Nottingham City sets out plan for managing coronavirus outbreaks

A plan for how future outbreaks of coronavirus will be managed and controlled in Nottingham City has been published.

The Local Outbreak Control Plan sets out the framework for how Nottingham City Council will work with partners, businesses and citizens to contain the spread of the virus, working with the NHS Test and Trace service.

Directors of Public Health at local councils across England have been asked by the Government to lead and manage the risk of potential future outbreaks of coronavirus at a local level. This includes a particular focus on reducing outbreaks in places such as schools, care homes, prisons and factories.

Nottingham City Council is leading the plan in partnership with Nottinghamshire County Council, local NHS organisations, Public Health England, the Nottingham and Nottinghamshire Integrated Care System and the Nottinghamshire Local Resilience Forum.

Alison Challenger, Director of Public Health for Nottingham City, said: “The Local Outbreak Control Plan provides a solid framework for how we can work with partners to manage future outbreaks. It gives us the power to make the best decisions for our local citizens based on our local knowledge and expertise. We know that every incident will be different and that we will have to assess outbreaks on a case-by-case basis, but having a plan will allow us to respond quickly in a structured way.

“The plan builds on existing health protection plans already in place between councils and the NHS locally. We have strong relationships and ways of working already in place and these have only been strengthened further during the Covid-19 outbreak. We will continue to develop this over coming weeks and months as we plan for specific scenarios in different areas of the city in the same way that we prepare for all emergencies.”

A joint Health Protection Board led by the two Directors of Public Health from the City and County councils, with oversight by two member-led Engagement Boards made up of elected councillors, will lead the Local Outbreak Control Plans in Nottingham and Nottinghamshire. A subgroup will meet daily look at all of the data and local intelligence so that any emerging issues are picked up and responded to right away.

Nottingham and Nottinghamshire received a share of the Government’s £300m fund to implement the plans.

The funding will support major communications activity to inform the public about effective handwashing, social distance and face-coverings, or specific campaigns where needed to contain the virus locally. The funds will also help to establish stronger test and trace systems, data management and emergency response efforts to help respond to outbreaks.

The Plan builds on national Test and Trace arrangements. Local testing arrangements will ensure a fast and accessible response to support the management of outbreaks, including in high-risk settings or specific geographical areas, which require more bespoke arrangements.

Targeted information campaigns to help prevent future outbreaks are also planned, with a focus on complex and high-risk groups such as Black, Asian and Ethnic Minority, men, older groups and vulnerable people who live alone.

Cllr Sally Longford, Deputy Leader of Nottingham City Council and Chair of the Nottingham City Engagement Board that will oversee the planning, said: “Preventing the spread of Covid-19 will continue to be a team effort. I’ve been proud of the way that Nottingham’s communities, partners and businesses have worked together during the pandemic.

“So far Nottingham has not seen the levels of Covid-19 experienced in other parts of the country. That is down to the way everyone has played their part in helping to manage the outbreak by staying home, staying safe, hand-hygiene and observing social distancing. We need everyone to continue to help us with this to keep our city and its people safe.

“The Local Outbreak Control Plan isn’t simply about health data but about receiving local information on the ground. We will need partners, businesses, community leaders and the public to work with us and help provide information about any outbreaks so we can respond as quickly as possible.”

Cllr David Mellen, Leader of Nottingham City Council, said: “The Local Outbreak Control Plan is about how we respond to a rise in Covid-19 cases – but prevention still remains a priority and the best way of stopping the spread. I would like to thank everyone in Nottingham who has done their bit to stop the spread. We can clearly all continue to make a difference by through hand-washing with soap and water, wearing face coverings on public transport and maintaining social distancing wherever possible.

“Nottingham residents also need to continue to follow national guidance on staying at home if symptomatic or in a household which contains a symptomatic person or people who are clinically vulnerable and continuing to shield.”

The Nottingham City Local Outbreak Control Plan has been submitted to Government and is published here:
https://www.nottinghamcity.gov.uk/coronavirus-covid-19/nottingham-city-local-outbreak-control-plan/ 

The Local Outbreak Control Plan is centred around seven themes:

  1. Planning for local outbreaks in care homes and schools (e.g. defining monitoring arrangements, identifying potential scenarios and planning the required response).
  2. Identifying and planning how to manage other high-risk places, locations and communities of interest including sheltered housing, dormitories for migrant workers, transport access points (e.g. ports, airports), detained settings, rough sleepers etc (e.g. defining preventative measures and outbreak management strategies).
  3. Identifying methods for local testing to ensure a swift response that is accessible to the entire population. This could include delivering tests to isolated individuals, establishing local pop-up sites or hosting mobile testing units at high-risk locations (e.g. defining how to prioritise and manage deployment).
  4. Assessing local and regional contact tracing and infection control capability in complex settings (e.g. Tier 1b) and the need for mutual aid (e.g. identifying specific local complex communities of interest and settings, developing assumptions to estimate demand, developing options to scale capacity if needed).
  5. Integrating national and local data and scenario planning through the Joint Biosecurity Centre Playbook (e.g. data management planning including data security, data requirements including NHS linkages).
  6. Supporting vulnerable local people to get help to self-isolate (e.g. encouraging neighbours to offer support, identifying relevant community groups, planning how to co-ordinate and deploy) and ensuring services meet the needs of diverse communities.
  7. Establishing governance structures led by COVID-19 Health Protection Boards and supported by existing Gold command forums and a new member-led Board to communicate with the general public.

There will be two key Boards:

  • The Nottingham COVID-19 Local Outbreak Engagement Board. This is a public-facing board led by Council members and chaired by the Deputy Leader of the City Council, which will provide effective public oversight and communication of the COVID-19 Local Outbreak Control Plan.
  • The Nottingham and Nottinghamshire COVID-19 Health Protection Board. This officer group will oversee the operational work being undertaken by the Outbreak Control Cell, evaluate effectiveness of the Plan, and identify priorities for strengthening preparedness based on trends and horizon scanning. 

The Local Outbreak Control Plan will set out the arrangements, including national, regional and local roles and responsibilities, for monitoring and reporting available testing and tracing data. Integrating a range of data will allow us to continually monitor the frequency & distribution of COVID-19 so that potential outbreaks can be identified early. Existing data sharing and reporting arrangements will be used, extending where required. This will include the necessary information governance protocols and arrangements.

Triggering an Outbreak Response

A regular Outbreak Cell, bringing together Public Health England, local authorities and others will monitor and review the available data and local intelligence to determine whether there are any emerging issues requiring a response. If a suspected or confirmed COVID-19 outbreak in any setting or community is identified an Incident Management Group will be stood up.

An outbreak is defined as a greater than expected occurrence of an infection compared with the usual background rate for that particular place and time.

The setting specific Incident Management Plans detail the roles and responsibilities, and processes that will be followed in the event of an identified outbreak.

Testing

The Plan builds on national Test and Trace arrangements.

Local testing arrangements will ensure a fast and accessible response to support the management of outbreaks, including in high-risk settings or specific geographical areas, which require more bespoke arrangements.

The Local Outbreak Control Plan will cover the proposed response to emerging requirements e.g. rapid deployment of mobile testing units to assist in the management of a local outbreak.

Contact Tracing

The national NHS Test and Trace service has been set up to undertake contact tracing for COVID-19.

Contact tracing may identify outbreaks where additional support to control the spread of COVID-19 at a local level is needed.

The Local Outbreak Control Plan will cover the proposed response to escalation of complex cases   e.g. address contact tracing in groups of individuals without fixed addresses.

High Risk Specific Settings, People and Places

National guidance specifically identifies care homes and schools as requiring outbreak management plans. However, it is for Local Authorities and partners to identify other high-risk places, locations and communities of interest in the main Local Outbreak Control Plan.

The following additional complex/high-risk settings have been identified:

  • Higher education / universities
  • Prisons and secure settings
  • Leisure settings
  • Rough sleeping, temporary housing and socially vulnerable individuals
  • Places of worship
  • Hospitals
  • Houses in Multiple Occupation (HMOs)
  • Public realm and transport
  • High risk workplaces

Detailed summaries of separate incident management plans have been developed for all of these.

Mobilisation

The Plan sets out the resources (financial and workforce) available for implementation and the approach to PPE.

Quality assurance arrangements including Plan review, updating, testing, monitoring performance and disseminating results are described.

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