There were no apologies for absence

There were no declarations of Interest.

RESLOVED: That the minutes of the previous meeting held on 14 December 2021 were agreed as an accurate record.

The Director for Public Health proposed that the sub-group stood down as a Sub-group.and recommended that a Task and Finish group be formed, so that if the need arises again the Sub-group would be able to restart.

The Director for Public Health stated that the report set out three proposals.

Option 1 supported that the Health and Wellbeing Board Community Sub-Group  holds its’ last meeting today as the restrictions are relaxed.

Option 2 The HWBB Community Sub-Group continued to meet for six months to be reviewed in September 2022.

Option 3 The HWBB Community Sub-Group would take on specifics including therapeutics and focus on vaccination equity. The proposal is in line with the borough resilience forum which is a statutory forum. The forum will go back to regular business

In response to questions from members if the sub-group must go through a formal process to be reformed, The Director for Public Health confirmed that this would have to go via the Health and Wellbeing Board formally.

The Chair confirmed that this item was on the agenda for discussion at the next HWBB meeting.

RESOLVED:

A. That the Sub-Group considered the future Options set out in point 4, and agreed Option 3, for 1st March to be our final meeting and to stand down the Subgroup.

 B. That members of the Subgroup remained ready to be reinstated as a task and finish group, if and when considered necessary and requested by the Health and Wellbeing Board.

Vaccination Programme

The Consultant in Public Health and Vaccination Equity Service Manager Equity presented an update.

The slides from this presentation are attached to these minutes

It was reported that the aim was to achieve vaccination equity for all Merton residents. The slides showed four key enablement’s.  This would ensure anything that is done is based on up-to date data.

·         Phase 1 was started in 2021 cohorts 9

·         Phase 2 moved on to vaccinate over 18s’

·         Phase 3 was to provide the majority of boosters to over 18s’ by March 2024

·          Phase 4 would be looking at those who were clinically vulnerable and healthy

The guidance in the slides showed data on where Merton was up to in this regard.

The Board were informed about the new regulations on compulsory vaccinations for care workers and NHS staff, which was no longer in effect.

Merton had achieved at least one dose of vaccination for over 400,000 residents however fifty two percent were not vaccinated. A lot of work had been carried out in deprived areas to try and increase vaccination rates. Merton continued to work to increase vaccine uptake.

Merton were keen to continue with the Evergreen Offer Programme (whereby anyone could receive any of their vaccinations at any stage).

Merton Connect and other partners were on board.

Weekly session with Champions and a grant has been given as funding to develop  network of champions in areas that have not taken up the vaccine. This would enable people to talk about general wellbeing and gain confidence. Clinical support will be provided. The programme would run during March 2022.

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In response to comments from the sub-group, it was reported that the unvaccinated were those that were currently hospitalised. Communication had not picked up on those that were infected and had been vaccinated.

The Chair thanked all for the comprehensive report.

Post COVID Syndrome

Long Covid

The GP Trainee – Merton presented the slides and gave an overview of

updates on estimates of managing long covid and updated the Board on emerging evidence relating to this.  The role of primary care in the management of long covid and the next steps. Some of the proposed next steps were to:

·         Continue to live with long COVID and the transitions to living with it

·         Champions raising awareness on vaccination intake

·         Participate in the review and complete NHS maturity matrix for fact finding

·         Conduct a Health and Equity Audit on Merton PCS Service, focussed on holistic responses and patients voice, identifying key actions for community case.

The GP Trainee touched on clinical definitions

·         These were reported as signs and symptoms of infections that developed before and after their onset, that are consistent with covid 19.

Anyone who had been infected with the Covid 19 virus, could have long term Covid.

Evidence of long covid

The Public Health Intelligence Specialist presented the report noting evidence and prevalence of long covid nationally and the specific demands for service. The modules based on prevalence were obtained from the ONS. The slides contained the numbers of those recorded as having long covid and their recorded genders. More data that would include information on diversity and relevance to Merton would be available in due course.

Estimated Prevalence Data

The NHS South West London CCG reported on the pathways and the slides showed the assessment services that can be signposted.  There had been a steady number of referrals, ranging from 20- 30 a week within Merton and Wandsworth.  Treatments were determined by symptoms. It was noted that there were more diagnoses than treatment reported. Patients were followed up to ensure they received the service they needed. It’s at primary care that patients present.

Staff are employed to manage cases and specialist staff are required however funding is dependent on the program.

There will follow treatment depending on what symptoms present. i.e. brain fog, fatigue.  Patients are followed up after 2 weeks to ensure needs are being met. The slide showed the role of service primary care presented.  GPs refer patients to the service to monitor.

Skilled staff are required to support the service and manage the service The Locality Executive Director Merton and Wandsworth touched on the difficulty in funding. Skilled workers are difficult to find if security is not present.

Estimate, Uncertainty on Long Covid and Challenges

The Locality Executive Director Merton and Wandsworth presented the slides on the next steps as follows:

·         Putting plans in place Long covid

·          Vaccination Champions to be used to raise awareness

·          Services including therapeutics

·         Peer reviews

·         Matrix and case finding. Including what HWBB sub- group had achieved

The Locality Executive Director Merton and Wandsworth advised to conduct health equity service to support people to access service.

HWBB Merton is functional and Merton Care together to carry on governance

Focussed on long covid and putting plans in place.  Next step to participate in  ...  view the full minutes text for item 7.