Local Outbreak Plan
Director of Public Health Jonathan Gribbin explains what the Local Outbreak Plan is and how Nottinghamshire people can do their bit to help control the spread of COVID-19.
The NHS Test and Trace service was launched on 28th May 2020 as part of the government’s COVID-19 recovery strategy,
Its primary objectives are to control the COVID-19 rate of reproduction (R), reduce the spread of infection and save lives
This will help return life to as normal as possible, for as many as people as possible, in a way that is safe, protects our health and care systems and releases our economy.
Achieving these objectives requires a co-ordinated effort with local government, NHS and other relevant organisations at the centre of outbreak response
Local authorities are required to work with partners to build on existing health protection plans to put in place measures to identify and contain outbreaks and protect the public’s health. Specifically, to develop a Local Outbreak Control Plan by the end of June 2020.
National government funding of £300m is being provided to local authorities in England to support this work. Nottinghamshire County Council has been allocated £3,802,915.
Purpose of this document
The purpose of this document is to provide a summary of the main Local Outbreak Control Plan.
The Local Outbreak Control Plan sets out the arrangements for ongoing local surveillance and the actions that will be taken in response to local outbreaks should they occur.
The Local Outbreak Control Plan is a working document and will be updated regularly to reflect changes required to ensure it remains up to date and can be successfully executed during outbreaks.
Nottinghamshire County Council and Nottingham City Council are working closely together in development of local arrangements, with aligned operating procedures and shared structures where possible. This will enable efficient use of capacity and resources.
Overview and Approach
The Local Outbreak Control Plan is primarily about controlling outbreaks. However, preventing spread of the virus is still critically important to prevent localised outbreaks and to avoid a second wave of the pandemic. Nottinghamshire residents need to continue to follow national guidance on staying at home if symptomatic or in a household which contains a symptomatic person, social distancing, washing hands, and using face coverings as required in public places. A Communications Plan will address how to encourage the public to follow this guidance.
In Nottinghamshire this Local Outbreak Control Plan builds on existing health protection plans already in place between Nottinghamshire County Council (NCC), Public Health England (PHE) East Midlands (EM), the 7 Nottinghamshire District and Borough Council Environmental Health Teams, Nottingham and Nottinghamshire Integrated Care System (ICS) Bassetlaw ICP, and the Nottinghamshire Local Resilience Forum (LRF).
The Department of Health and Social Care (DHSC) has advised that the Local Outbreak Control Plan is centred around 7 themes:
- Planning for local outbreaks in care homes and schools (e.g. defining monitoring arrangements, identifying potential scenarios and planning the required response).
- Identifying and planning how to manage other high-risk and/or complex places, locations and communities of interest.
- 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.
- Assessing local and regional contact tracing and infection control capability in complex settings 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).
- 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).
- 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.
- 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.
The Local Outbreak Control Plan sets out the current legal context and specific legislation to assist in the control of outbreaks.
Agreed East Midlands processes will be followed for the exercising of the legal powers, with consultation with key stakeholders and appropriate authorisations sought.
Local Governance and Boards
There will be two key Boards:
- The Nottinghamshire COVID-19 Local Outbreak Engagement Board. This is a public-facing board led by Council members and chaired by the Leader of the County 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.
Communications and Engagement
A communications plan will focus on both proactive and reactive communications.
- Proactive communications including information and messaging to the public to amplify and clarify national messages, promote adherence to guidance and support behaviours to reduce the spread of COVID-19.
- Reactive communications in the event of an outbreak which include tailored messaging and communication with hard-to-reach groups.
Data and Intelligence
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.
The LRF Data Cell will co-ordinate the work of analysts, use a range of methods to estimate R, and monitor excess all-cause mortality.
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.
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 complex 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.
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.
Supporting Vulnerable People
The Plan outlines the arrangements in place to support vulnerable people isolating in their own homes, or who are in a vulnerable group in another setting, and who have no other means of support.
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 Local Outbreak Control Plan.
The following additional high-risk and/or complex settings have been identified:
- Higher education / universities
- Prisons and secure settings
- Leisure settings
- Rough sleeping, temporarily housed and socially vulnerable individuals
- Places of worship
- Houses in Multiple Occupation (HMOs)
- Public realm and transport
- High risk workplaces
Detailed summaries of separate incident management plans have been developed for these.
The Plan sets out the approach to dealing with outbreaks in care homes by
- Ensuring the establishment of effective multi-agency responses
- Ensuring effective communication across the partnership
- Assessing the impact on, and the need to support, business and communities, both in the acute and recovery phases of the outbreak
Schools and other educational settings
The Plan sets out the approach to dealing with outbreaks in educational settings including schools, early years settings and nurseries, by
- Enabling the system to respond to outbreaks of Covid-19 in education and childcare settings in a timely way
- Ensuring the incident management plan is produced for education and childcare settings and that it is tailored to the local context & the needs of local communities.
- Sharing good practice and build on existing plans and skills within education and childcare settings.
- Implementing engagement and communications activity in line with the overall communications plan.
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.