk locations and to identify early potential outbreaks so action can be taken.
GDPR and Data Security We are required to adopt a proactive approach to sharing information by default, in line with the Instructions of the Secretary of State, the Statement of the Information Commissioner on Covid-19 and the Civil Contingencies Act. The Secretary of State has issued 4 notices under the Health Service Control of Patient Information Regulations 2002 requiring the following organisations to process information: NHS Digital, NHS England and Improvement, health organisations, arm’s length bodies, local authorities, GPs. These notices require that data is shared for purposes of coronavirus (Covid-19) and give health organisations and local authorities the security and confidence to share the data they need to respond to coronavirus (Covid-19). They can be found here https://www.gov.uk/government/publications/coronavirus-covid-19-notification-of-data-controllers-to-share- information. The data sharing permissions under the Civil Contingencies Act 2004 and the statement of the Information Commissioner all apply. Under the Civil Contingencies Act 2004 (CCA) and the Contingency Planning Regulations, Category 1 and 2 responders have a duty to share information with other Category 1 and 2 responders. This is required for those responders to fulfil their duties under the CCA. Public Health England Covid-19 Testing Data Sharing Contract in place. Start date: 26 June 2020. End date: On expiry of the Covid-19 – Notice under Regulation 3(4) of the Health Service Control of Patient Information Regulations 2002 (currently 30th September 2020)
Local data reporting 1 2 3 4 5 6 7 Current Council reporting mechanisms are outlined in the table below. LBBD produced Reports sent to DPH Data sets in public domain reports Confirmed covid Coronavirus in the Death registrations COVID-19 outbreaks Deaths involving Report Test and Trace and occurrences in care homes COVID-19 by cases (from UK by local authority Cases by care setting title report (LA level) deprivation (ONS) LCRC) (HM Gov) (ONS) (PHE) • All cause and • suspected or • List of care setting • Confirmed cases COVID-related confirmed outbreak • Cases by pillar in Test and Trace • Daily confirmed • COVID-related affected by Covid-19 Dataset/ deaths by date of COVID-19 in care with postcode, • Cases completed cases deaths by MSOA • Total confirmed and registered, date and homes report age at onset, • Total number of • Rate of cases (per place of death • By upper and lower • Age standardised suspected cases in ethnicity, gender contact reported 100,000) death rate by Barking and contents • Contacts • By upper and lower tier local authority, London boroughs Dagenham care and occupation • Cases by MSOA tier local authority, region and PHE completed region and country centre settings Frequency Daily Daily Daily Weekly (Tuesday) Weekly (Thursday) Infrequently Daily of reporting • Age-specific rate of cases 7-day moving Excess deaths in Further (per 10,000) average of cases 2020 compared to analyses • COVID-19 for Barking and the 5 year average cases by LSOA, Dagenham and done MSOA and London (2014-2018) Ward
List of reports to the Director of Public Health Subject Content Sender Sender email Frequency Contact Tracing Update Notification that the daily contact tracing update by UTLA, daily COVID-19 Contact Tracing Cell: data and WNCoV.firstname.lastname@example.org Daily yyyymmdd surveillance reports and exceedance reports have been uploaded to the surveillance PHE SharePoint site – reports no longer included in email Field Service, National Infection Service, Public Health England PHEC Daily COVID-19 Daily PHE regional report summarising data on laboratory-confirmed PHE London Incident ICC.London@phe.gov.uk Daily surveillance report COVID-19 cases and reported COVID-19 outbreaks/clusters Coordination Centre LCRC Daily Data London Coronavirus Response Cell Daily Data Summary (cases and PHE London Incident ICC.London@phe.gov.uk Daily Summary and LSAT situations) and LSAT Postcode Data (line listing with postcode, age) Coordination Centre data PHEC Weekly COVID-19 Weekly report summarising data on laboratory-confirmed COVID-19 PHE London Incident ICC.London@phe.gov.uk Weekly surveillance report cases; reported COVID-19 outbreaks/clusters; syndromic surveillance Coordination Centre indicators; and hospital and ICU/HDU admissions Care homes COVID-19 Information for each care home in borough on the following: DHSC Covid-19 Testing COVIDCareHomeTestingReferrals@dhsc.gov.uk Twice per week Order Report for Local • Registered places Programme Authorities (contains • Total no. of residents local data only not • Number / % of symptomatic residents London) • Total no. of staff • No. of tests requested • No. of tests delivered DHSC testing London • DHSC pillar 2 testing regional dashboard for London DHSC Covid 19 team Tom.email@example.com on behalf of Weekly dashboard John.Mitchell@dhsc.gov.uk NHS Digital pillar 2 • NHS Digital has produced Pillar 2 Testing Dashboards using current NHS Digital Pillar 2 Service Team firstname.lastname@example.org N/a - dashboard testing dashboard data to provide anonymous counts of Covid-19 tests completed and tests which are deemed void, aggregated by Upper Tier Local Authorities Daily Exceedance Report Regional daily exceedance report. An exceedance means that an area has PHE Contact Tracing Cell: data WNCoV.email@example.com Daily a greater than expected rate of infection compared with the usual and surveillance background rate for that location. Areas are RAG rated and in depth reports are produced for areas that have exceeded (RED reports). These are shared with the appropriate DsPH. 43
Pillar 1 testing (NHS/PHE labs) Pillar 2 testing (commercial partners) Results care home initial cases referred All postive results reported into the SGSS (second generation surveillance system) for testing Care home direct contact Results reviewed by LCRC Results flow into CTAS Daily review by Field Services (PHE) London Coronavirus response cell School direct contact (part of Health protection, PHE) Complex case identifed at Tier 2 e.g. care homes, vulnerable people Assimilation referred to Tier 3, LCRC* All outbreaks and received cases Data from HP zone extractred by FS input into Hpzone Information from SGSS and HPzone combined Data flows LCRC reports includes results from Pillar 1 and Pillar 2 FS reports includes results from Pillar 1 ONLY (at the moment) for Covid-19 cases and Reports to DPH in local authorities, some to wider stakeholders situations From LCRC From FS Daily summary - Number of new and cumulative cases (pillar 1 Exceedance reports Daily new cases reported with statistical assessment of and 2, from SGSS) impact on trend, localities where number of new cases exceed expected trend are highlighted - List of new situations e.g. care homes created by LCRC (from HP-Zone, gives name of REPORTING establishment, daily list) - Complex cases and situations notified from PHE Daily - Number of new and cumulative cases (pillar 1 only, from Tier 2 contact tracing Surveillance reports SGSS) - Cumulative number of situations by type - Graph of age and sex distribution of total cases (pillar 1 (from HP-Zone) only, from SGSS) - Cumulative number of confirmed and - Number of new outbreaks of suspected or confirmed suspected deaths of care home residents (from COVID-19 in care homes for prior week and cumulative HP-Zone) total (from HP-Zone) Daily Individual data Line listing to all boroughs of new cases with postcode and age Weekly reports: Weekly summaries of the above data Weekly reports Summary of surveillance systems reports * care home residents, schools and connected workplaces are mandatory fields for data entry. Care homes, schools and other situations are escalated as per protocol Postcode and workplace "coincidences" are picked up by CTAS and HP zone and reviewed Regular surveillance reports reviewed by PHE LCRC/ FS
Information received Query from settings or Information from Local All positive results reported into the SGSS (second member of the public Authority, Other generation surveillance system). Results flow into CTAS. Notifications from GP or other re. school, workplace, PHEregions, Devolved Complex case or setting identified at Tier 2 and referred healthcare settings prison, hostel, care Adm, International to Tier 1 home office London Coronavirus Response Cell (Tier 1) receive notification/information/query from setting, LA or GP or referral from Tier 2 Risk assessment SINGLE CASE IN A SETTING Information on case, outbreak or community cluster uploaded to HPZone (PHE case Clinical team provide advice and manage contacts, management system) Data flows for testing and infection control Clinical team provide information materials to the Outbreak setting Clinical team recommend ongoing control measures Clinical team gather information and conduct risk assessment with the case or setting Management DPH notified OUTBREAK (2 OR MORE CASES) IN A SETTING OR A CASE IN A COMPLEX SETTING Hospital Prison and hostel/homeless school/educationa workplaces care homes and community faith and other prescribed places services l settings other care settings clusters settings Hospital lead outbreak of detention response; LCRC provide Outbreak management advice and support Arrange IMT with Arrange incident management meeting when required with setting and relevant stakeholders setting and including Local Authority (DPH, EHOs, adult social care, children and young persons services) relevant stakeholders including Healthcare, MoJ or Home Office. Coordination and lead for outbreak agreed RESPONSE - case finding, contact tracing, isolation, testing (if appropriate by PHE/NHS pillar 1, 2, MTU or Find and Treat), decontamination, advice and communication
Communication and Engagement
Communications & engagement – key to outbreak planning Engage our communities to ensure reasoning behind decisions widely known encouraging compliance Objective: in accordance with the goals of containment Campaign Launch • National Test & Trace campaign launch • TV, Radio, Social Media, TV, Print • Public access to timely local data about infection rates to ensure public are informed Info Availability • Strengthen online and telephone information about reporting outbreaks via PHE • More consistent local council COVID helplines Community Engagement • Strong local community engagement: equivalent of national campaign in all 152 upper tier councils • Proactive and reactive Local authority • Maximise individual and community ownership and local "peer pressure" to self isolate Strategy • Make comms appropriate for all communities, esp. vulnerable, diverse, hard to reach • Build on national campaign with a tailored local campaign (e.g. use local partners, local languages) • Transparent, open, frequent local briefings
Communications Plan for a local outbreak Aim: Responsibility: • To develop a common approach across B&D’s partners to All partners are responsible for fulfilling their duty to “warn and communications regarding outbreaks in the borough and inform” under the Civil Contingencies Act 2004. This plan will support the development of a coordinated approach to guide the work of all partners. proactive and reactive communications across the borough This group will be responsible for: Objectives: a common approach across B&D’s • All staff, members, partners, the media and the public are • Coordinating all reactive media handling across the informed of developments regarding local outbreaks in a partnership to enquiries from the media about local timely, accurate way using established channels outbreaks • All partners work together to communicate with their • Developing a coordinated approach to communications – stakeholders and the public using their established getting consistent information to all stakeholders in a timely channels to reinforce behaviours required to control manner Covid-19 and prevent local lockdowns • Identifying opportunities to amplify messaging about keeping • Reassure the public that B&D partners are working the borough safe and making information readily available to together to control Covid-19 those who need it. • Build confidence across the partnership that we have timely and accurate information about developments regarding Covid-19 and are able to play their part in managing a local outbreak or local lockdown..
1 2 3 4 5 6 7 Communications strategy to target three distinct themes These support all 7 areas of the local outbreak control plan. 1. Build on prevention messages (link with town centres campaign on reopening local businesses). 2. Raise awareness of test and trace (pan-London campaign in development to be adapted to meet local objectives). 3. Support LOCPs – Reactive communications actions rooted in area action plans. Objectives include: • Fulfil our legal duties of warning and informing (as set out in the Civil Contingencies Act 2004) and any other legislation introduced • Ensure we provide a single point of truth in terms of communications for key partner organisations locally and that all groups remain on message • Identify risks and vulnerabilities that could impact on our communications work • Scope opportunities to address misinformation • Ensure communications and actions around contact tracing are linked in with wider work being done by the Council on the digital divide.
1 2 3 4 5 6 7 Build on prevention messages Current activity Next steps • Town centre and Heathway campaign: Working with Consider wider dissemination of prevention messages via businesses to safely reopen. Social distancing / print and digital channels. prevention is being heavily promoted • External comms: Prevention messages continue to be shared via social media and digital channels such as One Borough newsletter • Internal comms: The internal team continue to provide messaging around staying safe in and outside of the workplace on Yammer, and via staff news letters
1 2 3 4 5 6 7 Raise awareness of test and trace Current activity Next steps • Limited information on testing on /covid19 hub. • To address trust issues and encourage compliance we Weekly promotion of mobile testing unit. will need to ensure the pan-London campaign is adapted to reach Barking and Dagenham specific • Pan-London comms group has completed audiences. Activity should be highly targeted using local research on test and trace attitudes in London. advocates and partner channels to reach our Only 44% of people would know how to get a test audiences. (less amongst over 65s and BAME groups) 35% know little or nothing about test and trace (higher • Develop a stakeholder map that breaks down audience amongst younger and BAME groups). specific channels and advocates. • Pan-London campaign (Keep London safe) is • Adapt the core script for Barking & Dagenham and being developed with a communications toolkit for update key channels / share with partners. use. Core script for frontline services should be ready w/c 22 June along with a 40 second video • Create area specific videos with partners. script. • Visuals will also be focus grouped ready to be issued by end of month.
1 2 3 4 5 6 7 Supporting area outbreak plan- Next steps Using the insight and stakeholder mapping from the London test and trace campaign we will identify communications actions that need to support the area action plans. As part of the wider toolkit content will be packaged and ready to go in the event of an outbreak. Keep London Safe campaign is in development
Local Planning Guides • https://www.lbbd.gov.uk/sites/default/files/attachments/1-Local-comms-planning-guide-29- June.pdf • https://www.lbbd.gov.uk/sites/default/files/attachments/2-LA-comms-matrix-planning-tool- 29-June.xlsx • https://www.lbbd.gov.uk/sites/default/files/attachments/3-Local-Outbreak-Plans-press- handling-guide-29-June.docx • https://www.lbbd.gov.uk/sites/default/files/attachments/Letter-to-LAs-on-data-access_9- July-2020.pdf.
Risks and threats 1 2 3 4 5 6 7 The Council is responsible for addressing issues of low-take up and engagement with hard-to-reach groups and communities. Our challenge is that the assumption that most of the contact and engagement with the testing and tracing regime will be managed through the app, website and phone and direct engagement with the public. There are potentially several barriers to users successfully engaging with the proposed national model, which will be particularly relevant to Barking and Dagenham: • Gaining local communities’ trust with regards to national contact tracing initiative • Digitally excluded groups being missed • Residents without access to an email account being disadvantaged • Residents facing financial hardship as a result of Covid-19, who would usually have access to a smartphone, but no internet connection (due to insufficient funds) • Demand for tests exceeds the number of tests available • Tracing programme is unable to meet demand • Exacerbating existing inequalities through the (method of) delivery of messages • Access issues beyond our control are reflected negatively on the Council • Those concerned about surveillance/ data protection may not engage with the contact tracing programme • Covid-19-related fraud and scams undermining trust in the national programme and individual representatives
Risk matrix (to be populated further) HIGH • Outbreaks in care settings, shared living, HMOs, special schools, school transport HIGH RISK • Places of worship such as churches, mosques LIKELIHOOD • Lack of engagement with NHS Test and Trace and inability to contain local spread MEDIUM RISK • Outbreaks in people with substance misuse, hostels, DV Refuge and refugee • Data sharing and publishing data to engage communities • Outbreaks in workplaces such as Town Hall, Roycraft or Frizlands STANDARD RISK LOW
You can also read