Agenda item

The Chairman invited the following to the meeting:

·       Dr Tamara Djuretic, Director of Public Health, London Borough of Barnet

·       Dr Charlotte Benjamin, Vice Chair, North Central London Clinical Commissioning Group (NCL CCG)

·       Dr Deborah Sanders, Chief Executive, Barnet Hospital

Dr Djuretic reported that infection rates have been increasing nationally and that Barnet currently were just under 100 per 100,000 population. Barnet is testing in the region of 15,000 people and seeing about 350 positive cases each week. However, there are fewer outbreaks in Care Homes, schools and houses of multiple occupation. The Council is continuing to work with these group in order to contain any outbreaks as soon as possible.

Barnet has significantly increased its number of Enforcement Officers and this had shown improved compliance. The Council has worked with places of worship to ensure that good Covid-secure systems are in place. In addition, Barnet has around 200 Covid Champions and is putting great effort into engaging with all communities across the Borough.

Testing sites are available in Barnet and capacity is being retained to ensure surge testing can be carried out if needed to continue to keep infection rates low in the case of new variants.

Dr Djuretic reported that 95,000 people have been vaccinated in Barnet so far and 3,500 have received a second vaccination. The uptake in residents over 75 years old is 80%. There is a lower uptake in more deprived communities and Black African and Black Caribbean residents. There is a good uptake amongst the Asian population. Barnet continues to work with faith leaders and Covid Champions to promote vaccination. In addition, Dr Djuretic reported that, together with Dr Benjamin, she sits on the NCL Vaccination Board and the Barnet Vaccination Oversight Group which includes the Director of Adults, Public Health and Social Care colleagues. The group meets regularly to look at ways of promoting the vaccine.

A Member commented that she had had very positive feedback from residents complimenting the way that the vaccination programme was being rolled out.

 Another Member asked whether the lower uptake of the Covid vaccine correlated with the same areas where ‘flu vaccination and childhood vaccination was lower and therefore there is a long-term driver around that work. She also asked whether people were largely hesitant or opposed to the vaccine.

Dr Djuretic responded that much of the work focused on people who were hesitant rather than opposed to vaccination. Feedback showed that there were different barriers to immunisation such as childcare and Clinic opening hours so Barnet is working to improve access. She would bring a further update on vaccination to the next HOSC meeting.

The Member then asked whether increasing the opening hours of some vaccination centres to support ‘out of hours’ workers might help. Dr Benjamin responded that a pilot is currently underway with Cullimore Pharmacy.

A Member reported that Cullimore Pharmacy is in their Ward and there had been problems getting sufficient people to attend when they had a lot of vaccines available. Dr Benjamin explained that there is a national booking system for mass vaccination sites and pharmacies and a separate system for GP Surgeries. These systems do not link in with each other until after an individual has been vaccinated. At present, only the first four cohorts of the Priority Groups can be invited to attend.

Dr Benjamin reported that the vaccination programme went live in Temple Fortune, Barnet on 15 December 2020 and since then five other sites had been set up. Many pharmacies have also got involved. General Practice is operating a Primary Care Network (PCN) model, with Practices working together for around 30,000-50,000 patients. 100% of people in cohorts 1-4 have been offered the vaccine and the uptake has been 79.1%. By the end of January 2021, GPs had vaccinated residents in 78 Care Homes throughout the Borough, although the vaccine cannot be administered to anyone who has had Covid in the previous 28 days. GPs are also offering the vaccine to the housebound, sometimes working with Central London Community Healthcare (CLCH), and 81% of this cohort has accepted. Currently, cohorts 5 and 6 are being offered the vaccine. At a later stage, mass vaccination sites have been identified such as Allianz Park to cope with the larger volume of younger people who will be invited but so far cohorts have been managed via pharmacies and Primary Care.

Dr Benjamin reported that GPs have been given the responsibility to phone individuals who do not wish to be vaccinated at present to ensure that they are given another opportunity. The national plan is for all adults to be offered the vaccination by June 2021. At present the hubs are using the Pfizer and AstraZeneca vaccines.

Dr Benjamin noted that ‘flu vaccination had been approached differently this year, including efforts being made to register more homeless people with GPs. The Barnet Vaccination Oversight Group (BVOG) is looking at a range of other health inequalities and is also working with the voluntary sector. As a result of the work being done to contact a wide variety of communities who do not readily access the NHS, it is hoped that people will be encouraged to come forward so that their children can be vaccinated and their health issues managed better, such as diabetes.

A Member reported that she speaks to many refugees who cannot get a NHS number easily so cannot be vaccinated. They are frightened to give information to the NHS because of their refugee status. Dr Benjamin responded that a piece of work is being undertaken in relation to this group, especially with the asylum-seeking hotels and Barnet Refugee Services. Barnet is looking to facilitate this group so that they can attend the Vaccine Hubs and obtain emergency NHS numbers.

The Chairman asked Ms Sanders for an update on the newly opened Rainbow Ward and the vaccination rollout at the Royal Free London NHS Foundation Trust.

Ms Sanders reported that vaccination is being carried out at Barnet, Chase Farm and the Royal Free Hospitals, with over 20,000 people having been vaccinated across all three sites. This included vaccination of the Trust’s staff, Central London Community Healthcare (CLCH) and Barnet Enfield and Haringey Mental Health Trust (BEHMHT) staff as well as Residential and Nursing Home staff.

Ms Sanders reported that Rainbow Ward had been used as a modular ward during the first wave of the pandemic, given that Barnet Hospital did not have sufficient inpatient capacity. It has 35 beds in total with 15 ensuite side rooms and 4 bays with five beds in each. This had provided a good environment for patients with better facilities and feedback from patients has been positive. This would remain a Covid Ward for the time being, as the extra capacity is still needed.

Ms Sanders reported that currently Barnet Hospital (BH) has 66 and the Royal Free Hospital (RFH) has 68 patients with Covid. Both Intensive Care Units (ICUs) are very busy, with the RFH going beyond its surge capacity at one point with 92 patients in ICU. Other Trusts had provided staffing to help with the demand. Staff are very tired, particularly those working in ICU and the emergency departments. Some staff are also reporting being traumatised. Psychological support is being offered to staff.

Access to testing is so much better during this second wave. Patients are being tested on admission and regularly thereafter. 7,000 staff are using Lateral Flow Tests twice a week which has already picked up 250 staff who were asymptomatic.

The Chairman read out the responses which she had received in advance to the four questions regarding Covid-19 which the Committee have asked at the recent HOSC Meetings:

1)    How many people with Covid-19 have been admitted to the Trust’s hospitals in November and December 2020 and January 2021?

·       November 245, December 718 and January 887.

2)    How many patients were discharged having been successfully treated for Covid-19 in November and December 2020 and January 2021?

·       November 203, December 581 and January 732. Some of these people are still inpatients at present. 

3)    How many patients have died of Covid-19 in the Trust’s hospitals during November and December 2020 and January 2021?

·       November 42, December 137 and January 155.

4)    How does the mortality rate for November and December 2020 and January 2021 compare with the same months in 2019 and 2020?

·       Dr Sanders responded that there is no data that is publicly available at present but she would send this through to the Committee as soon as possible.

The Chairman enquired whether Care Homes with younger residents are also now being vaccinated. Dr Benjamin responded that the definition of Care Homes changed in January 2021 and this does now include Care Homes for young people with learning disabilities and other disabilities. Primary Care and CLCH are now undertaking vaccination of this group.

A Member asked what the vaccination uptake is amongst Care Home staff. Dr Benjamin reported that it is just under 50% across NCL, which is disappointing. However, she has not seen Barnet-specific figures. Work was underway to try to improve this including webinars with opportunities for staff to ask questions. Hospitals are facing similar challenges, particularly among BAME (Black, Asian and Minority Ethnic) staff.

RESOLVED that the Committee noted the three verbal updates.