Surrey COVID-19 Local Outbreak Management Plan - 10 December 2021
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Surrey COVID-19 Local Outbreak Management Plan 10 December 2021
Surrey COVID-19 Local Outbreak Management Plan (v15.0)
Contents
Foreword ................................................................................................................................................................................................... 4
Section A – Context................................................................................................................................................................................... 5
1.0 Introduction................................................................................................................................................................................... 5
2.0 National Context ........................................................................................................................................................................... 5
3.0 Legal Context ............................................................................................................................................................................... 6
4.0 Local Context ............................................................................................................................................................................... 7
5.0 Trigger of the Plan ...................................................................................................................................................................... 11
Section B – Tackling COVID-19 as a System ......................................................................................................................................... 13
6.0 Governance, Assurance and Oversight ...................................................................................................................................... 13
Section C – Managing COVID-19 - Surveillance ..................................................................................................................................... 17
7.0 Surveillance ................................................................................................................................................................................ 17
Section D – Managing COVID-19 - Preventing and Reducing Transmission .......................................................................................... 20
8.0 Testing........................................................................................................................................................................................ 20
9.0 Contact Tracing .......................................................................................................................................................................... 22
10.0 Vaccinations ............................................................................................................................................................................ 23
11.0 Variants of Concern ................................................................................................................................................................ 25
12.0 Being COVID-19 Secure – Care Homes (Adult)...................................................................................................................... 26
13.0 Being COVID-19 Secure – Care Homes (Children) ................................................................................................................ 27
14.0 Being COVID-19 Secure – Education Settings ....................................................................................................................... 29
15.0 Being COVID-19 Secure – Prisons and Other Prescribed Places of Detention ...................................................................... 31
16.0 Being COVID-19 Secure – Workplaces including Tourist Attractions and Faith Settings ........................................................ 32
17.0 Being COVID-19 Secure – Healthcare Settings ...................................................................................................................... 34
18.0 Being COVID-19 Secure – Major Transport Hubs, Managed Quarantine Service and Asylum Seeker / Refugee / Other
Foreign Nationals Accommodation ...................................................................................................................................................... 36
19.0 Tackling Inequalities – Self-Isolation Support.......................................................................................................................... 38
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Surrey COVID-19 Local Outbreak Management Plan (v15.0)
20.0 Tackling Inequalities – Homeless Communities ...................................................................................................................... 39
21.0 Tackling Inequalities – Asylum Seekers and Refugees ........................................................................................................... 40
22.0 Tackling Inequalities – Ethnic Minority Communities .............................................................................................................. 41
23.0 Tackling Inequalities – Gypsy, Roma and Traveller (GRT) Communities ............................................................................... 42
24.0 Tackling Inequalities - Action to Reduce Transmission ........................................................................................................... 43
Section E – Managing COVID-19 - Enduring Transmission .................................................................................................................... 46
25.0 Enhanced Response Areas..................................................................................................................................................... 46
Section F – Communication and Engagement ........................................................................................................................................ 47
26.0 Public Health Messages .......................................................................................................................................................... 47
27.0 Community Engagement ......................................................................................................................................................... 48
Section G – Appendices .......................................................................................................................................................................... 50
28.0 Version Control ....................................................................................................................................................................... 50
29.0 Glossary of Terms ................................................................................................................................................................... 51
30.0 List of Figures.......................................................................................................................................................................... 52
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Surrey COVID-19 Local Outbreak Management Plan (v15.0)
Foreword • Preventing and reducing transmission of COVID-19
through testing, contact tracing, vaccinations, dealing with
Throughout this pandemic the government’s primary objectives variants, being COVID secure in specific settings, and
have been to control the COVID-19 rate of reproduction (R), tackling inequalities
reduce the spread of infection and save lives. Since March 2020 • Managing enduring transmission within our local
there have been three national lockdowns, the spread of new communities
and more transmissible variants, changes to restrictions on our • Communications and engagement with the public, our
daily lives, widely available testing regimes, and a very communities, partners, and national bodies
successful ongoing vaccination programme.
Government guidance is updated regularly and therefore this
With the improvements in our understanding of COVID-19 and plan is under constant review.
how to manage the pandemic both nationally and locally, our
Surrey Local Outbreak Management Plan has been updated.
While the plan sets out the ways in which we continue to tackle
and manage COVID-19 as a multiagency organisational system,
it will take everyone’s efforts to bring COVID-19 under control.
Each of us is responsible for our personal decisions around safe
behaviours such as wearing face coverings, washing hands,
meeting others safely, staying at home if we feel unwell, getting
fully vaccinated and taking a test before socialising or mixing in
crowded or enclosed spaces. Businesses and institutions are
supported with national guidance on how to work safely,
including providing sufficient ventilation to disperse the virus. The
voluntary and faith sectors provide practical and wellbeing
support to their local communities. Public sector bodies work
together to support their communities with for example, services
providing self-isolation support, vaccinations, testing, contact
tracing, advice to businesses, and support for vulnerable
communities.
The plan includes:
• The national, legal and local context which we operate
within
• The governance structures where decisions are made
• The surveillance system that provides COVID-19 data to
help inform service needs and support local decision
makers
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Surrey COVID-19 Local Outbreak Management Plan (v15.0)
Section A – Context • Pursuing an international approach: helping to vaccinate
the world and managing risks at the border
1.0 Introduction Plan A identifies seven safer behaviours and actions as shown in
We are updating the Surrey Local Outbreak Management Plan Figure 1, that are key to people protecting themselves and
(LOMP) to reflect the changing face of the pandemic in England. others:
Since our plans were first written there have been improvements
in our understanding of the impact of COVID-19 and in how we Figure 1 – Safer Behaviours and Actions
need to manage the pandemic both nationally and locally, with
improved treatments, widespread availability of testing, the
availability of vaccines effective against the current dominant
strains of COVID-19 in the UK. There have also been some less
welcome changes including the emergence of COVID-19
variants that may be more transmissible, cause more serious
disease and potentially be more able to evade current vaccines.
Our plan needs to develop to respond to the changing nature of
the pandemic and new developments in drugs, vaccines, tests or
technology.
2.0 National Context
On 14 September 2021 the Government published the COVID-
19 Response: Autumn and Winter Plan 2021. This includes:
• Plan A - a comprehensive approach to managing COVID-
19 throughout autumn and winter 2021-22
• Plan B - a contingency plan that will only be enacted if the
One of the safe behaviours is to download the NHS COVID-19
data suggests further measures are necessary to protect
App which has a number of tools including symptom checking,
the NHS
getting tested, contact tracing, information on local area
Plan A includes: restrictions and venue check-in. It’s the fastest way to see if
• Building defences: vaccines (prevention), antivirals and you’re at risk from COVID-19, to help make informed decisions.
disease modifying therapeutics (mitigation)
Plan B focuses on reducing transmission and minimising
• Limiting transmission: Test, Trace and Isolate economic and social impact by:
• Supporting the NHS and social care: managing pressures • Communicating increased risk clearly and urgently to the
(Flu vaccination) and recovering services public and with it the need to behave more cautiously
• Advising people on how to protect themselves and others: • Mandatory vaccine-only COVID-status certification in
clear guidance and communications (supporting positive certain settings
behaviours)
• Legally mandating face coverings in certain settings
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Surrey COVID-19 Local Outbreak Management Plan (v15.0)
On 7 October 2021, the COVID-19 Contain Framework: a guide or prevent specific events, in response to a serious and imminent
for local decision makers was updated, setting out how national, threat to public health to prevent the spread of COVID-19.
regional and local partners should continue to work with each
other, the public, businesses, and other partners in their Working with partners across the county a comprehensive Local
communities to prevent, manage and contain outbreaks of Legal Powers Process Guide which sets out the information that
COVID-19. should be considered and the steps that must be taken before a
Direction can be served on any individual or business has been
3.0 Legal Context developed and is regularly reviewed. This guide includes a local
The legal context for managing outbreaks of communicable COVID-19 Checklist for Events which is used by Safety Advisory
disease which present a risk to the health of the public requiring Groups, Licensing teams and Environmental Health teams to
urgent investigation and management sits with: assess event risk assessments against. This checklist is also
• UK Health Security Agency (UKHSA) under the Health available to event organisers to help them complete the risk
and Social Care Act 2012 assessment to control the transmission of COVID-19, including
• Directors of Public Health (DPH) under the Health and the use of the NHS COVID Pass where appropriate. There is
Social Care Act 2012 also a COVID-19 risk assessment template to support small
• Chief Environmental Health Officers (EHO) under the event organisers.
Public Health (Control of Disease) Act 1984 and suite of
3.2 Health Protection (Coronavirus Restrictions) (Self-
Health Protection Regulations 2010 as amended
Isolation) (England) Regulations 2020
• NHS Clinical Commissioning Groups (CCG) to collaborate
These regulations set the legal requirement to self-isolate for all
with DPH and UKHSA to take local action (e.g. testing and
persons receiving a positive test result. Close contacts who are
treating) to assist the management of outbreaks under the
not fully vaccinated, or not under the age of 18 years and 6
Health and Social Care Act 2012
months, or not in an approved COVID-19 vaccine trail, or not
• Other responders’ specific responsibilities to respond to exempt for medical reasons, must also self-isolate.
major incidents as part of the Civil Contingencies Act 2004
3.3 Health Protection (Coronavirus, International Travel
The Coronavirus Act 2020 was enacted in March 2020 and it and Operator Liability) (England) Regulations 2021
remains the primary legislation underpinning the various duties, These Regulations impose requirements on some travellers to
powers and restrictions that have been in place since that time. England to take coronavirus tests before and after arrival, and to
Since 19 July 2021 most legal restrictions have been lifted and self-isolate where required. They also require operators to
the general public is expected to exercise personal judgement to ensure passengers receive information and comply with the
help control the spread of infection. The following Regulations requirements.
currently remain:
3.4 The powers contained in the suite of Health Protection
3.1 Health Protection (Coronavirus Restrictions) Regulations 2010 as amended, sit with district and borough
(England) (No:3) Regulations 2020: council environmental health teams, and are a last resort
A County Council may issue a Direction to close individual mechanism.
premises (except essential infrastructure), public outdoor spaces,
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Surrey COVID-19 Local Outbreak Management Plan (v15.0)
3.5 Data sharing Figure 2 - Map of Surrey County, Districts and Boroughs
There is a proactive approach to sharing information between
local responders by default, in line with the instructions from the
Secretary of State, the statement of the Information
Commissioner on COVID-19 and the Civil Contingencies Act
2004. Data-sharing to support the COVID-19 response is
governed by 3 different regulations:
• Four notices issued by the Secretary of State for Health
and Social Care under the Health Service Control of
Patient Information Regulations 2002, requiring several
organisations to share data for purposes of the
emergency response to COVID-19
• The data sharing permissions under the Civil
Contingencies Act 2004 and the Contingency Planning
Regulations 2005
• The Statement of the Information Commissioner on
COVID-19 Surrey residents generally have very good health, and the
average healthy life expectancy is one of the longest in the
4.0 Local Context Country. Surrey residents also do well on aspects of social life
which we know contribute to health and wellbeing, such as
4.1 Overview of Surrey County and the health needs of its employment and education.
residents
Over 1.1 million people live in Surrey, which is one of the most There are health inequalities within Surrey which are a risk for
densely populated shire counties in England. Surrey has a poor outcomes. In some areas, people have poorer life chances,
complex geography with a mixture of rural, semi-rural and urban poorer health outcomes and greater health care use. Existing
areas and is comprised of 11 borough and district councils as health inequalities have been further highlighted and, in some
shown on the map at Figure 2. cases, increased due to the impacts of COVID-19.
During the course of the pandemic, it has become clear that
there are significant risk factors that have led to the
disproportionate impact of COVID-19 for some people and
communities. The key risks include age, gender, deprivation,
occupation, and certain health conditions.
At the start of the COVID-19 pandemic, an assessment was
carried out to estimate the number of people in vulnerable
population groups in Surrey who were at risk of being
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Surrey COVID-19 Local Outbreak Management Plan (v15.0)
disproportionately impacted by the pandemic. The estimated Figure 4 – Mid-Year 2019 Population Estimates in Surrey (ONS)
numbers of people are shown in Figure 3.
Figure 3 – COVID-19 Vulnerability indicator examples in Surrey
4.1.1 Ageing population Surrey has the third highest number of care home beds,
The Office of National Statistics (ONS) population projections registered with the Care Quality Commission (CQC) in the
estimate that between 2016 to 2041 the population aged 65 country with 13,626 beds, after Kent (14,579) and Hampshire
years and older in Surrey will increase by more than 50% and will (13,876). Most of these care home beds are in Reigate and
make up a quarter of the population by 2041. Surrey has the Banstead, followed by Waverley and Elmbridge. Care home
fourth highest number of people aged 80 years and over residents were one of the populations who were significantly
(67,388), out of the 149 upper tier local authorities in disproportionately impacted by COVID-19 in the first wave.
England. Figure 4 shows most of the population is aged 35
years and over and there are more females than males in the 4.1.2 Socio-economic environment
older age groups in Surrey, particularly in the population aged 85 Surrey is one of the least deprived counties in the country. The
and over. backdrop of a generally affluent county is in vivid contrast to the
areas of poverty, poorer health and avoidable premature deaths
that are scattered across Surrey. The areas with the most
deprived communities are in Spelthorne, Woking, Guildford, and
Reigate and Banstead. The map below in Figure 5 shows most
of the county in yellow (least deprived) with the most deprived
areas in Guildford, Reigate and Banstead and Woking (dark
blue). Reducing the health inequalities experienced within Surrey
is a part of our wider health and wellbeing strategy.
Page 8Surrey COVID-19 Local Outbreak Management Plan (v15.0)
Figure 5 – Map of Indices of Multiple Deprivation Deciles in 10 and 50% higher risk of death when compared to people of
Surrey (Index of Multiple Deprivation IMD, 2019) White British ethnicity.
Across the county in different areas there are very different
communities. Spelthorne has the highest proportion of people
from Indian ethnicities (4.2%), Woking has the highest proportion
of people from Pakistani ethnicities (5.7%), Spelthorne and
Reigate and Banstead have the highest proportion of people
from Black ethnicities (1.6%) and Elmbridge has the highest
proportion of people from other White ethnicities (10.4%) – as
shown in Figure 6.
Further information on the population of Surrey can be in the
Surrey County Council Joint Strategic Needs Assessment data
visualisation tool.
Figure 6 – Map showing areas in Surrey where higher
proportions of people from ethnic minority populations live in
Surrey (Census 2011)
4.1.3 Ethnic Minority populations
Surrey is less diverse than England as a whole, with 83.5% of
the population reporting their ethnic group as “White British” in
the last census compared with 79.8% in England. The proportion
of the population from ethnic minority populations varies in each
local authority. Woking is the most diverse local authority in
Surrey, with more than a quarter of its population from ethnic
minority populations, while Waverley is the least diverse with
over 90% of people from White British ethnicities.
The Public Health England (PHE) analysis of national evidence
showed that after accounting for the effect of sex, age,
deprivation and region, people of Bangladeshi ethnicity had
around twice the risk of death when compared to people of White
British ethnicity. People of Chinese, Indian, Pakistani, Other 4.1.4 Occupation and Unemployment
Asian, Black Caribbean and Other Black ethnicity had between Figure 7 shows the percentage of the Surrey working age
population who are out of work and receiving workless
Page 9Surrey COVID-19 Local Outbreak Management Plan (v15.0)
benefits (Jobseekers Allowance / Universal Credit and Incapacity 4.2.2 COVID-19 Deaths (registered up to 29 October 2021)
Benefit / Employment and Support Allowance), between October There has been a total of 3,039 deaths in Surrey residents where
2004 and October 2020. COVID-19 is mentioned as a cause on the death certificate,
reported on the GOV.UK Coronavirus (COVID-19) in the UK
In 2020 across Surrey there was an increase in unemployment Deaths Dashboard. Of these deaths 1,606 have been reported in
from around 1% in February 2020 to around 4% by October 2021 and:
2020, which was similar to South East (2% to 5.5%) for the same • 1,035 (64%) occurred in hospital in 2021
period. This highlights the initial impact of the pandemic on local • 436 (27%) occurred in care homes in Surrey in 2021
communities. • 135 (8%) occurred in other community settings (including
hospices) in 2021
Figure 7 – Percentage of working age population (16-
These figures include people since the beginning of the
64) receiving workless benefits in Surrey and South East
pandemic whose death certificate mentioned COVID-19 as one
between Oct 2004 and October 2020
of the causes of death (where a person had a laboratory
confirmed positive result, or clinical suspicion of unconfirmed
COVID-19).
4.3 Disproportionate impact of COVID-19
The pandemic has shone a light on entrenched health
inequalities and provided a necessary wake-up call. The situation
found nationally is no different in Surrey. The learning from this
has enhanced our plans for recovery and controlling future
outbreaks.
To support our residents and identify who is likely to be at
increased risk, the key criteria that lead to poorer outcomes have
been mapped at a small area level (Figure 8). This risk
4.2 The impact of COVID-19 in Surrey stratification includes:
The data below provides a snapshot of the impact of COVID-19 • Levels of Deprivation (IMD 2019 within Surrey)
in Surrey up to November 2021, with particular reference to the 2 • Where BAME communities live (Census 2011)
broad indicators of infection rates and deaths • Historical and current vaccination rates
• Long-term condition prevalence (the people who were
4.2.1 COVID-19 Cases (as of 5 November 2021) shielded)
A total of 144,840 laboratory confirmed cases of COVID-19 have • Proportion of population aged under 20
been reported to date in Surrey on GOV.UK Coronavirus • Proportion of population aged over 60
(COVID-19) in the UK Cases Dashboard. This is a rate of • Proportion of contact-traced contacts refusing to
12,071.3 cases per 100,000 population, which ranks Surrey 159 cooperate (covering June to August 2021)
out of 214 Upper Tier Local Authorities (UTLAs) in the UK, in
terms of rates of COVID-19 to date.
Page 10Surrey COVID-19 Local Outbreak Management Plan (v15.0)
Figure 8 - Areas within Surrey that are at risk from a 5.1 Aims of the Local Outbreak Management Plan
disproportionate impact of COVID-19 COVID-19 has had a profound impact on people’s lives in Surrey
and across the world. Three waves of COVID-19 have
precipitated three national lockdowns since March 2020 and over
143,000 people have lost their lives. But now we have effective
vaccines, and the future is looking brighter.
Our plan therefore aims to:
• Effectively prevent and manage outbreaks of COVID-19 to
mitigate the impact of the virus on Surrey’s residents
• Support a safe return to a normal way of life for residents,
businesses and visitors to the borough as we 'live with
COVID'
Our plan describes the ways in which we will seek to work with
our partners to prevent outbreaks of COVID-19 across Surrey
Lower Super Output Areas (LSOAs) at highest risk of being and to respond swiftly and effectively to any outbreaks that do
disproportionately impacted by COVID-19 were identified in each occur, including in the event of the emergence of Variants of
Surrey district and borough. LSOAs have an average population Concern.
of 1500 people or 650 households. There is a concentration of
priority areas in boroughs and districts in the north of the county, Our work to inform, engage and communicate with residents is a
specifically, Woking, Runnymede, Spelthorne and Elmbridge. critical success factor in the implementation of our plan. We are
clear that our testing and tracing services must be accessible for
This stratification has identified key areas to target support to everyone to use including people facing deprivation and
reduce inequalities for both the testing and vaccination teams. exclusion. Support for residents continues to be a priority.
5.0 Trigger of the Plan
The Surrey LOMP will be triggered when there are suspected or
confirmed COVID-19 outbreaks in any setting type, increased
community transmission, or a single Variant of Concern (VOC) or
Variant Under Investigation (VUI) case (when locally advised by
UKSHA). In the event of an identified outbreak, there are
established frameworks and processes for working across UKHSA
South East, local authority public health teams, integrated care
systems (ICS), and other relevant organisations.
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5.2 Objectives of the Local Outbreak Management Plan
The objectives are to:
• Prevent outbreaks of COVID-19 in our communities and
complex settings (schools, care homes, custodial
settings, communal settings, healthcare settings and
public spaces)
• Respond rapidly and effectively to emerging outbreaks of
COVID-19 as evidenced by data and health intelligence
• Manage and control established outbreaks of COVID-19,
particularly those in complex settings
• Rapidly reflect on and adapt to lessons learnt during the
management of outbreaks
• Have a robust oversight and assurance process for the
prevention and management of outbreaks of COVID-19
• Ensure the highest possible uptake of the vaccination offer
by our residents and tackle hesitancy
Page 12Surrey COVID-19 Local Outbreak Management Plan (v15.0)
Section B – Tackling COVID-19 as a Figure 9 – COVID-19 multiagency response structures overview
System
6.0 Governance, Assurance and Oversight
6.1 Surrey’s health and care landscape
The health and social care landscape in Surrey are complex and
evolving. This includes:
• A Voluntary, Community and Faith sector
• 2 Integrated Care Systems (ICS)
• 5 Place-Based Partnerships
• 127 GP practices organised into 24 Primary Care
Networks (PCNs)
• 209 community pharmacies providing NHS services
• 11 District and Borough Councils
• 5 acute hospital trusts Figure 10 shows Surrey’s Emergency Preparedness, Resilience
• 3 providers of NHS Community services and Response (EPRR) planning structure and provides an
• 1 mental health trust overview of the relationship between Surrey Heartlands ICS
• 424 CQC registered care homes Resilience and EPRR Board and the local system partnerships,
including Surrey’s Health and Wellbeing Board, the Local Health
6.2 System governance Resilience Partnership (LHRP) and the LRF.
Figure 9 provides an overview of the COVID-19 multiagency
response structures at national, regional and local level across
Surrey. This is a complex structure involving the health system
(Department of Health and Social Care (DHSC), NHS England
(NHSE), Frimley ICS and Surrey Heartlands ICS), UKHSA,
and Department for Levelling Up, Housing and Communities
(DLUHC) including Surrey Local Resilience Forum (LRF).
Multiple communication routes between all partners follow
established processes and the structure is under constant
review as the demands on the COVID-19 response changes over
time.
Page 13Surrey COVID-19 Local Outbreak Management Plan (v15.0)
Figure 10 – Local EPRR planning structure 6.5 Surrey Heartlands Integrated Care System (ICS)
Resilience and EPRR Board
In September 2021 the Surrey Heartlands ICS Resilience and
EPRR Board replaced the COVID-19 Management Group. The
primary role of this Board is to provide assurance and oversight
of the ICS resilience and continuing pandemic response. This
includes the strategic management and oversight of the Surrey
LOMP which covers the programmes for vaccination, testing,
contact tracing, PPE, Infection Prevention and Control (IPC),
Long COVID, Data Cell, Managed Quarantine Service (MQS),
and temporary Immigration Removal Centres (IRC).
6.6 Contact tracing governance
Reporting to the Surrey Heartlands ICS Resilience and EPRR
Board, is the Contact Tracing Delivery Group (Figure 11). This
group enables a co-ordinated and partnership led response to
local COVID-19 contact tracing across all areas of Surrey. It is
6.3 Surrey Local Outbreak Engagement Board
responsible for the development and operational delivery of local
The Surrey Local Outbreak Engagement Board (LOEB) is a
contact tracing following national direction and guidance. The
member-led public facing oversight board, chaired by the Cabinet
group also provides updates to the LOEB, and links with DHSC
Member for Adults from Surrey County Council. The LOEB is a
South East regional, Surrey County Council (SCC) Public Health,
sub-committee of the Surrey Health and Wellbeing Board. The
and contact tracing operational meetings.
primary roles of the LOEB are to have oversight of the Surrey
LOMP, outbreak response, resource allocation, and to provide Figure 11 – Contact tracing governance in Surrey
direction and leadership for community engagement, and
approve public facing communications
6.4 Surrey Local Resilience Forum
The Surrey Local Resilience Forum (LRF) has now stood down
from a Major Incident due to the COVID-19 outbreak. The
partners of the LRF continue to work collaboratively in the Surrey
COVID-19 Recovery Co-ordinating Group, to provide support to
the partners of the forum in supporting the needs of Surrey
residents, covering humanitarian, economic, infrastructure and
environmental aspects. The on-going demands of the COVID-
19 outbreak continue to be monitored.
Page 14Surrey COVID-19 Local Outbreak Management Plan (v15.0)
6.7 Testing governance Engagement leads, and has three task delivery groups to ensure
The Testing Operational Group also reports to the Surrey that Convenience, Confidence and Complacency are understood
Heartlands ICS Resilience and EPRR Board (Figure 12). This and addressed in under-represented groups.
group enables the operational delivery of the testing programmes The three task groups are:
in Surrey, using a common model as far as is appropriate with
• Equality Impact Assessment System Reference group –
clear messaging, robust management of personal data,
provides input on the Equality Impact Assessment (EIA)
prioritisation mechanisms where needed, while applying national
process
best practice guidance. The group also provides updates to the
• Outreach Operational Delivery Model sub-group –
LOEB and links closely with DHSC South East Region, and SCC
commissions and develops outreach models to improve
Public Health and testing operational meetings.
access for vulnerable groups
Figure 12 – Testing Programme governance in Surrey • Insight, Engagement and Communications group –
addresses challenges round vaccine confidence and
complacency through engagement with Community
(COVID) Champions, Community and Faith Leaders; and
communications
Figure 13 – Vaccination Equality, Engagement and Inclusion
governance
6.8 Vaccination Equality, Engagement and Inclusion
governance
The national COVID-19 vaccination programme follows the
prioritisation guidance issued by the Joint Committee on
Vaccinations and Immunisations (JCVI).
6.9 COVID Matrix Response Group
Reporting to the Surrey Heartlands ICS Resilience and EPRR The purpose of the COVID Matrix Response Group is to provide
Board; the Equality, Engagement and Inclusion Group is chaired an agile and coordinated response to operational priorities within
by the Director of Public Health and oversees the equity of the three COVID-19 programmes – vaccinations, testing and
vaccination uptake across Surrey (Figure 13). This group has contract tracing. The group enables the programmes to deliver
wide representation from across the partnership including GP matrix style working to respond to changing priorities and
Federation, Equality, Workplace, Communications and
Page 15Surrey COVID-19 Local Outbreak Management Plan (v15.0)
demands, maximising operational impacts and ensuring joint
working and streamlined support.
Page 16Surrey COVID-19 Local Outbreak Management Plan (v15.0)
Section C – Managing COVID-19 - 7.2.1 Reports and datasets provided by UKHSA:
• Exceedance reports for pillar 1 and 2 combined lower tier
Surveillance local authority (LTLA) level)
• Situational awareness – national report
7.0 Surveillance • Power BI COVID-19 Situational Awareness Explorer
An effective local response to COVID-19 relies upon an Portal, containing datasets including information on:
Intelligence Team with the right systems and process to make o COVID-19 Epidemiology, including positivity
best use of local, regional and national data–sharing and o Contact Tracing and update by Upper tier local
intelligence developments, and who can produce a range of authority (UTLA)
specialist and informative intelligence products. o Outbreaks, Clusters and Settings
o Postcode level testing data (pillar 1 and 2 positive
7.1 Data objectives tests, cases, negatives and voids)
The data accessed by the SCC Public Health Intelligence Team o Common Exposures and Coincidences
is used for monitoring and supporting the management of o QR Venue Alerts
COVID-19 infections in Surrey to: o Local Contact Tracing data
• Review data 2 times a week on infection levels, testing, o Vaccine data
contact tracing, vaccinations, and VOCs o Variants identified through sequencing of
• Inform targeting of prevention and communication specimens, including both VOC and VUI
interventions • Contact tracing weekly epidemiological report (South East
• Identify epidemiological patterns in Surrey to refine region data)
understanding of high-risk places, locations, and • Weekly epidemiological report for Surrey
communities • Epidemiology reports for the 11 constituent Districts and
• Identify outbreaks so that appropriate action can be taken Boroughs in Surrey
in deciding whether to convene an incident management • iCERT (Integrated Common Exposure Report Tool)
team (IMT) • Institutional outbreak locations and details
• Consolidate latest COVID-19 data and make it easily
accessible for the public 7.2.2 Reports and dataset provided by Surrey Local Registry
• Ensure that those who require legitimate access to the Office:
intelligence for different purposes can do so, regardless of • Local registry deaths data including details of COVID-19
organisational affiliation, whilst ensuring Information related deaths, age, sex and place of death occurrence.
Governance (IG) and confidentiality requirements are met 7.2.3 Reports and datasets provided by Surrey Heartlands ICS:
• Provide intelligence to support quality and performance • Vaccination uptake, reported by cohort, dose type, GP
reporting to the LOEB practice/Primary Care Network, ethnicity, and deprivation
7.2 Data sources 7.2.4 Reports and datasets provided by SCC Adult Social Care:
The SCC Public Health Intelligence Team receives or accesses Vaccination uptake for residents and staff of care homes.
the following data and reports. Reported by dose type.
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7.2.5 Open-source datasets: • Report - Twice-weekly analysis on cases in each district
• GOV.UK dashboard provides data on cases, deaths, and borough including information on demographics,
testing, hospitalisations, vaccinations, and deaths outbreaks, variants, and exposure locations
• NHS COVID-19 Vaccination Statistics provide • Meeting - COVID-19 Data Monitoring
breakdowns of vaccinations by dose, age group, gender,
ethnicity, and geographical area. Data also includes 7.3.2 COVID-19 Vaccinations
uptakes of vaccinations in care home residents and staff. • Audience - Two reports are produced, one containing
• NHS COVID-19 Hospital Activity contains an analysis of official sensitive data and the other with public data only
reported COVID-19 admissions and diagnoses by age • Report - Data and analysis on vaccination uptake
band including reporting by equity variables such as age,
• UKHSA provides information on variant cases, with a gender, ethnicity, location and deprivation
distribution of variant cases available weekly and
Technical briefings published weekly/fortnightly 7.3.3 Intelligence Briefing (summary of cases, deaths, and
• ONS mortality data releases include analysis and insight outbreaks in a specific area)
into COVID-19 and other deaths. A weekly dataset Death • Audience - The Chief Executive and other colleagues of
registrations and occurrences by local authority and health the relevant district/borough
board provides provisional counts of the number of deaths • Report - Summary on the current situation in the specified
involving coronavirus (COVID-19) by local authority in the area. Data presented is tailored to show the key
latest weeks for which data are available. areas/issues
Using internal tools, the SCC Public Health Team, and IT and • Meeting - If required an IMT will be arranged to discuss
Digital department have developed an intelligence reporting the situation with the relevant district/borough colleagues
system to provide the intelligence required for daily review of test
and trace data to inform health protection decision making. 7.3.4 Summary of COVID-19 in Educational Settings
• Audience - Public Health Education Leads, Area School
7.3 Data reports and meetings Officers, SCC Education colleagues
The SCC Public Health Team, SCC Public Health Intelligence • Report - Statistical identification of schools with a high
Team and Surrey Heartlands ICS have responsibility for ensuring prevalence of COVID-19 relative to its number of pupils
the intelligence needed to support the COVID-19 response is • Meeting - Twice-weekly meeting to review the settings
sourced and provided in appropriate formats for different groups identified
in the LRF.
7.3.5 COVID-19 Short Summary
The Public Health team provides a comprehensive suite of • Audience – Public (Surrey residents or service users)
COVID-19 surveillance reports for meetings which they support • Report - Summary of cases and rates in each district and
and for specific audiences as follows: borough and an indication of the change from the previous
week. Hospital admissions are presented at South East
7.3.1 COVID-19 surveillance level. First and second dose vaccination uptake for each
• Audience - Public Health Consultants and Leads. district and borough
Communications colleagues
Page 18Surrey COVID-19 Local Outbreak Management Plan (v15.0)
7.3.6 COVID-19 Intelligence Summary
• Audience - Public (Surrey residents or service users)
• Report - Summary of publicly available data including
information on cases, hospitalisations, deaths, positivity
and vaccinations
7.3.7 Identification of locations reporting high infections
• Audience - Environmental Health Officers for the 11
constituent districts and boroughs in Surrey
• Reports -
o Weekly update on settings reported during contact
tracing
o Twice-weekly update on Common Exposures and QR
venue alerts to Environmental Health Officers
o Fortnightly COVID-19 surveillance update to
Environmental Health Officers (EHOs)
• Meeting - Fortnightly meetings with EHOs
7.3.8 Deaths with COVID-19 on death certificate
• Audience - Death management and Community care cell
colleagues
• Report - Weekly data and analysis of deaths based on
local registry data. Including summaries of excess deaths,
COVID-19 and non-COVID-19 related deaths, by age, sex
and place of death occurrence
Surrey Heartlands ICS provides a weekly Surveillance Report,
which is circulated by the EPRR Team to the Strategic Incident
Management (SIM) Group.
Surrey Heartlands ICS have mature IG co-operation
arrangements including an ICS IG lead. Surrey Heartlands ICS
and SCC have set up systems with partners for recording and
delivering data-sharing agreements and data workflows.
Page 19Surrey COVID-19 Local Outbreak Management Plan (v15.0)
Section D – Managing COVID-19 - our Agile Testing Units and providers partners such as
pharmacies, foodbanks and local charities
Preventing and Reducing Transmission • Symptomatic testing - planning and oversight of
symptomatic Polymerase Chain Reaction (PCR)
8.0 Testing testing resources on behalf of UKHSA which includes
8.1 Summary Local Testing Sites (LTS) and mobile testing units (MTU)
8.1.1 Goal
• Outbreak and settings testing - providing operational
The aim of the Surrey COVID-19 Testing Team is to provide a
delivery of PCR testing support in high-risk settings such
coordinated and partnership-led service in Surrey, enabling
as prisons, other vulnerable settings and local testing
residents to have access to high quality, timely and accessible
pathways across Surrey
tests and information, aligned with national programmes and best
practice. • Universal symptom-free testing - oversight and
signposting to government-led testing programmes of
8.1.2 Scope symptom free rapid lateral flow testing for example:
The Testing Programme includes symptomatic and symptom free pharmacy collect, home direct ordering, school and
COVID-19 testing, in line with national guidance and locally education testing.
determined pathways.
• Surge testing - operational and strategic support for surge
8.1.3 Context testing operations as requested via local and regional
The Testing Programme (formally known as the Testing Cell) UKHSA Health Protection Teams.
was formed as part of the Surrey LRF response to the COVID-19 National programmes to reduce transmission include:
pandemic and has been in place since April 2020. The • Symptomatic testing - anyone with symptoms of COVID-
programme is supported by partners including Surrey Heartlands 19 can get a free PCR test online or by calling 119.
CCG, DHSC, SCC, local District and Borough Councils, Public
Health provider organisations, and the military. The Testing • Symptom-free adults and secondary school aged children
Programme is now an integrated team between SCC Public - rapid Lateral Flow Devices (LFDs) are used focusing on
Health and Surrey Heartlands CCG. those who are not fully vaccinated, those in education,
and those in higher-risk settings such as the NHS, social
8.2 Current position care and prisons. Regular rapid testing can help to
The Surrey Testing Programme includes: manage periods of risk such as returning to the workplace,
• Operational delivery of the targeted community testing after close contact in a higher risk environment or when
programme, which is the local Surrey symptom-free spending prolonged time with a more vulnerable
testing programme focussing on disproportionately individual. Anyone over the age of 18 can collect a home
impacted (DIG) and under-represented groups testing kit or anyone over the age of 11 can order on the
(URG). This workstream delivers rapid lateral flow testing GOV.UK website.
(assisted and home test kits) and testing education, via
Page 20Surrey COVID-19 Local Outbreak Management Plan (v15.0)
• There are multiple nationally led testing streams that • Pharmacy providers
provide regular routine testing in different settings. Test • Community and charity providers
kits are provided by NHS Test & Trace directly • Portaloo providers
8.3 Resources required to manage COVID-19 response 8.4 Future / additional resources required
It is vital to understand the resources required to continue to If the Testing Programme needs to continue beyond March 2022,
deliver an effective service across all workstreams. appropriate funding will need to be identified to continue the
service.
The Testing Programme operates with short term/temporary
staff, including secondments, fixed term contracts and agency IT support is needed across SCC and Surrey Heartlands CCG
staff across SCC Public Health and Surrey Heartlands CCG. jointly to determine actions to mitigate the risk of using multiple IT
Funding is in place until March 2022. systems both operationally and for safe governance processes.
Current staffing of the programme includes 14 Whole Time 8.5 Priorities and future planning
Equivalents (WTE) core team members and 11 WTE operational Priorities and future planning for the Testing Programme include:
testing team members. • Improved community engagement to increase the reach of
symptom-free testing within DIG and URG
There are also a number of key enabling functions from across • Increasing community and charity provider partners to
Surrey partner organisations including: support testing and education on behalf of the Testing
• Communications Programme
• Properties • Improved targeting of deployment of our Agile Testing Unit
• Finance based on data and intelligence to improve the reach of our
• Information Technology services to the DIG and URG
• Public Health specialist support (including Intelligence) • Evidencing of our effectiveness of our testing programmes
• Infection prevention and control at reducing the impact of COVID-19
• District and Borough Councils
• Adult Social Care 8.6 Anticipated changes to national guidance/policy
• Education UKHSA are carrying out an ‘in-person testing review’ to look at
• Military support current PCR symptomatic testing at LTS. It is anticipated that this
• Joint working with contract tracing and vaccination will see a reduction in LTS across the region at some point in
programme 2022, based on intelligence and a prioritisation process.
Universal symptom-free testing available to everyone is likely to
The Testing Programme has contracts with providers to support cease at some point in the future, although there is currently no
operational delivery, including: timeline identified for this change.
• IT portal provider Funding for the targeted community testing programme is
• Courier providers currently confirmed until 31 December 2021, although it is
• Warehousing/logistics provider anticipated this funding will be extended until the end of March
2022.
Page 21Surrey COVID-19 Local Outbreak Management Plan (v15.0)
8.7 National weblinks 9.1.2 Scope
• Testing for coronavirus (COVID-19) - NHS (www.nhs.uk) All COVID-19 positive cases, regardless of age or vaccination
• Get tested for coronavirus (COVID-19) - NHS status, are contacted to:
(www.nhs.uk) • Advise them to self-isolate and check whether they need
• Get a free PCR test to check if you have coronavirus support to do this
(COVID-19) - GOV.UK (www.gov.uk) • Identify close contacts who they may have infected
• Get a collect code to pick up coronavirus (COVID-19) • Identify where they may have been infected
rapid lateral flow tests - Get a coronavirus test - GOV.UK
(test-for-coronavirus.service.gov.uk) 9.1.3 Context
• Order coronavirus (COVID-19) rapid lateral flow tests - The national NHS Test and Trace service was launched in May
GOV.UK (www.gov.uk)Find where to get rapid lateral flow 2020. Through the Local Tracing Partnership (LTP), SCC
tests Contact Tracing team began supporting the national service in
• Report a COVID-19 rapid lateral flow test result - GOV.UK November 2020 by speaking to cases.
(www.gov.uk)
9.2 Current position
• Get coronavirus tests for your employees - GOV.UK
9.2.1 Contact tracing journey
(www.gov.uk)
The full journey for cases to provide information on close
• COVID-19: guidance for households with possible
contacts and places they have visited, can be completed at any
coronavirus infection - GOV.UK (www.gov.uk)
of the following consecutive stages:
• Guidance overview: Guidance for contacts of people with
• 4-hour opportunity to complete form online
confirmed coronavirus (COVID-19) infection who do not
• 20 hours of calls from the national Test and Trace team
live with the person - GOV.UK (www.gov.uk)
• 48 hours of calls from the Surrey Contact Tracing team
• Travel to England from another country during coronavirus
• Home visits from Environmental Health teams
(COVID-19) - GOV.UK (www.gov.uk)
• Find a coronavirus (COVID-19) travel test provider if This model of partnership working between National Test and
you're arriving in England - GOV.UK (www.gov.uk) Trace and the Local Authority is described as ‘Local 24’. It is
supported by the LTP who facilitate the South East Weekly
8.8 Local weblinks
Contact Tracing Update and Best Practice Sharing meeting.
• Coronavirus testing - Surrey County Council
(surreycc.gov.uk) 9.2.2 Surrey Contact Tracing Team
• Pharmacy assisted testing booking portal – SCC – Surrey Local contact tracing is completed by the SCC Customer
County Council (covid19testing.org.uk) Services Team, supported by Public Health. This well trained and
experienced team reach between 70 and 80% of the more
9.0 Contact Tracing difficult to reach cases.
9.1 Summary
9.1.1 Goal The benefits of the local team contacting Surrey residents
To break the lines of transmission and reduce the spread of include:
COVID-19. • Calls are made from a local number 01483 404939
Page 22Surrey COVID-19 Local Outbreak Management Plan (v15.0)
• Surrey residents can call back when convenient for them • Reaching more Surrey cases, leading to a higher
on 0300 200 1008 successful completion rate (when previously on Local 4 it
• Signposting to welfare support available during the self- was between 92-97%), than the national Test and Trace
isolation period team attains
• Cases within a family who test positive at the same time
can be contacted in one call Plans are in place to capture residents experience in order to
• Communication links with complex settings such as monitor and maintain quality of the Surrey Contact Tracing team
military bases and prisons, facilitate effective contact service.
tracing
9.6 Anticipated changes to national guidance/policy
9.2.3 Enhanced Contact Tracing Upcoming changes to the national Test and Trace processes
This is a systematic approach to gathering and analysing contact include:
tracing data and other information to rapidly detect, risk assess, • From 24 November 2021, isolation support follow-up calls
and take appropriate actions to prevent community transmission for cases and close contacts with a mobile number or
for new COVID-19 clusters locally. email address will be contacted by text message/email on
days five and eight. Calls will still be made to individuals
9.3 Resources required to manage COVID-19 response those without a mobile number or email address
There are currently 26 WTE contact tracers in the Surrey team. • From 1 December 2021, close contacts where a mobile
Recruitment is underway to increase this to 32 WTE contact number or email address has been provided will follow the
tracers and seven team leaders/managers to support the service digital journey, and be provided with advice by text
until end June 2022. message or email
• From December 2021, case and close contacts under 18
9.4 Future / additional resources required years of age will be included in the digital journey
If the contact tracing service needs to continue beyond June
2022, appropriate funding will need to be identified. 9.7 National weblinks
• NHS Test and Trace: what to do if you are contacted -
9.5 Priorities and future planning GOV.UK (www.gov.uk)
When case number return to a more manageable number, the • NHS Test and Trace (phe.gov.uk)
Surrey Contact Tracing team aim to return to the ‘Local 4’ model
where cases that have not completed the online form in the first 9.8 Local weblinks
four hours, then come directly to the Surrey Contact Tracing • NHS Test and Trace - Surrey County Council
team. This will initially be targeted at those areas with the highest (surreycc.gov.uk)
priority risk scores. This has previously been shown to improve:
• Compliance with self-isolation guidance and identifying 10.0 Vaccinations
close contacts 10.1 Summary
• Early identification of potential outbreaks
10.1.2 Goal
• The speed of access to welfare support
Page 23Surrey COVID-19 Local Outbreak Management Plan (v15.0)
The aim of the COVID-19 vaccination programme is to protect 10.2.2 Equality, Engagement and Inclusion Group
those who are at most risk from serious illness or death from • Develop a communications plan.
COVID-19. The vaccination programme needs a high uptake of • To respond to requirements from the National Equalities
at least 70% to be effective. It is not yet known how long board on Outreach Programme
protection from the vaccine will last. • Utilise the EIA to provide insights
• Develop strategies specific to population needs and
10.1.2 Scope vaccination resistance
In December 2020, the JCVI issued guidance on the roll out of • Ensure seldom heard groups are supported to make
the COVID-19 vaccinations to patient and staff groups with informed decisions and be vaccinated and support
ranked priority groups, based on age. The first priorities for the improved access to information and services
COVID-19 vaccination programme should be the prevention of
• Develop communication channels to respond to low uptake
mortality and the maintenance of the health and social care
systems. 10.2.3 Non-Clinical Support Group
• Work closely with the other workstream leads to determine
10.1.3 Context
current and future capacity
There are four models of delivery of the COVID-19 vaccination
available across Surrey. These include 16 GP-led local • Highlight any key risks related to estate capacity which
vaccination sites delivered by four GP Federations, one National could impact on vaccination delivery
Mass Vaccinations Site, two roving models for the housebound • Identify new opportunities to extend, renew or bring on
and other groups as required, and four Hospital Hubs designed additional site capacity
to be easily accessible by healthcare staff. • Work with partner organisations to address any logistical
issues
10.2 Current position • Identify other support required to ensure optimum site
The operation of the COVID-19 Vaccination Programme in Surrey delivery
is supported by five operational delivery groups. The functions of
the groups are as follows: 10.2.4 Clinical Operational Group
• Advice and guidance on all aspects of clinical training and
10.2.1 Data and Modelling Group governance
• Lead all modelling, data collection and routine reporting • Advice and guidance on vaccine administration and
associated with the programme including penetration management
across different population demographics to reduce health • First point of escalation at system level for any clinical
inequalities incidents associated with the programme and identification
• Develop capacity planning models. of trends and training needs
• Strong links with regional and national modelling teams • Where necessary, working with national and regional
• Support future capacity planning to include second dose teams
and changes to sites/run rates. • Support the clinical model development
• Ensure all IT systems links and outstanding issues are • Identification of and delivery of vaccinations to key
resolved to ensure robust data collection population cohorts as released by the JVCI
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