Northamptonshire COVID-19 Outbreak Prevention and Control Plan · The Care Home Resilience Plan...
Transcript of Northamptonshire COVID-19 Outbreak Prevention and Control Plan · The Care Home Resilience Plan...
Northamptonshire COVID-19 Outbreak Prevention and Control Plan
This headline summary outlines our objectives as a Northamptonshire system in preventing and controlling COVID-19 outbreaks.
• It provides an overview of the roles and responsibilities of key partners, identifying where there are interfaces with key stakeholders and the flow of information.
• The plan will address both prevention as well as identification and management of outbreaks.
• It also outlines the route for identification of cases via the NHS “test and trace system” and key processes to be followed as part of this outbreak response.
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COVID-19 Health Protection Board• Provides health protection expertise.• Leads development of the Outbreak
Prevention and Control Plan.• Assures system of delivery of the plan.• Makes strategic decisions about the outbreak
response.
Local Oversight and Engagement Board• Provides political oversight of the plan.• Engages with the public on elements of the
plan.
Strategic Coordination Group (SCG) • Mobilises the multi-agency resources required
to deliver the plan.
GovernanceCOVID-19
Health Protection
Board
Local Oversight and Engagement
Board
Strategic Coordination Group (LRF)
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Engagement
• We will speak with, listen to and understand the concerns of local communities.
• We will ensure vulnerable groups and marginalised communities are heard.
• We will use existing channels as well as digital and social media to reach out and engage.
Proactive Communications
• We will build on the LRF’s existing #NorthantsTogetherbranding.
• We will use local intelligence alongside published literature on behavioural insights to shape local messaging.
Reactive Communications
• We will work closely with the Public Health England regional communications team as well as key local stakeholders to keep residents informed.
Communication and Engagement
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Dimensions of primary prevention measures
1. Environmental and structural measuresSupporting physical measures in place to supportsocial distancing in public spaces and workplaces.
2. Advice, guidance and trainingSupporting measures through tailored advice and guidance and local training support.
3. Resources and staffing measuresTo ensure that settings (particularly high risk settings including care homes) have sufficient resources to implement infection control measures.
Population-level measures
Targeted prevention in settings
Targeted prevention – vulnerable individuals
Rapid testing and contact
tracing
Outbreak management
Tiered Prevention
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• Logistics and distribution hub – both rail freight (at the Daventry International Rail Freight Terminal DIRFT) and road distribution with the M1 traversing the county.
• Large rural areas with dispersed pockets of employment and large manufacturing and industrial centres primarily in Northampton and Corby with still some shoe industry including in Rushden/Kettering.
• Though we have no abattoirs in the county there are a number of meat cutting plants and cold stores.
• Silverstone is a significant sporting venue with Northampton Town Football Club currently playing ‘closed doors’ and The Saints Rugby and County Cricket Club planning a similar approach.
• The county also has a number of country houses, country parks and a small theme park.
Northamptonshire Context
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Understanding and Managing Risk
Why identify high risk settings?1. To be able to target proactive prevention activity including advice and guidance.2. For surveillance/mapping – so that we can identify patterns early and act quickly. 3. To have access to contact details out of hours to be able to gather information if any reports of
possible/suspected cases or outbreak.
What support is given to high-risk settings around prevention?1. Care homes – offered infection control training and regular guidance updates.2. Schools – offered advice and guidance updates via the NCC Education Cell.3. Businesses and workplaces – offered guidance and advice from Northamptonshire Environmental
Health Officers and the local Safer Public Spaces Taskforce.
The plan identifies a number of potentially high-risk settings and vulnerable populations. Settings are considered high risk if outbreaks are highly likely to occur or if the consequences of an outbreak in the setting would be significant.
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Carehomes
Schools Sharedaccommodation
Prisons and otherdetention
Healthcare
settings
Industrial and office settings
Public open spaces
240 with an additional 29
supported living facilities
326 mainstream,
15 special schools, 10
independent schools plus 5 boarding
schools
Homeless shelters largely closed but 2
hotels running. Multiple HMOs
(houses of multiple occupancy).
University Halls of Residence
3 detention facilities at border of
county
2 districtgeneral
hospitals,14 other hospital
settings, 69 GP practices
54 food processing and meat packing
10 train stations, bus
and coach stations. List of
tourist attractions
being compiled
High Risk Settings
Access to Testing
Rapid testing is accessible
for all, including vulnerable
groups.
Targeted Prevention
Appropriate advice on
infection prevention is
accessible to all.
Outbreak Management
Outbreak response
recognises specific needs and
context of vulnerable groups.
We can consider ‘vulnerability’ in terms of:• People who are clinically at higher risk of more serious illness and poor health outcomes e.g.
black and minority ethnic communities, people with long term conditions, people who are “shielding”.
• People who are socially isolated or excluded and marginalised e.g. deprived communities,people for whom English is not their first language, traveller communities, people who are homeless, carers, etc. * to note that there is significant overlap in these categories
We want to ensure:
Vulnerable Communities
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The Safer Public Spaces Task Force aims to
promote COVID-secure workplaces and public
places as well as additional walking and cycling
infrastructure across Northamptonshire. This
will be delivered via six work streams led by
multi agency partners:
1. Public Transport2. Active Travel3. Retail and Town Centres4. Schools and educational facilities5. COVID-Secure Workplaces6. Communications
Targeted PreventionThe Care Home Resilience Plan outlines
actions that will be taken across the tiers of
prevention to support care homes in their
resilience including support around:
1. Workforce Capacity
2. Access to personal protective equipment
(PPE)
3. Access to IPC training and advice
4. Access to clinical support
This action will be supported financially by the
National Care Home Support Package
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The UK Government Testing Strategy has 5 pillars, of
which two are particularly relevant to the local
contact tracing and outbreak control plan, namely:
Pillar 1. NHS swab testing – this focuses primarily on
antigen testing for key workers and outbreak
response and in Northamptonshire is coordinated
via Northampton General Hospital and their
partnership with commercial laboratories
Pillar 2. Nationally coordinated commercial swab
testing (antigen testing) at Regional Test Centres
(RTCs), Mobile Testing Units (MTUs) and home self-
test kits) – this provision is for all members of the
public including those in the Pillar 1 category.
Coordination of Capacity
As well as laboratory capacity, swabbing staff
capacity will be expanded in wider workforce to
support setting-specific swabbing e.g. NASS staff
swabbing care home admissions.
Prioritisation
National blanket-testing capacity in care hone will
be prioritised according to local risk assessment.
Escalation
Thresholds for escalating to request additional
capacity (both from within and outside of the local
system) will be clarified.
The above will be coordinated by the Outbreak
Prevention and Control Hub
Testing
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LOCAL Current staffing capacity Current lab capacity
In-hospital testing N/A
NGH Lab 700 swabs/day
NGH/KGH drive-through
Max 500 tests/day(KGH max capacity 200 NGH max capacity 300)
Infection Prevention and Control swabbing team
2 core team (RNs: registerednurses) with 3 short term RNsupport and 10 volunteers
Mobile Testing Units Max 300 tests/day N/A
REGIONAL/NATIONAL Capacity
Regional Testing Centres Not limited by local factors
Home Testing Kits Not limited by local factors
How we scale up additional capacity in response to an outbreak/incident will be dependent on the setting and population:• Care homes/children will be
managed by mobilising community Infection Prevention Control support staff (as well as potentially other nursing staff e.g. 0-19 team)
• Other settings can be managed with self-swabbing via established drive-through sites or Mobile Testing Units
Testing Capacity
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We will amplify messaging
on accessing rapid testing
for anyone with symptoms
of COVID-19.
People who have
symptoms will be
encouraged to choose from
a range of testing options
with a strong emphasis on
good communication with
employers on test results.
Individual Testing
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Initial focus on testing of
symptomatic individuals only
has shifted towards whole-
home testing. This has been
supported by the availability of
Pillar 2 home testing kits
available on request via the
Care Home Portal.
The care home cell and
Infection Prevention and
Control team work with national
colleagues to prioritise blanket-
testing of care homes according
to local risk assessment and
known needs.
Care Home Testing
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• The 3-Tiered National Test and Trace System will support contact tracing for all positive cases identified –regardless of the testing route.
• Any cases associated with contact in a high risk setting or community will be escalated to Tier 1 of the system coordinated by Public Heath England (PHE) regional Health Protection Team.
• In complex cases with multiple contacts in a high risk setting, or in a context where local insight is required, the Northamptonshire local Health Protection Team will work together with PHE, or if a hospital-related case, with the NHS Trust Infection Control Team.
• This arrangement is underpinned by the East Midlands Contact Tracing Standard Operating Procedure (SOP).
Contact Tracing
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• Outbreaks are defined as two or more laboratory-confirmed cases of COVID-19 connected by time and place.
• In all outbreaks, the initial risk assessment will be led by PHE.
• The interface between the regional PHE Health Protection Team and the local NCC Health Protection Team will be by:• Daily briefings/situational reports (sitreps)
• Weekly detailed teleconference between the local team and PHE EM
• Notification of new outbreaks to [email protected] [email protected]
Operational Delivery/ Command and Control Structure
COVID-19 Outbreak Prevention
and Control Hub
Daily OPCH strategic lead
SCC IPC Team
Intelligence Capacity -
STAC
Logistics and testing
cell
Outbreak Management
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Care Home Outbreaks - Overview
While all outbreaks will follow the same core processes and procedures, actions required from certain parts of the local outbreak response will vary according to setting.
For example in care homes the SCC Community Infection Prevention and Control Team will lead on swabbing, rather than require staff to swab residents –allowing both rapid testing and risk assessment of the setting.
The weekly Care Home Cell meeting will cover both prioritisation of proactive support as well as reviewing current outbreaks and any trends in settings declaring outbreaks.
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School Outbreaks - Overview
While all outbreaks will follow the same core processes and procedures, actions required from certain parts of the local outbreak response will vary according to setting.
For example in schools the NCC Education Cell are likely to be involved early on as they are notified of suspected single cases.
Testing in these settings is likely to be organised by staff and parents themselves but in cases of mass wider testing the IPC team may support.
There also may be a role for the IPC Team in reviewing infection prevention and control procedures.
While developing detailed protocols for local response to all categories of high risk setting is not practical, there are a number of key specific situations that will need consideration, namely:
NHS SettingsNHS Trust outbreaks will primarily be managed by Trust Infection Prevention and Control (IPC) Teams and Directors of Infection Prevention and Control (DIPCs) with support if required from the Community IPC Team and oversight from local health protection team.
Prisons/Detention CentresResponse in these settings is being led by the relevant healthcare provider.
Businesses and other workplacesProtocols for local response are a collaboration between the local health protection team, environmental health officers and regional HSE and FSA colleagues.
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Outbreak and complex contact tracing notifications
Midlands testing SitRep and contact tracing data overview
Exceedance Reports
Pillar 1 testing data
Local soft intelligence
Outbreak Prevention and Control
Hub – Intelligence Cell
Joint
Biosecurity
Centre
(JBC)
East Midlands
Health Protection
Team
National and Regional Local
Proactive
risk-assessments
Health Protection
Board Intelligence
Pack
Outbreak LogSituation and
case mapping
Information Governance• Personal Identifiable Information only shared securely
between NHS email for purposes of care/outbreak management
• All other information shared anonymised
Data Flow
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