Agenda and minutes

The Chair welcomed everyone to the meeting and led introductions.

Apologies received:

Tim Poole

Janet Rowse (Claire Chapman substitutes)

Andrea Young (Tim Keen substitutes)

Robert Wooley (Cathy Caple substitutes)

To note any declarations of interest from the Councillors.  They are asked to indicate the relevant agenda item, the nature of the interest and in particular whether it is a disclosable pecuniary interest.

Any declarations of interest made at the meeting which is not on the register of interests should be notified to the Monitoring Officer for inclusion.

None received.

Up to 10 minutes is allowed for this item

Any member of the public or Councillor may participate in Public Forum.  The detailed arrangements for so doing are set out in the Public Information Sheet at the back of this agenda.  Public Forum items should be emailed to democratic.services@bristol.gov.uk and please note that the following deadlines will apply in relation to this meeting:-

Questions - Written questions must be received 3 clear working days prior to the meeting.  For this meeting, this means that your question(s) must be received in this office at the latest by 5 pm on Friday 19 June 2020.

Petitions and Statements - Petitions and statements must be received on the working day prior to the meeting.  For this meeting this means that your submission must be received in this office at the latest by 12.00 noon on Wednesday 24 June 2020.

None received.

To agree the minutes of the previous meeting as a correct record.

The minutes of the meeting held on 27 February 2020 were agreed as a correct record.

Report to follow.

Christina Gray gave a slideshow presentation on Covid-19. This gave an overview of the position in terms of numbers and an overview of the plan. Looking at NHS lab results, there are 722 total cases since the beginning of records. The current rate of incidence is low at the moment.

·       The negative effects of Covid related restrictions on public health are now significant. The virus is still a present risk.

·       The LA needs to submit an outbreak plan by 30 June. This will be a method to identify and contain outbreaks.

·       Remember that the virus will travel through multiple locality areas. We are working with the South West region authorities to align policy. This work is also taking place in the Resilience Forum and BNSSG. We are already doing a lot of joint work but now formalising this, especially in regard to care homes.

·       There will be 2 new boards: the Covid Health Protection Committee and the Communication and Engagement board. The Engagement Board is Mayoral led, building on existing engagement work and equalities. The outbreak plan needs high levels of public trust to work. The Health Protection Committee contains a wide and diverse membership of health experts. This is to provide visible leadership and works through existing health networks such as the HWB.

·       The Covid data is held in the joint bio security system, which is nationally held. However, local authorities are important contributors as they can get live feedback from the public. Our local intelligence then feeds into the data.

·       Testing / tracing / isolating. Identify a case, identify ongoing transmission and stop the spread. Test tells us if someone is positive at the time. Testing needs to be agile and fast to deploy correctly and accessible for the public. An antibody test is being rolled out to key staff, which will tell if you have been exposed in the past. Note that we do not currently know whether this grants immunity.

·       Health protection committee is expected to account and help vulnerable people e.g. homeless.

·       There needs to be specific plans for care homes and schools. The BCC Education Director has regular meets with school heads, with lots of mutual communication, support and advice. There is a response plan in place for schools. Each school has its own needs.

·       The outbreak plan has an appendix of high risk contexts, e.g. prisons, homeless, BAME community. This is a planning process not a fixed object. We need to help vulnerable people to isolate otherwise the outbreak plan cannot work. Some will have social, welfare or economic reasons that incline them to resist isolating.

Discussion Notes:

·       Members gave their thanks to CG and the public health team for developing a comprehensive Outbreak Plan.

·       The BCC Director of Policy will be leading on managing and supporting the Engagement Board. Engagement has been going well so far, but this will formalise the approach to take it into the next level.

·       There have been some concerns from older people and BAME individuals about mixed  ...  view the full minutes text for item 110.

Dr Loubaba Mamluk & Dr Tim Jones, University of Bristol

Dr Tim Jones (University of Bristol) gave a presentation on the impact of Covid-19 on BAME Communities.  There is a disproportionate death toll on BAME, so looked for evidence about this based on publicly available data. This report combines 5 studies. We need to understand factors to protect BAME individuals with future policies.

·       Factors include deprivation, housing, employment, geography, discrimination, comorbidities, etc. The report itself goes into more detail.

·       Risk of death increases with deprivation. Roughly double risk between most and least affluent.

·       BAME are more likely to live in intergenerational and crowded housing, meaning it is harder to self-isolate and easier to infect the elderly.

·       Low English proficiency means it is harder to understand medical advice.

·       BAME are more likely to work in health, social care or other environments that put them at greater risk, e.g. taxi/bus driver, care homes. They are also more likely to work in areas that have shut during lockdown.

·       BAME have higher rates of diabetes, heart disease, anaemia, etc. which increases risk. There are lower levels of physical activity and higher smoking in certain groups such as South Asians.

·       BAME live primarily in urban areas, which have a bigger risk of infection.

·       Experience of racism causes health issues, esp. mental health. Genetics is only a minor factor.

·       Some measures to help include: ensuring adequate income support so self-isolation can happen, supplying cultural / language appropriate communications, suspending NHS charges during outbreak, collecting data by ethnicity, tailoring interventions that are understanding but not stereotypical, and ensuring a good representation of BAME in any Covid-19 response.

Discussion Notes:

·       This is a good piece of work and has been developed quickly. Equalities group presentations have gone on and are helpful. We have also set up a Covid Race Equality Group. There are some additional actions that will need addressing coming out of the community. This will require resourcing, many BAME are concerned about the situation but there are trust issues that need overcoming. The BAME Community wants to see action.

·       Some acute practitioners have noticed BAME patients are more anxious about Covid risks. There is anxiety coming from BAME staff on the frontline, they feel they are not getting the information that they need. Clear communications is vital.

·       Covid is an event that has exposed inequalities in the city and country. An action plan is currently being put together based on recommendations from equalities groups. All of the thematic boards need to be aware of this and take appropriate actions. HWB will lead on this work and it will get regular updates from the equalities board. 

Mark Allen, BCC Public Health

Mark Allen gave an update on the HWB “Plan on a Page”, which links closely to the HWB strategy. The integrated care system section will be updated after the next development session. The recommendation is to approve the plan, pending the update of integrated care.

Discussion Notes:

There is currently no mention of Covid-19 activity on the plan. While health inequalities are on the plan, they will need updating to include Covid related actions.

ACTION MA to add Covid and BAME Covid activity into the Plan on a Page.

Any Other Business:

There has been a question from the Connectivity Board to the HWB: How can the public access NHS services via (public) transport and how do we promote active travel?

·       There is a hospital bus is running from Bristol Temple Meads to the BRI now. Capacity is reduced to ensure social distancing. 

·       Southmead has a community service and regular First buses, but there has been a reduction. Running these services is up to First.

·       Many standard NHS services are up and running, but some are now delivered virtually. Sarah Truelove at BNSSG silver group has detailed reopening plans.

ACTION Mark Allen to contact Sian Trew (CCG) re: healthcare reopening plans and related communication plans. 

ACTION Sally Hogg to draft a response to the Connectivity Board addressing active travel schemes.