HEALTH PROTECTION BOARD
Minutes of the meeting held on 07.11.16
at 09.30-11.30 in CR5, Civic Suite
Present: Sangeeta, Donna, Bharat, Lynn, Debbie, Michael, Mary, Mark, Nikki Bennett and Natalie Foley
Apologies: Stephen and Clement
2. / Notes/Actions of last meeting 09.05.16
The notes were agreed as accurate.
3. / Health Protection Updates
Communicable Diseases and Port Health: Bharat discussed his report which was circulated to the group.
Recent incidents (Solihull): There have been eleven incidents reported in Solihull since the last Health Protection Board report was produced for the meeting held on 12 September 2016. These included:
- two cases of Legionnaires’ disease notified two months apart with possible links to a supermarket in Solihull, one also with foreign travel history (more likely source); EH and HSE report no concerns with supermarket or cooling towers in the area
- two cases of Giardia with possible links to a swimming pool in Solihull; EH reports no concerns regarding pool
- a possible TB exposure at a workplace
- a decontamination issue at a private hospital
- seven outbreaks of suspected/confirmed norovirus (4 care homes, 1 hospital, 1 school and 1 nursery)
Changes to the Port Medical Inspector functions in England. Bharat confirmed that PHE no longer commission the services from a local GP provider, but work directly with a telephone support service provided by Heathrow airport. PHE have been allocated the continued use of a room at the airport.
ACTION: Bharat confirmed that PHE are re-starting the daily outbreak reports this week. Anyone who wants to be included who was not on the previous circulation list to send Bharat an email.
Bharat updated the group on the reorganisation within PHE. There is now a single acute unit in Birmingham with 7/8 nurses answering calls from all over the West Midlands. The nurses are aiming to deal with the calls there and then. If there is an outbreak it gets passed onto the patch teams. There is no change for us only PHE. For out of hours there is one consultant for the West Midlands.
Bharat discussed the recent PHE desktop exercise. The topic of the exercise was a new strain of flu and the reason behind the exercise was the winter season coming and testing out the new escalation levels. The date of the new strain was the 01.09.16 and the exercise took place 7 weeks after. We tested plans, treatment, responses and communication internally. A debrief of the exercise is yet to happen. There will be an updated PHE plan following the exercise.
Sexual Health:
Current situation summary: Umbrella has completed their first full year of service delivery under the new contractual arrangements. Their end of year summary report is due in November after submission of Q4 data. Donna/Ian to include on the agenda for the March meeting. This is starting to include data for services delivered through sub-contractors and Partners as contracts are agreed. Public Health held two further update events in September and October for clinicians in Primary Care who fit Long Acting Reversible Contraceptives (LARC) contracted by SMBC, which were attended by 14 clinicians and evaluated well.
· Public Health also held update training on Emergency Hormonal Contraception for Pharmacists providing under the Solihull scheme which was attended by 35 Pharmacists.
· National HIV Testing Week (NHTW) will start on Saturday 19 November 2016, building on the It Starts With Me theme of previous years to promote HIV testing to gay and bisexual men and black African men and women, who are at higher risk of infection. http://www.hivpreventionengland.org.uk/2016/06/29/national-hiv-testing-week-2016/
Food Liaison Group:
Current situation summary:
Healthier Takeaways Project.
Officers are now working with 15 fish and chip shops all of which have a food hygiene rating of 3 or more.
The initial intervention was to provide fish and chip shop owners with free salt shakers (with fewer holes than conventional designs) in a bid to reduce the amount of salt shaken onto chips. Interim feedback has been encouraging, food business owners noticing a reduction in the amount of salt they use (and the associated costs) and for the most part, customers are not noticing the difference in the taste of their chips (health by stealth).
In addition, initial information gathered from the premises visited indicated that the sauces used were manufactured and supplied by two major companies. Officers made contact with both of the companies and discussed the composition of the sauces they supply. Following this, one of the manufacturers has provided samples of a low fat mayonnaise for traders to try, which officers are in the process of distributing. In addition to the samples, officers are distributing bottles of water, for traders to offer as part of a meal deal instead of drinks high in sugar. Data will be collected on the success of these interventions for analysis at a later date.
Tattoo Project
50% of registered tattoo premises in the borough have now been visited and assessed against an infection control toolkit. Where necessary the team have worked with businesses to ensure they meet the required standards to keep both staff and customers safe. The remaining premises will be audited when time becomes available. Resource has become limited due to a freeze on the recruitment to the vacant health & safety officer post and the on going investigation of a serious accident, the completion date of which is currently unknown.
As mentioned in the last report, with the increased use of lasers in tattoo premises, basic laser use will be included and assessed during project visits. In the meantime, all relevant premises have now been sent information about safe laser use.
Pseudomonas aeruginosa Infection
Letters have been sent to all relevant premises in Solihull where cosmetic piercing is carried out warning them of an unsafe cleansing spray provided by piercing studios for aftercare use. The product has been linked to cases of Pseudomonas aeruginosa infection, (some of which have been in the West Midlands).
Night Time Economy Project - Licensing
The Licensing team have organised a series of events focussing on activity in the Night Time Economy in Solihull Town Centre. These events involve a number of partners and include various activities such as; interventions; engagement; awareness raising and the provision of advice and support. A Licensing blog details activity from each of the events and provides some statistical and anecdotal evidence. However, to create a more scientific method of measuring the value of the events and the work involved, the Licensing team is working with members of the Public Health and Observatory teams to pull objective evidence together. It is hoped that this evidence will demonstrate that the work is having a positive effect on the health, safety and wellbeing of visitors to Solihull’s night time economy.
Screening and Immunisation: Mary gave a brief update re the internal restructure. Annette Wood has now left for a new role. Discussion around how immunisations queries are all done via email now. Bharat queried what happens when a GP is with a parent and child and have a query. Mary to look into and update at the next meeting or via email beforehand. Mary to circulate the immunisation email address . The first lot of flu data is due towards the end of the month and a report will come to the next meeting. Mary confirmed that HEFT midwifery will be giving vaccines. A detailed report will come to the next meeting. Donna to add Nicola Benge to the circulation list for this group. Mary confirmed that Ash and Mary are to continue to attend the Flu group.
Emergency Planning:
Current situation summary:
Cold Weather Planning: The Cold Weather Plan has been updated and sent out for final comments prior to its launch on 1st November. The Stay Well This Winter Campaign was launched mid-October with members of the CSW Team handing out Winter Warmth Kits to members of the public in Solihull Library. The CSW Team are also carrying out an online media campaign which offers daily tips, advice and general information on how to prepare for and stay safe during the winter.
Pandemic Flu Plan: Members of the pandemic flu group have been identified. In the meantime individual meetings have been arranged with colleagues from various directorates to review and update the section relevant to their directorates within the plan.
Recovery Planning: Work is progressing on recovery planning within the Solihull borough. There will need to be liaison with health colleagues across the economy in relation to how they can contribute to recovery after an incident.
Solihull Flood Plan: The Solihull multi-agency flood plan has been reviewed and updated following consultation with colleagues from police, fire, ambulance service and the highways agency.
Solihull CCG – Core Standards Assurance: The inclusion of the business continuity as the ‘deep dive’ questions to support the review of business continuity planning for the 2016/17 EPRR Core Standards Assurance there is commitment to ensure Business Continuity Plans and procedures are in place within Solihull CCG. As a result the existing CCG business continuities plans have been reviewed. Developments include a general refinement of the process, in part through the introduction of a new and improved business continuity template, improved BC communication plan and development of key local external partner’s business continuity.
This improvement programme will in turn, address any gaps in business continuity planning and ensure a more consistent approach across the CCG and Solihull. To support this activity, awareness training will be arranged, targeted to all relevant officers, together with positive business continuity planning support, delivered by the CSW Resilience Team. This development will ensure BC is an integral part of the future EPRR strategy and integrated across the CCG.
Training and Exercising: An incident on the M6 motorway in February caused it to close for 4 hours causing major disruption, stranded motorists on the highway and also had a big economic impact. The report from the Police and Crime Commissioners highlighted 14 recommendations, 6 of which related directly to local authorities. As a result of this enquiry a desktop exercise was carried out with the highways department and the resilience team. The exercise has already been carried out in Warwickshire and will be repeated in Coventry. The learning from it will be incorporated into a report.
Other training carried out by the team include:
· Control room support staff training
· Loggist training
· Rest Centre Training
· Tactical Team meeting during which an update on counter terrorism and presentation on recovery was given to members
· Tactical Commander training
Infection Control:
Debbie stated that Jill Harries has now moved on. Lot of work around the CCG’s amalgamating. It has been agreed to recruit to Jill’s post. Natalie Foley will be with us until the end of January. The post will go to national advert this week with commencement of the 01.02.17. There will be no interruption to the service. Natalie will be working three days a week and will just be covering the Solihull SLA. Sangeeta and Debbie to have a discussion outside the meeting re the SLA for 2017/18 and what can be delivered given the cost pressures.
Current position, improvements and good practice
Homes audited in Q3: A total of 8 homes were audited this quarter.
Ardenlea Grove 80% - A re-visit will be scheduled for this home as the home has triggered the one month re-call for audit.
Longmore – awaiting report completion
Olton Grange – awaiting report completion
Outbreaks
Two homes are currently dealing with vomiting and diarrhoea outbreak (suspected Norovirus) both homes remain open with precautions in place. Regular communication between home managers and CCG continues to update on situation and offer advice.
St Bernards – First case within the home 27/10/2016 with 14 residents (1 repeated) and 23 staff infected, currently (01/11/16) 3 staff and 3 residents are symptomatic, no samples sent for confirmation but suspected Norovirus.
Silverbirches – First case within the home 27/10/2016 with 17 residents infected and 1 staff member at present (01/11/16). A potential index case of a gentleman attending for respite was symptomatic with diarrhoea upon arrival to the home. This gentleman was also symptomatic with diarrhoea on a previous admission for respite from Heartlands Hospital earlier in the year, in addition to this he is on long term antibiotics for UTI and advised a stool sample should be sent for elimination of potential C.diff. Other symptomatic residents have a mixture of vomiting and diarrhoea or diarrhoea only. It has been advised to continue regular cleaning with a sporicidal disinfectant (chlorine releasing) and deep cleans of all rooms are completed upon recovery of symptomatic residents.
Planned events:
· Infection prevention and control training booked for St Michaels and Longmore Nursing Home.
· Arrange a drop in IPC training event for staff at Friars Gate.
· Audits booked for 7 homes with a target of all SMBC large homes within Solihull audited in Q4 with follow up visits where required.
7. / Flu Group Update
Sangeeta informed the group that the flu group continue to meet monthly. The focus has been around myth busters and communication.
Sharon to bring the pandemic flu plan to the March meeting.
8. / Items for Forward Plan
13.02.17: To be used for the scenario desktop exercise. Sharon/Michael to work with Sangeeta and Bharat on the topic for the exercise.
9. / Any Other Business
None
10. / Date and Time of Next Meeting
Donna to arrange future meetings with the next one being in March and then quarterly.
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