North Yorkshire Outbreak Management Advisory Board

Notes of the remote meeting held on Friday 29^th October 2021 at 2.30 p.m.

THOSE WHO JOINED THE DISCUSSION:

North Yorkshire County Council Representatives:

Councillor Carl Les, Leader, North Yorkshire County Council (Chair)

County Councillor Andrew Lee, Executive Member, Public Health, Prevention, Supported Housing

Councillor Michael Harrison, Executive Member for Adult Services and Health Integration

Victoria Turner, Public Health Consultant

Richard Webb, Corporate Director, Health and Adult Services

District Council Representatives:

Councillor Liz Colling, Scarborough Borough Council

Councillor Dinah Keal, Ryedale District Council

Councillor Ann Myatt (Harrogate Borough Council)

Other Partners’ Representatives:

Phil Cain, Deputy Chief Constable (substitute for Lisa Winward)

Jane Colthup, Chief Executive, Community First Yorkshire

Tina James-McGrath, representing the Office of the North Yorkshire Police, Fire and Crime Commissioner

Sue Peckitt, North Yorkshire Clinical Commissioning Group (substitute for Amanda Bloor)

Ian Yapp, Chief Education Officer, the STAR Multi-Academy Trust

In attendance (all from North Yorkshire County Council, unless stated):

Patrick Duffy, Principal Democratic Services Scrutiny Officer (Clerk)

Mike James, Team Leader, Marketing and Customer Communications

Apologies received from:

Amanda Bloor, Accountable Officer, North Yorkshire Clinical Commissioning Group

Simon Dennis, Chief Executive and Monitoring Officer, Office of the North Yorkshire Police, Fire and Crime Commissioner

Richard Flinton, Chief Executive, North Yorkshire County Council

Ashley Green, Chief Executive Officer, Healthwatch, North Yorkshire

County Councillor Stuart Parsons

Helen Simpson, Chair, York and North Yorkshire Local Enterprise Partnership

Sally Tyrer, Chair, North Yorkshire local medical Committee

Louise Wallace, Director of Public Health

Lisa Winward, Chief Constable

Copies of all documents considered are in the Minute Book

NO.	ITEM
192	WELCOME AND INTRODUCTION BY THE CHAIR County Councillor Carl Les welcomed Members of the Board and any members of the public or media viewing the meeting.   He advised that he is the Leader of the Council and Chairs this Board and that:- - the main role of this Board is to support the effective communication of the test, trace and contain plan for the county and to ensure that the public and local businesses are effectively communicated with;   - decisions of the Board are purely advisory and its recommendations will be considered through the governance arrangements of the bodies represented, which retain their decision making sovereignty; - the papers for this meeting had been published in advance on the County Council’s website; and - the Board comprises, among others, representatives of the County Council; District and Borough Councils; the NHS; Public Health England; Schools; Healthwatch; the Care Sector; and the Voluntary Sector
193	APOLOGIES As stated in the attendance on the previous page.
194	NOTES OF MEETING HELD ON  29^TH SEPTEMBER 2021 AGREED that these were an accurate reflection of the discussion.
195	DECLARATIONS OF INTEREST There were no declarations of interest.
196	NOTIFICATION OF ANY OTHER BUSINESS The Chair asked Members if they could advise him, at this stage, whether they had any item of urgent business they were likely to raise under that heading, so that he could ensure there was sufficient time at the end to consider it.  No Members indicated that they had any urgent business to raise.
197	UPDATE ON THE CURRENT POSITION IN NORTH YORKSHIRE  Slides were presented by Victoria Turner, which contained data on North Yorkshire daily cases; 7-day infection rates; and daily deaths. Victoria highlighted the following aspects:- - The North Yorkshire 7-day infection rate of 529 cases is well above the England average of 461.9.  However, the gap is narrowing, with decreases in all Districts over the last 24 hours and the North Yorkshire figure now at 503, compared to the national figure of 450. - The bulk of the cases currently are among children and young people. There is also a concentration on care homes, given the vulnerable nature of the residents.  Encouragingly, the number of people isolating within Care Homes reduced significantly in the last week and it is hoped that this is due to the booster vaccination programme. - There were 8 deaths in North Yorkshire last week and a gradual increase in the number of people in Hospital. Ian Yapp asked about the impact of half term, with children not being at School.  Victoria Turner said that we are seeing their impact of half term now.  The figure could increase following half term, but could be attenuated by the vaccination programme – although not everyone in the 12-15 year old cohort has had the opportunity to be vaccinated yet. In response to questions from County Councillor Andrew Lee, Victoria Turner advised that in August/September younger older adults were coming through, but the bulk of people in Hospital are aged over 65.  She will provide more details on hospitalisations to Councillor Lee separately. NOTED.
198	EXCESS MORTALITY Slides were presented by Victoria Turner which contained data on excess mortality in England and Wales; excess mortality in North Yorkshire; cause of death; and place of death Victoria made the following points, in particular:- - The information looks at the period 3^rd January 2020 to 2 July 2021, during which there were 98,000 excess deaths – that is the additional number of deaths, compared to what would have been expected in a non-pandemic period. - Using the five-year average of deaths in North Yorkshire, the expected figure would have been 11,347 deaths, whereas the figure was 11,906 – an extended count of 559. - In terms of the cause of death, Research published in the British Medical Journal had found that acute respiratory infections and circulatory diseases sit alongside Covid-19.  It is interesting to note that Alzheimer’s is the third biggest cause of death, where Covid was an underlying cause.  People with dementia may not, for example, remember requirements in terms of face coverings and increased social isolation will have led to a significant strain on their wellbeing, which is likely to lead to a decrease in cognitive ability. - With place of death, during the first wave of Covid, there has been an excess of deaths of people dying at home.  Research by the Kings Fund found that it is likely that many of the people who died at home would, if it had not been for the Pandemic, have died in Hospital. There were concerns about fear of infection and visiting restrictions may have deterred some people with a terminal illness from having a Hospital admission.  Equally, Covid-related pressures may have precluded choice for some people.  There had already been a gradual shift towards dying at home prior to the Pandemic. Therefore, some of this may be down to personal preference. - There was a high peak of deaths in Care Homes, particularly during the first peak, prior to protections coming fully into place and there were a lot of discharges into Care Homes to free up Hospital beds at that time. - The number of deaths in Hospital is more evenly spread across both peaks. Councillor Ann Myatt felt that it would be helpful to continue to receive this type of information to make sure the Health Service is coping with all of the other diseases as well as it can. This could help to identify if there is a trend in the rise of excess deaths, because if people are unwilling to access services this could show up in subsequent months.   Councillor Myatt also asked whether there was any further information available about deaths caused by diabetes, which have increased every month.  Victoria Turner said that diabetes appears to be the most common underlying cause of death that included Covid.  She will see if there is any further information about this. NOTED.
199	VACCINATION UPDATE Sue Peckitt updated as follows:- - The Vaccination Programme is going well - 596,400 people have received a first dose and 565,825 people have received a second dose. - Booster jabs have been administered to 84,968 people. - GPs are working to deliver the vaccination booster to Care Homes, together with the flu jab at the same time, where this is possible. The booster programme is operating on a booking basis, as are vaccination clinics, because there is no walk in capacity at the moment. - On the Schools Programme, Harrogate District Foundation Trust are rolling this out.  Three sites have been opened, via the national booking system, in Knaresborough, York and Middlesbrough. In response to a question by Ian Yapp, Sue Peckitt confirmed that that all Schools will have received an offer date by the end of November 2021. Councillor Ann Myatt asked if the booster programme is on target for other groups,  as well as those clinically vulnerable.  Sue Peckitt advised that people are being contacted in age order.  There is no target for the system as a whole, but there is a target to give the booster to Care Home residents and staff by the end of October 2021. NOTED.
200	COMMUNICATIONS UPDATE Mike James made a presentation. He outlined the working principles and the approaches to help deal with a developing situation, including supporting campaigns that are focused on related issues, which help the wider community response in the long term. Mike also highlighted the following:- Respect and Protect - He reminded Members about the Campaign and how it fits into other activities. - We are pushing the message that a little kindness goes a long way. - The current stage is to make use of community assets for marketing e.g. Town Centres.  This enables physical as well as digital marketing. - The presentation highlighted graphical examples of Town Centre visibility and how this is complementing the online marketing material. Increasing communications activity to support the local response - In places where there have been an increase in infection rates, co-ordinated sharing of messaging occurs across the Local Resilience Forum and Health and Social Care partners. Wider support for other Health and Social Care issues - These include:- · Social Care recruitment campaign – work in progress · Health and wellbeing priority campaigns – such as supporting weight management services NOTED.
201	PARTNER UPDATES Care Sector – Richard Webb - Dealing with five Residential/Nursing Homes who are experiencing problems, including some closures. - About half a dozen providers have handed back packages of care. - Major recruitment campaign pending.  This will take time to have effect, so we are managing the contingencies as best we can. - A very challenging situation. NHS – Sue Peckitt - Continued high demand into Primary Care and Urgent and Emergency Care – the demand is high overall; not just related to Covid. - 171 beds are occupied by patients with Covid, which is a significant number – 20 of these are in Intensive Care. - The majority of admissions are for people aged over 65. - Significant numbers of Care Providers are struggling – this is putting pressure on acute provision, as there is a good chance people will present to Emergency Care, which is not the right place for them. - Unprecedented levels of demand. Ian Yapp – Schools - The last half term has been another significant one. - The impact and, therefore, prevalence has varied across the Sector. - 160 School settings have sought bespoke guidance from North Yorkshire Teams. - Updated Question and Answer level advice and guidance and letters to School Leaders and parents have been issued by the Director of Public Health. - As roll out to the 12-15 year old age group is incomplete, it is very important that our communications emphasise the need to keep Covid infection rates as low as possible over the next few months to allow the vaccination and roll out to take effect in School age groups and parental communities.  So there are some key messages we want to circulate, in addition to our existing controls. For example, early reintroduction of face coverings may need to be considered where Schools and settings experience caseload. - Advice received today is to consider reducing wider unnecessary mixing between year groups and classes, including Inter-School Events; restricting visits to School sites and considering whether educational trips should go ahead.  None of these are measures that Schools would want to take but this is done under close and bespoke School level advice and with the important aim of maintaining and maximising on site classroom provision. Voluntary and Community Sector – Jane Colthup - Continuing to work with Health and Social Care colleagues and colleagues in the Sector to help alleviate pressures in the system.
202	NEXT MEETING The Chair confirmed that the next meeting will be on Wednesday 24^th November at 2.00 p.m.
203	ANY OTHER BUSINESS There was no other business to consider.

The meeting concluded at 3.16 p.m.

PD