Agenda item

·       Group Chief Medical Director, Royal Free London NHS Foundation Trust

·       Director of Public Health, London Borough of Barnet

The Chairman invited the following to the meeting:

• Dr Chris Streather, Group Chief Medical Director, Royal Free London NHS Foundation Trust
• Dr Tamara Djuretic, Director of Public Health, London Borough of Barnet
• Cllr Caroline Stock, Chairman, Health and Wellbeing Board, London Borough of Barnet

Dr Djuretic spoke to her presentation which provided an update on the Local Outbreak Control Plan which Local Authorities have been asked to produce in order to prevent local outbreaks and manage any that arise. Barnet has been selected as one of the Best Practice Groups which also included Camden, Hackney and Newham. The Group is bound by guiding principles agreed at a national level and underpinned by legislation.

Cllr Stock reported that the Health and Wellbeing Boards (HWBBs) have been asked by the government to work with the public to prevent and help resolve outbreaks. Two informal webinars had been held so far with community groups that are considered at higher risk of infection. The first webinar had been with Head Teachers and which 60 people had attended. The second webinar had been with the Faith Forum.  Cllr Stock added that the HWBB would like to be kept informed about any areas that they should address.

Dr Djuretic added that Local Authorities have powers to impose local lockdowns and more details are awaited on this. She stated that London is fortunate in having the Public Health England London Corona Response Cell (PHE LCRC) which is providing help with contact tracing in Barnet. The PHE LCRC has also published a series of action cards for prevention and management of outbreaks in various settings.

Dr Djuretic added that the work to support vulnerable people continues, including supporting them to self-isolate and providing information on testing. Barnet has been part of the national Best Practice Group Network and contributed to a guide for Care Settings, people with dementia, learning disabilities and mental ill health as well as places of worship. Barnet has implemented a Communications strategy to support its Outbreak Control Plan. This includes raising awareness on NHS Test and Trace, and focuses on houses of multiple occupancy (HMO) and landlords, as HMOs have been shown to be a risk in some areas.

Dr Djuretic reported that Local Authorities, GPs and others are expected to assist with data sharing during an outbreak and adopting a proactive approach in line with the requirements set out by the Secretary of State for Health.

A Member enquired what the data from NHS Test and Trace showed so far for Barnet. Dr Djuretic responded that Barnet has received notice of around 70 people testing positive for Coronavirus since Test and Trace began. In Barnet over 80% of cases and contacts had been traced, including those in Care Settings. Dr Djuretic added that she would share more data with the HOSC, when available.

A Member asked whether recent reports that the Test and Trace technology did not work were true. Dr Djuretic noted that the NHS application that had been piloted on the Isle of Wight had been found to be not as effective as telephone contact tracing, so it had not been launched nationally. The Government would be investigating a new Test and Trace App further from September.

A Member asked why Barnet has been chosen as part of the Best Practice Group. Dr Djuretic responded that this was probably because Barnet has managed the pandemic response well so far and the fact that it has a large number of Care Settings and is an outer London Borough. Barnet is leading on a Best Practice Group Network toolkit for Care Settings and places of worship, Camden is leading on transport and Newham and Hackney have been asked to provide guides on engaging with Black, Asian and Minority Ethnic (BAME) communities.

A Member commented that small clusters of infections had been reported to Members and wondered whether any causes had been identified. Dr Djuretic noted that this is an area that the Council would be focusing on much more. Some outbreaks were associated with Care Settings whereas outbreaks in Golders Green and Childs Hill appear to have spread in the community. Anecdotal evidence has suggested some community and religious festivals had caused infection rates to rise. Barnet has tried to improve social distancing in such areas, with some success, and now has only very few cases scattered around the borough. Currently there are almost no cases in Care Settings, despite testing being in place.

A Member asked what, as a School Governor, she should be vigilant about from September. Dr Djuretic responded that the team has ensured that schools are informed and well equipped, with risk assessment tools in place. Seminars were ongoing to support overall health and wellbeing as schools reopen. The schools have strong links with the Public Health team and support is available.

The Chairman noted that she had put the following questions to Dr Chris Streather. Dr Streather responded:

1.    How many people with Covid-19 had been admitted to the Trust’s hospitals in   May and June?

·       There had been 73 hospital admissions of patients with Covid-19 (tested positive on swab test within two days of admission) during May and June in Barnet Hospital and the Royal Free Hospital.

2.    How many people had been discharged having been successfully treated in May and June?

·       8621 patients during May and June across all specialties. 250 patients had a primary diagnosis of Covid-19 and 214 of these had been discharged home. Of the remaining 36 patients, some remain in hospital and some had passed away.

3.    How many people have died of Covid-19 in the Trust’s hospitals in May and June?

·       Below 36; the total mortality across the specialties in May and June was 210 patients. In a normal year the mortality rate would be around 170 per month. This does not mean that mortality decreased. There were fewer elderly patients attending A&E during this period. 

4.    How does the mortality rate for May and June this year compare with the same months in 2019? 

·       There was a 2.7% mortality rate in May and June 2020 and a 2.2% rate in 2019. There are currently only 2 patients in Barnet Hospital with Covid-19.

The Chairman and Committee commended and thanked the Trust and its staff for their hard work. They commented that it was heartening to see the reduction currently in the rate of Coronavirus infections and the excellent care that patients had received as presented on the excellent recent BBC programme about   the Royal Free Hospital during the pandemic.

The Chairman asked about delays to general patient care because of Covid-19. Dr Streather responded that this had been difficult and the priority is to deal with patients who need urgent treatment, then to deal with the backlog, ensuring that this is done safely. Most urgent cancer operations and heart surgery had been carried out during the outbreak in other London hospitals. Some patients remain on the waiting list and work is ongoing; the Trust can only work at around 60% capacity but life-threatening conditions have been prioritised. There have been delays in endoscopy procedures so there will be delays in some cancer diagnoses and the Trust is working hard to resolve this.

RESOLVED that the Committee noted all three verbal reports.