Agenda item

Vic Turner, Public Health Consultant, presented her report to the Board. As background she said the report was representative of the North Yorkshire Health Protection Group (HPAG) and provided strategic oversight on Health Protection across the whole the system. The report was intended to tighten up some of the assurance processes and plan for the next series.

In her presentation she highlighted:-

Update on 23/24 Priorities

-          The Implementation of the School Immunisation Service had move across to Vaccinations UK.

-          Health Protection had benefitted from LGR merger of Environmental Health and Public Health into one organisation.

-          A Military Health Liaison Group had its first meeting. Further, that a link to the group would be developed as military health was a key issue at the moment.

Screening and Immunisations

-          There were good links between the public health UKHS IBC.

-          Work was ongoing with awareness campaigns.

-          Health Inequalities was being considered, especially in Scarborough.

Infection Prevention and Control

-          They were reviewing the specification around the IPC.

-          A new service was expected to be in place from the 1^st January, 2025 and feature a new specification.

Sexual Health

-          Its provision continued to be provided by York Sexual Health

-          The Health Protection Assurance Board had been linked up with the relevant Board on sexual health.

-          Sexual Health data was now reported through HPAG.

Environment

-          Seasonal health was a key issue due to a changing climate.

-          The Cold Weather Plan was replaced by the Adverse Weather Plan.

-          A North Yorkshire website was set up to include messaging from all partners of seasonal health.

-          ICB money had been used to appoint to post a seasonal health role.

-          Collaboration between environmental health and public health was easier due to the merger into one organisation.

Emergency Preparedness, Resilience, and Response

-          The Local Resilience Forum (LRF) for York and North Yorkshire had a three year cycle in reviewing its risks and plans, and had featured health in the previous year.

-          The two health related risks of particular interest were around pandemics and emerging infectious diseases. A new strategic plan had been developed for the LRF around the two highlighted risks, and would sit above the operational plans held at the council level.

-          They held an exercise in February which had gone well.

-          The findings of the Covid Inquiry would factor into the new model of the LRF such as messaging around preparing for the wrong pandemic. This involved taking a more holistic approach to pandemics due to similarities in deploying testing, vaccinations, contact tracing etc. There should also be particular interest in routes of transmission.

Incidents and outbreaks.

-          There had been two major incidents in the past 12 months.

-          The first was a mass bird die off on the coasts of Scarborough and Filey and had posed challenges as it was on a public beach in a non-controlled area and did not receive a response from DEFRA. Despite this the service managed the incident.

-          The second was the influenza A(H1N2)v incident, which was the first case identified in Europe. This was reported to the World Health Organisation (WHO) which caused some international attention to be turned on Yorkshire. Though the response was national-led, the service fought to be heavily involved, which showed there was more scope to use local authority capabilities.

-          The service had also been providing advice to various organisations regarding measles and tuberculosis, which had seen rates rise nationally.

Priorities for 2024/25

-          The IPC/TB contract/service specification review should be completed this year.

-          They would further develop intelligence sharing between partners but there were challenges as they various organisation used different systems.

-          To complete the NY infectious Diseases operational plan and Gastrointestinal Infection plan, that sit under the LRF.

-          To sign off the Avian Influenza protocol.

-          To focus on Health inequalities regarding screening and immunisations.

-          Continue the NY military liaison group.

-          To work on the Air Quality strategy and NY Air Quality Action Plan.

-          Further the health agenda around key risks such as TB and migrant health.

-          Continue the Joint seasonal health communications plan.

The Chair sought clarity on if the military health liaison group went beyond current servicemen. Vic Turner responded that it tended to engage with military defence health teams who were focused on current servicemen however that infectious diseases, for instance, applied to the local community and family members of servicemen. Suicide prevention would in contrast look broader such as the Gurkha needs assessment.

John Pattinson commented on the changed perception towards covid-19 and that he held concerns towards the rise in cases and new variants. He believed there was a general lack of concern around the serious impact of covid-19 and its implications for vulnerable people. He asked whether there should be new campaigning to remind people of the dangers of covid-19. Further, he wondered what learning or key lessons could be learnt for independent social care around CDIF or LMRC.

Vic responded that she did not have much information around social care as the IPC does not share the RCA’s. This was something that she wanted to develop so that there was oversight in future. Regarding covid-19, she spoke of a large summer wave which had not appeared in the data as the data is now restricted and unavailable. In terms of the seriousness of covid-19, she was still concerned and continued to do work on indoor air quality and was soon to start a new indoor air quality monitoring pilot. This would hopefully produce the evidence needed to push indoor air quality is care homes. There was also a change in risk appetite towards flu where there were unhelpful comparisons to covid-19. Therefore, this was one reason behind the new seasonal health post which could look at the messaging on this topic. Finally, she emphasised that in addition to the acute infection point, long covid presented increased risk towards cardiovascular health, diseases, and diabetes.

Richard Webb was pleased that such valuable work was receiving attention. He thought it was important that health protection was recognised and received development due to all the reasons mentioned in the presentation. He commented that immunisation and screening was a challenge given the various views around vaccines and asked if there were particular issues in terms of welcoming people from abroad who had a different experience of routine screening and vaccinations. Vic confirmed that there was a comprehensive immigrant health guide on the intranet which breaks down the requirements per country and what should be offered on arrival to the UK. She expanded on an issue around tuberculosis cases being linked to people coming from abroad. Therefore, the team had reinstated screening since Christmas and consequently recorded more cases. Regarding attitudes to vaccinations, she reported that the take up from staff in care homes was poor, at 11-12%. Although a national issue, they continued to work on ways to increase vaccination uptake in staff.

Janet Sanderson, portfolio holder for Children and Families echoed concerns around immunisation, particularly towards children. She said that immunisations for looked after children had improved for the third consecutive year but that the number who were up to date was 74%, 20% lower than that of the non-looked after children. She also made the point that the individual who refuses the vaccine is not always the one impacted and provided a personal anecdote of its dangers and effects on others.

Vic agreed and pointed towards home educated children as another group to target. The school immunisation service had done work in this area so that those not in an educational setting could access vaccinations. Vaccinations UK had aimed to increase uptake through using Gillick competence as a means to allow under 16’s to consent to their own treatment, as well as contacting parents on the day of vaccination to gain consent if not yet given.

Building off this, Sally added that she had had conversations with parents who were vaccine hesitant and warned of an emerging theme of vaccine fatigue. Further, she shared that there was a new programme for respiratory RSV virus coming in November which would target people aged over 75, and pregnant women. A public health communications campaign would be held to raise awareness of RSV as the public was not familiar with the risks.

The Chair asked if long-covid was still an issue and whether cases of covid were as serious as they were early in the pandemic. Sally responded that people were still suffering from long covid but possibly at a lower rate due to the reduction in cases. She added that covid was still a serious disease, and there were misconceptions that future recurrent infections would be milder. Ashley asked where the public could receive vaccinations due to uncertainty on who provided them.

Nancy responded that the Spring Covid-19 Vaccination Campaign had concluded which found that there were fewer people eligible for the free vaccine. There were also issues around vaccine storage in hospitals, especially at Erdale Hospital. Regarding access to vaccines she stated they were currently searching for partners who would deliver the vaccines, but that around 75% of the delivery of across Bradford and Craven would be done through community pharmacists.