To note the report and to support efforts to tackle the spread of infection and antimicrobial resistance.

(Note: presented by Dr Lincoln Sargeant, Director of Public Health, Julia Chisnell, Consultant in Public Health and Mandy Guy, Health Protection Specialist).

The Consultant in Public Health and the Public Health Specialist provided an update on infection prevention, anti-microbial resistance and the Winter vaccination programmes as set out in the submitted report and presentation.

Infection prevention was important because it:

·                 Prevents disease;

·                 Prevents or limits spread;

·                 Saves lives;

·                 Protects the vulnerable;

·                 Saves time and money; and

·                 Keeps the NHS and Care system moving.

Combating ant-microbial resistance was important as there were approximately 1.27 million deaths globally in 2019, expected to increase to 10 million a year by 2050.  Infections last longer and were more difficult to treat and people rely on antibiotics for so many treatments.  There is a five-year rolling national action plan to help address this as well as work taking place across the region through the South West Infection Prevention and Management Strategy 2024-29.  Locally the Public Health Team are working with NHS, Environmental Health, food businesses, schools (encouraging children to be ambassadors), and also through World Anti-Microbial Resistance Awareness week 18 to 24 November 2024.

Members noted the Winter vaccination programme included the following:

·                 Flu for 65+, pregnancy, children aged 2 to 16, clinical risk groups, carers and health and care workers;

·                 Covid-19 for 65+, older care homes, health and care workers, clinical risk groups and pregnancy; and

·                 RSV (respiratory syncytial virus – this was not a live vaccine) for 75-80 years and pregnancy (28 weeks).

Members were encouraged to:

·                 recognise the importance of infection prevention, vaccines and AMR;

·                 be an ambassador with their family, friends and neighbours;

·                 become an antibiotic guardian; and

·                 promote World AMR Awareness Week.

Members heard representations from Robert Loxton (member of the public) in respect of how safe and effective the Covid-19 vaccination was and how was this communicated and promoted.

The Sub-Board asked whether the offer of free Flu vaccinations could be extended to people working in the community and voluntary sector (it was agreed that a written response would be provided on this question); how could it be made easier for the community to have vaccinations where they carry out their day to day activities; did community venues show up on the NHS App; what could be done to raise awareness about people with colds, Flu or Covid-19 not meeting vulnerable people and trying to prevent spread through contacts; and what happens to children in schools whose parents do not consent to vaccination and was there an age when a child could give consent themselves.

It was noted that the online booking system for Covid-19 was not advising that patients could book both Covid-19 and Flu at the same appointment.  The Consultant in Public Health agreed to advise the NHS of this and to request clearer messaging that you could have both vaccinations together.

In response to questions, Members were advised that there was a reducing take up of vaccinations such as Flu and Covid-19, nationally and locally, but vaccinations remained the best defence against infectious diseases.  Although a vaccination may not prevent 100% of cases, vaccinations such as Flu and Covid-19 should reduce the symptoms even if someone contracts the illness. 

In terms of promotion, one of the best ways of promoting uptake was through friends, family and people who are known and trusted voices in the local community.  Another important route was to offer opportunities for vaccination as locally as possible to where people live and work and spend their time.  The Devon-wide Flu and Covid Outreach Vaccination Team ran a programme of clinics in community settings through the season.  It was not yet known which sites would be used and Members were encouraged to advise the Consultant in Public Health of any venues where they feel would attract the most residents to come forward and get vaccinated. 

In response to a question about total death rates, it was noted that the population was increasing and therefore total deaths were increasing too, however there had not been a change in excess mortality (actual compared with expected deaths based on the local and national population) in Torbay.

Members noted that the NHS App included pharmacies but not community outreach venues because the community outreach sessions were scheduled over the season and were drop in only, with no booking required.  It was suggested that once known the community venues should be shared with the Community Partnerships so that they could help get the message out to residents and encourage more take up.

In terms of managing symptoms and spread, although there was no longer guidance about quarantining with Covid, the advice was to stay at home if unwell or with a high temperature, and practice good infection control if out and about with mild cold-like symptoms, trying to avoid contact with people who are vulnerable.  This is part of communications messaging that will be shared with staff and with the community. 

Members noted that the schools’ vaccination provider sent an electronic consent form to parents to sign and also spoke to parents face to face or by telephone to chase up consent and encourage as many children and young people as possible to receive their vaccination.  If a teenager felt they were able to consent themselves they were permitted to do so if the provider felt that they were able to give consent, using Gillick competence principles.

Resolved (unanimously):

1.       that the Adult Social Care and Health Overview and Scrutiny Sub-Board notes the contents of the submitted report and presentation and supports efforts to tackle the spread of infection and antimicrobial resistance; and

2.       that the Director of Public Health be requested to review the locations for drop in vaccinations to ensure that they are based in known community locations, particularly in areas with low take up and high needs and Councillors be encouraged to identify suitable locations in the community for vaccines and include details of where to go, including local pharmacies, and share promotions with Community Partnerships so that they can spread the word to residents.