Local Outbreak Control Plan for Covid-19 infection

DRAFT IN DEVELOPMENTLast Update : 1st July 2020

Contents (cross linked to the Local Outbreak Control Plans seven areas)

Glossary

Introduction

What are the key components

Guiding Principles

Local Outbreak Control Plan seven areas

Governance

• National governance

• Role and responsibilities in London

• Local governance

• Escalation Criteria

• Range of levers available to encourage

compliance locally

• Local lockdowns

Settings

• Setting specific action cards

• Surge capacity planning

Supporting Vulnerable People

• Barking and Dagenham’s support offer

• Specialist support hub

Methods for Testing

• National portal & MTU arrangements

• Additional testing capacity

Data Integration

• Local reporting arrangements

• GDPR & Data Security

• Roles & Responsibilities

Communications & Engagement

• Build on prevention messages

• Raise awareness of NHS Test & Trace

• Support area outbreak plan

Risk Matrix1 2 4

7

3

5

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Glossary

BAME: Black, Asian and Minority Ethnic

CCG: Clinical Commissioning Group

CQC: Care Quality Commission

DPH: Director of Public Health

GDPR: General Data Protection Regulation

HMO: House of Multiple Occupation

HR: Human Resources

IMT: Incident Management Team

JBC: Joint Biosecurity Centre

LBBD: London Borough of Barking & Dagenham

LA: Local Authority

LOCP: Local Outbreak Control Plan

LCRC: London Coronavirus Response Centre

MDT: Multi-Disciplinary Team

MTU: Mobile Testing Unit

MSOA: Middle Layer Super Output Area

PCN: Primary Care Network

PHE: Public Health England

PPE: Personal Protective Equipment

SPOC: Single Point of Contact

UTLA: Upper Tier Local Authority

Introduction

This document is intended to outline seven steps in local preparedness to prevent, control and manage Covid-19 incidents and outbreaks, if and as when they emerge. It describes our local whole system response and it has been developed with a wide range of stakeholders and overseen by the Health Protection Board. It is signed off by the Recovery & Legacy Group and approved at the Health and Wellbeing Board on 28 July 2020. This Plan is iterative and will be regularly updated, as further evidence and guidance emerge.

London as a global city, with celebrated diversity and numerous ports of entry has an established ‘world class’ health protection system. The local and London public health response will be designed around these responsibilities and existing health protection good practice. Together with our partners we will utilise local governance and partnership arrangements toensure the design of our Local Outbreak Plan Control Plan for Covid-19 infection is developed and delivered to meet local needs.

Within these plans we will need to consider what preventative measures are required, how the situation in schools and care homes are monitored, possible scenarios and what strategies are needed to manage an outbreak in these settings (such as temporary closures to allow the deep cleaning of facilities). As part of our local response, will be able to draw on the expertise and support of the London Coronavirus Response Centre (LCRC).

The main aim of the Plan is to:Build on existing plans to prevent and manage outbreaks in specific settings, ensure the challenges of Covid-19 are understood, consider the impact on local communities and ensure the wider system works together to contain the spread of infection locally.

What are the key components of our Local Outbreak Plan?

A document, easily understood & shared to provide assurance in preventing & managing outbreaks

• Practical and in simple language and clear objectives

• Likely to have a web based version for easy access and sharing

• Primary audience include local decision makers, advisors and stakeholders most likely to be affected by

the plan. It should be accessible to the general public to build confidence and trust

Supported by key tools

• Templates e.g. SITREP, readiness, tracing data to receive

• Checklists and other proformas

• National assurance and support framework

Content developed to enable day to day working & rapid escalation of actions if / when required

• Detailed governance arrangements with clear roles and responsibilities

• Mapped interfaces with key stakeholders and flow of information day to day and in case of outbreak

• Trigger points for escalation outlined

• Key processes to be followed proactively day to day (e.g. infection control) and in case of outbreak

• Develop or plug into existing plans for high risk locations / vulnerable people

• Summary of risks associated with each theme, and suggested mitigations

• Proactive and reactive communications and engagement plans including pre-prepared / example

materials, and usage of data to tailor messaging to clusters

Guiding Principles

Barking and Dagenham’s Local Outbreak Control Plan (LOCP) is guided by the principles and legislative framework specified in the

document below and signed by Association of Directors of Public Health, Faculty of Public Health, Public Health England, Local

Government Association, Solace and UK Chief Environmental Officers Group.

There are four principles for the design and Operationalisation of LOCPs arrangements, including local contact tracing, if needed.

They are stated below:

1. Be rooted in public health systems and leadership

2. Adopt a whole system approach

3. Be delivered through an efficient and locally effective and responsive system including being informed by timely access to data

and intelligence

4. Be sufficiently resourced

Read the document here.

Our Covid-19 Local Outbreak Plan builds on existing plans to manage outbreaks in specific settings, ensure the challenges of Covid-19 are understood, considers the impact on local communities and ensure the wider system capacity supports the Director of Public Health

• Increased capacity requirements for:o Community

engagemento Testingo Contact tracingo Infection control o Support for

vulnerable people

o Enforcement• Specialist expertise

required• Mutual aid

arrangements available

Capacity Stakeholders Scale Integration & Delivery

• Significant and sustained

increase in number of

stakeholders, including:

o Residentso Employerso PHE

o NHSo Facilities e.g. schools,

hospitals

o Joint Biosecurity Centre

(JBC)o National government

o Local & national mediao Community, faith and

voluntary sector

• Plans must be able to

deal with outbreaks at

an unprecedented scale

across multiple

locations and facility

types simultaneously

• Some plans will involve

coordination across

other London boroughs

and in some cases

London as a whole

• Requirement to integrate

with new bodies, including:

o NHS Test & Trace

o Support and Assurance

teams

• Requirement to integrate

multi-source data to support

local decision making

• Requirement to collaborate

with PHE Health protection

teams, MDT LA, CCGs,

hospitals, GPs, around

infection control, advice on

ground, delivery etc.

Backup

Communication

& Engagement • Requirement for comms

campaign, with more

frequent and consistent

messaging & broader

scope and channels

(e.g. The leader, cabinet

members, Director of

Public Health, CEO

school leaders,)

• Requirement for

proactive comms and

comms plans

Local Outbreak Control Plans seven areas

1

4

3

2

5

6

7

Governance

The Director of Public Health is the identified Barking and Dagenham NHS Test and Trace Programme single point of contact (SPOC)

The Director’s primary role is to give assurance that the key organisational elements outlined below are aligned

and functioning effectively.

7

Who are the key decision makers?

Level Decision maker(s) Co-ordination, advice and engagement

Individual

setting

Individuals or bodies responsible for that setting

(e.g., Head Teacher, restaurant owner)

• London Coronavirus Response Centre

• Director of Public Health and team

• Multi-functional Silver Groups

London

Borough of

Barking &

Dagenham

Depending on the specific action required

decisions may be taken by the:

• Acting Chief Executive

• Director of Public Health

• Acting Deputy Chief Executive/Monitoring

Officer/Gold Commander

• Covid-19 Health Protection Board (Local

Outbreak Control Board)

• Barking and Dagenham Strategic Gold

Command

London Agreed cross-boundary decisions will be

implemented at London system level through the

London Coronavirus Response Centre

• Local Resilience Forums

• GLA

• New Contain/Joint Biosecurity Centre

Support and Assurance Teams

National Under specific escalation scenarios

Roles and responsibilities in London

A Joint Agreement between the LCRC and the London

boroughs Directors of Public Health for supporting the

management of Covid-19 outbreaks and complex

settings has been agreed. This Joint Agreement

provides a framework for joint working between the

LCRC and the public health structures in the London

boroughs (LA) for managing Covid-19 outbreaks.

Details the following:

• Summarised roles by setting (LAs and LCRC).

• Brief Standard Operating Procedures/Roles and

responsibilities for London boroughs and LCRC, by

setting type

This Agreement will be kept under monthly review

initially due to the rapidly changing regional situation

and guidance, and fluctuating capacity across the

system. This document is therefore intended to be

flexible and adaptable for local operation due to the

different support and capacity arrangements available in

local systems in London.

Read the document here.

1 2 3 4 5 6 7

Local Governance

Health and

Wellbeing Board

Tri Borough Resilience

Forum

Covid-19 Health

Protection Board

• Chaired by Cabinet Member for Social Care &

Health Integration and includes Chief Officers,

Met Police, Healthwatch, DPH, CCG, GP

Governing Body members, elected members. If

local lock-down needs to be imposed, Leader will

chair the Board;

• Political and partnership oversight of strategic

response and proactive engagement with the

public.

• Read the Terms of Reference here

• London boroughs of Barking and Dagenham,

Redbridge and Waltham Forest and includes all

Category 1 responders;

• Responsible for determining Council’s overall

proactive management and emergency response,

deployment of local resources and escalate need

for mutual aid, if needed.

• Read the Terms of Reference here

• Chaired by Director of Public Health and include

the whole system membership including PHE,

EHOs, PCN/GP, HR, B&D Collective

• Oversee development of and provide assurance

that there are safe, effective and well-tested

Local Outbreak Plans in place to protect the

health of local population during Covid -19

pandemic.

• Read the Terms of Reference here

Supported at a national level by Government

Departments (CCS/RED), TTCE programme and

Joint Biosecurity Centre and at a

regional level by Local Resilience Forums and

Integrated Care Systems (e.g., for mutual aid and

escalation)

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Covid-19 Health Protection Board Incident Management Team

In case of local complex settings outbreak or community cluster that needs investigation, LCRC or Director of Public Health will convene an Incident Management Team (IMT) that will report to Covid-19 Health Protection Board. The purpose of the IMT is to agree and coordinate the activities of the key stakeholders involved to manage the investigation and control of an individual outbreak situation. This includes assessing the risk to the public’s health and ensure control measures are implemented as soon as possible.

Notification of an incident or outbreak will come via various sources (e.g. LCRC, Enforcement, local schools etc.) and this will trigger data flow. Incident Management Team meeting may be convened when there are:

• 2 or more cases in a setting

• A single case in complex setting

Cases in three household at an MSOA level (Director of Public Health likely to be the main lead for IMT)

Read the IMT meeting Terms of Reference and Agenda here

Escalation criteria

Setting Criteria for escalation Escalation to:

Covid-19 Health Protection Group Strategic Gold Command

(Recovery & Legacy Board)

Events /gatherings (any setting ) - Death of a child Yes - immediate Yes - immediate briefing needed

- Outbreak linked to a major public

building, faith gathering or event in the

borough

Yes – immediate Yes – immediate briefing needed

Schools/Childcare/Early Years - More than one case in a school/EY

setting

Yes Yes – routine reporting only

- Setting not able to contain outbreak

- School closure Yes – immediate Yes – immediate briefing needed

- Media interest in outbreak/cases Yes Yes

Adult social care/Supported Living - More than 6 cases in ASC setting Yes Yes – routine reporting only

- Setting not able to contain outbreak

- Cases linked to a hospital outbreak Yes Yes

Large employers - More than 6 Cases in setting Yes Yes

Homeless setting - More than 6 cases in setting Yes Yes – routine reporting only

- Setting not able to contain outbreak Yes Yes

Council as workplace - Any outbreak Yes Yes

Local businesses - More than 6 cases in setting Yes Yes – routine reporting only

- Setting not able to contain outbreak Yes Yes

Local Lockdowns

• At present, there are limited powers given directly to Local Authorities to impose Lockdowns on the population level. Most powers under

the Health and Social Care Act 2012 and the amended Public Health (Control of Disease) Act 1984 and associated regulations, g ive

statutory responsibilities to Director of Public Health to plan and oversee outbreak control and management or detain individual cases

that pose infectious risk to the general population, via designated ‘Proper Officer’, who is appointed by PHE London.

• Schedule 22 of the Coronavirus Act 2020 provides further powers relating to events, gatherings and premises. For the purposes of

preventing, protecting against, delaying or otherwise controlling the incidence or transmission of coronavirus or facilitating the most

appropriate health care response, events or gatherings can be restricted or other requirements imposed and premises can be closed.

• Schedule 21 of the Coronavirus Act provides extensive powers to public health officials (PHE’’s Proper Officer, police and immigration

officers that exist for the period that the Secretary of State has declared that: coronavirus constitutes a serious and imminent threat to

public health in England, and that the powers conferred by the Schedule will be an effective means of delaying or preventing significant

further transmission of coronavirus. This is currently not passed on to Local Authorities.

Further information is awaited on the following:

• Governance

• Regulations of this etc.

• What stage (within action cards) is it implemented

• Recovery following local lockdown

Read the document here.

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If collaboration and co-ordination efforts are insufficient, established pathways may be used to escalate decision making to higher levels

1. National level may include NHS Test and Trace service (including Contain/JBC), Chief Medical officer,Whitehall, Cabinet Office Briefing Office (COBR) etc.Test and Trace

National

London

Setting

UTLA

Sub-UTLA

London Coronavirus Response Centre

London borough level

National level1

C-19 Health

Protection

Board Chief

Exec &

DPH

Health &

w ellbeing

Board

Strategic Co-

ordination

Group (Gold)

Lead public communications

Public facing oversight

Liaison with Ministers as needed

Rapid deploy resource

Council Chief Exec. DPHUltimately accountable for

escalation

Deep local infection control expertise

Individuals or bodies responsible for that setting (e.g., Head Teacher, restaurant owner,

Care Home manager, faith leaders etc)

Settings

Prevent and manage outbreaks – NHS Test and Trace

Test

Contain

TraceEnable

The London Coronavirus Response Centre working with the London boroughs provides an integrated

Covid-19 Test and Trace service, designed to control the virus and enable people to live a safer and more

normal life

Underpinned by a huge public engagement exercise to build trust and participation

Rapid testing, at scale, to identify and treat those with the virus

Integrated tracing to identify, alert and support those who need to self isolate

Identify outbreaks using testing and other data and contain locally and minimize spread

Use knowledge of the virus to inform decisions on social and economic restrictions

Test

Tra

ce

Conta

inE

nable

Continuous data capture and information loop at each stage that flows through Joint Biosecurity Centre to recommend actions

Note: Test, Trace, Contain, Enable diagram is illustrative only

The table below summarises the role of the Council and LCRC in managing local outbreaks as part of the Test and Trace system:

Range of levers available to encourage compliance locally

Health and Wellbeing

Board will:

• Provide public-facing

delivery oversight of NHS

Test & Trace locally

• Provide timely

communications to the

public

• Act as liaison to Ministers

as neededPublic

Health Lead

Resource

Deployment

Lead

Comms.

Lead

• Social media

• Tailored local marketing

• Local champions

Behavioral nudges

• Possible option for Ministers to chair

combined Local Outbreak Control

Boards until legislation is approved

Political engagement

• Public Q&A forums

• Press calls

Active communication

The Health and Wellbeing Board has a mandate to

provide public communications and provide local

accountability…

… and are well-placed to encourage

compliance

What is our approach to local containment?

● It is of utmost importance that we understand the geographic spread of the virus and take rapid steps in order to

contain any potential outbreak and keep our communities safe.

● In order to do that, we need to know what is happening, and have robust principles for decision making, co-

created and agreed by all stakeholders.

● These principles are set out in the Contain Framework (previously called the playbook/toolkit).

● We will then ensure that decision makers have the guidance they need via the Action Cards.

Contain Framework Action Cards

Prevent and Manage Outbreaks in various settings

Setting Schools &

Early Years

Care

Settings

Hospitals Places of

Worship

Workplaces Community

Clusters

Action Card Read the

document

here

Read the

document

here

Read the

document

here

Read the

document

here

Read the

document

here

Read the

document

here

Plans/Risk

assessment

tools

Read the

document

here

Read the

document

here

Read the

document

here

Read the

document

here

Read the

document

here

Read the

document

here

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Surge Capacity Resource Plan

From September onwards into the winter months we will be managing the usual winter pressures, other communicable

diseases along with Covid-19. We have been advised that no modelling of demand has been done. Therefore, our services will

have to flex to meet the peaks and dips in demand over the next 10 months.

The Covid-19 Health Protection Board will need to consider where additional surge resourcing will be needed across the

Council as part of the business continuity planning process. The Board will recommend to the Recovery & Legacy Group the

use of the £1,566,647m Local Authority Covid-19 Test & Trace Service Support Grant Determination 2020/21. The

purpose of the grant is to provide support to local authorities in England towards expenditure lawfully incurred or to be incurred

in relation to the mitigation against and management of local outbreaks of Covid -19. The majority of the Grant will be held as a

contingency and will be deployed based on need as it arises or is anticipated on a case by case basis.

Actions

• Mutual aid plans are developed by LCRC and London boroughs

• Discussions between Tri-Borough Resilience Forum and at the London level are taking place to agree escalation

points/mutual aid mechanisms

• Director of Public Health and Consultants may be required for surge capacity for BHR wide local outbreak investigation and

contact tracing

• Escalation points for surge capacity/large outbreak plan to be developed and agreed including recovery process.

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Supporting Vulnerable People

Supporting vulnerable residents

Supporting vulnerable residents through our front line services is core Council business. Our Community Solutions

Service will be ensuring that a comprehensive system of support is and remains in place as we all respond to Covid-19 at

the individual and at the community level. Working together with our partners, we want to ensure that no one becomes

more vulnerable or is left without appropriate support as a result of the rollout of the national Test and Trace service.

Where the contact tracing process identifies a complex case or one involving a high-risk location, the case will be referred

to LCRC and the Director of Public Health and his team to deal with. These teams have worked in this way for many years

and have tried and tested ways to deal with such complex cases.

All referrals from the LCRC for the supporting vulnerable resident pathway will come to the Director of Public health as the

Council’s single point of contact. The Public Health team will undertake their normal health protection practice which is:

• Check the resident is not known to council services in respect of safeguarding. If known the case is directly referred to

social care as per existing protocol

• If the resident is not known to services, the Public Health team will refer the resident to the Adult Intake Team in

Community Solutions. The intake team will assess the residents needs and put a support package in place for the

duration of the isolation period

Contact: intaketeam@lbbd.gov.uk or phone 020 8227 2915 if you would like further advice or support.

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Recap…support offer

1

2

3

• Barking & Dagenham Citizens Alliance Network

(BD-CAN) – generalist support for vulnerable members

of the community who lack support networks and need

help with simple, practical tasks

• The Specialist Support Hub – specialist support for

our vulnerable residents, including anyone who

currently receives adult social care services or who has

been identified as extremely vulnerable by the NHS

• Community Solutions – integrated front door support

on issues ranging from homelessness, debt advice,

benefits support, job support, food, early help

• Central food hub – coordinated access to food supply

managed across a network of distribution sites

Barking and Dagenham’s support offer

Specialist support hub

1

2

3

Main community partners are the ILA and DABD:

Supports the following residents:

• Anyone who is shielding – who has received a letter from

the NHS telling them they are extremely vulnerable

• Anyone who receives adult social care, whether arranged

by the Council or arranged privately

• Anyone living in specialist Council accommodation such

as sheltered housing, a hostel or a domestic violence

refuge

• Anyone who has recently come out of hospital and needs

support

• Anyone who is not known to social care, but who is

believed to be especially vulnerable due to additional

needs

• Food shopping (the resident pays for

the food shopping but not the service)

• Medication

• Gas and electricity top up

• Referrals on to other partners including

Reconnections

Supported access pathway for vulnerable residents

A supported access pathway is also under development to address some of the risks with applying the national model locally. This approach is based on Community Solutions, B&D Collective, NHS and other colleagues working together to support our most complex and vulnerable residents by using relationships of trust, wherever they may exist. We recognise that in order to support people best we need to take a person-centred approach which builds on existing relationships.

This means that in developing a pathway for ‘supported access’ we recognise that the initial referral point could come from a variety of locations depending on who the resident feels most comfortable with for example: GP, pharmacist, faith leader, food bank, other B&D Collective organisation, social worker, local public services (like mental health, SEND etc), housing officer, Facebook, mutual aid provider etc.

Residents who go through the supported access pathway is also intended to put in place the support the resident might need to enable them to participate in testing and possible 14 day self isolation (e.g. translation, food and supplies, financial support etc.

The supported access pathway will evolve from our learning from the BD-Can programme and Community Solutions Specialist Support Hub.

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Local Testing Capacity

Access to Testing

This section outlines arrangements for local testing to ensure rapid access for residents and settings. Whilst, in the majority of cases it is expected that testing will be done through the national testing process, localised capacity has also been created as we recognise that many of our residents will struggle to engage for a variety of reasons with the national testing system.

Since May 28 2020 anyone (including the under fives) with symptoms can get a test via a the NHS portal https://www.nhs.uk/ask-for-a-coronavirus-test Most testing is via self-test swab kits either from home delivery, fixed or mobile drive thru or for whole home testing. There are a range of online portals for key workers, care homes, employers of key workers

There is also a North East London local offer which offers individual home or drive through tests to essential workers and has also been focussed on care settings, using a self-test model by staff who then test residents. This model, using the capacity at the Barts Lab, is being flexed to support other local settings to target and proactively test in possible hotspot locations, like care homes unable to access the care home portal (non CQC registered, non-elderly population), hostels and temporary group housing for the homeless, and similar locally identified locations. In the event of an outbreak we will draw on this local testing capacity if necessary to expedite access to testing in the borough.

Where appropriate the Director of Public Health may need to arrange for the rapid deployment of mobile testing units to assist in the management of a local outbreak. A response of this or a similar nature may require activity across a range of local partners, and the Covid-19 Health Protection Board will provide the means of coordinating that action.

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Key workers

Care settings

Residents

Residents who have

symptoms access testing

online or by calling 119

Key workers access priority

testing through dedicated

website

Book testing via

following options

Mobile testing

unit Drive through

testingHome test kits

National testing should

offer a 48-72 hr turnaround

Care setting access testing for

symptomatic and non-symptomatic

residents via a national care home

testing portal

Residents directed to

testing via comms

Key workers (inc. teachers and

social workers) directed to testing

via comms

Care settings directed to national

testing portal for that setting

Methods for testing

The primary method for testing is the national testing portal.

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Additional Testing Capacity

In the case of large outbreaks we may need to expedite testing. Access to these tests will be determined on a case by case basis, requiring a specific request from Director of Public Health

1 2 3 4 5 6 7

LCRC identifies a situation

where enhanced investigation

is required.

LA/LCRC identifies need for

local testing at scale

DPH notifies MTU cell

and confirms number of

tests needed and day of

testing (as early as next

day).

LCRC

London Borough

of Barking &

Dagenham

MTU cellIntelligence data Notified by DPH

Yes.Can LBBD

support scale of

testing required?

No.

Setting lead or LA notifies

all people who need to be

tested.

Standard MTU

operating procedures

are followed.

Read the document here

Data Integration and Joint Biosecurity Centre Arrangements

Data sharing and reporting

In the context of Covid-19 this means:

• Timely data flows from testing to be able to predict and intervene in outbreaks

• Updated evidence on spread of infection and control measures

Daily data reports will be provided at regional level for London on numbers of cases and contacts successfully traced and numbers escalated to the LCRC. Weekly epidemiology and quality monitoring reports will provide further granularity on programme effectiveness.

Scoping work with London stakeholders across the NHS, local government and Directors of Public Health have highlighted the need for borough level data to identify individual support needs, track local disease transmission

and inform testing capacity. This will be provided by the Joint Biosecurity Centre. Additional epidemiological modelling will be provided by PHE London to further understand disease transmission at borough level.

Alongside this the Director of Public Health will need to work closely with the Joint Biosecurity Centre, which has the role of bringing together data from testing and contact tracing, alongside other NHS and public data, to provide insight into local and national patterns of transmission and potential high-risk locations and to identify early potential

outbreaks so action can be taken.

GDPR and Data Security

We are required to adopt a proactive approach to sharing information by default, in line with the Instructions of the

Secretary of State, the Statement of the Information Commissioner on Covid-19 and the Civil Contingencies Act. The

Secretary of State has issued 4 notices under the Health Service Control of Patient Information Regulations 2002 requiring

the following organisations to process information: NHS Digital, NHS England and Improvement, health organisations,

arm’s length bodies, local authorities, GPs.

These notices require that data is shared for purposes of coronavirus (Covid-19) and give health organisations and local

authorities the security and confidence to share the data they need to respond to coronavirus (Covid-19). They can be

found here https://www.gov.uk/government/publications/coronavirus-covid-19-notification-of-data-controllers-to-share-

information.

The data sharing permissions under the Civil Contingencies Act 2004 and the statement of the Information Commissioner

all apply. Under the Civil Contingencies Act 2004 (CCA) and the Contingency Planning Regulations, Category 1 and 2

responders have a duty to share information with other Category 1 and 2 responders. This is required for those

responders to fulfil their duties under the CCA.

Public Health England Covid-19 Testing Data Sharing Contract in place. Start date: 26 June 2020. End date: On expiry of

the Covid-19 – Notice under Regulation 3(4) of the Health Service Control of Patient Information Regulations 2002

(currently 30th September 2020)

Local data reporting

Current Council reporting mechanisms are outlined in the table below.

Confirmed covid cases

(from LCRC)

• Cases by

postcode• Cases by age at

onset

Test and Trace report

(LA level)

• Confirmed cases in

Test and Trace • Cases completed

• Total number of contact reported

• Contacts completed

Report

title

Dataset/

report

contents

Frequency

of reportingDaily Daily Daily Weekly Infrequently

• Age-specific rate

of cases (per

10,000)

• COVID-19 cases

by MSOA

Further

analyses

done

7-day moving average

of cases for Barking

and Dagenham and

London

Daily

Reports sent to DPH Data sets in public domain

Coronavirus in the UK

(HM Gov)

• Daily confirmed

cases in London• Rate of cases (per

100,000) for London boroughs

• Daily confirmed cases in Barking

and Dagenham

Death registration and

occurrences by local authority (ONS)

• COVID-related death registrations

by place of death

• COVID and non-COVID death

registration for

Barking & Dagenham

Deaths involving COVID-19 by local area

and deprivation (ONS)

• COVID-related

deaths by MSOA• Age standardised

death rate by London boroughs

LBBD produced

reports

Cases by care setting

• List of care setting

affected by Covid-19 • Total confirmed and

suspected cases in Barking and

Dagenham care settings

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39

List of reports to the Director of Public HealthSubject Content Sender Sender email Frequency

Contact Tracing

Update yyyymmdd

Notification that the daily contact tracing update by UTLA,

daily COVID-19 surveillance reports and exceedance

reports have been uploaded to the PHE SharePoint site –

reports no longer included in email

Contact Tracing Cell: data and

surveillance

Field Service, National

Infection Service

Public Health England

WNCoV.datacontacttracing@phe.gov.uk Daily

PHEC Daily

COVID-19

surveillance report

Daily PHE regional report summarising data on laboratory-

confirmed COVID-19 cases and reported COVID-19

outbreaks/clusters

PHE London Incident

Coordination Centre

ICC.London@phe.gov.uk Daily

LCRC Daily Data

Summary and

LSAT data

London Coronavirus Response Cell Daily Data Summary

(cases and situations) and LSAT Postcode Data (line

listing with postcode, age)

PHE London Incident

Coordination Centre

ICC.London@phe.gov.uk Daily

PHEC Weekly

COVID-19

surveillance report

Weekly report summarising data on laboratory-confirmed

COVID-19 cases; reported COVID-19 outbreaks/clusters;

syndromic surveillance indicators; and hospital and

ICU/HDU admissions

PHE London Incident

Coordination Centre

ICC.London@phe.gov.uk Weekly

Care homes COVID-19 Order Report for

Local Authorities (contains your local data only not

London)

Information for each care home in borough on the following:

• Registered places• Total no. of residents• Number / % of symptomatic residents

• Total no. of staff• No. of tests requested• No. of tests delivered

DHSC Covid-19 Testing Programme

COVIDCareHomeTestingReferrals@dhsc.gov.uk Twice per week

DHSC testing London dashboard

• DHSC pillar 2 testing regional dashboard for London DHSC Covid 19 team Tom.addey@adphlondon.org.uk on behalf of John.Mitchell@dhsc.gov.uk

Weekly

NHS Digital pillar 2 testing dashboard

• NHS Digital has produced Pillar 2 Testing Dashboards using current data to provide anonymous counts of

Covid-19 tests completed and tests which are deemed void, aggregated by Upper Tier Local Authorities

NHS Digital Pillar 2 Service Team ccsm@nhsdigital.nhs.uk N/a - dashboard

Data flows

for Covid-19

cases and

situations

Pillar 1 testing (NHS/PHE labs) Pillar 2 testing (commercial partners)

care home

initial

cases referred

for testing

Care home direct contact Results reviewed by LCRC Results flow into CTAS Daily review by Field Services (PHE)

London Coronavirus response cell

School direct contact (part of Health protection, PHE) Complex case identifed at Tier 2

e.g. care homes, vulnerable people

referred to Tier 3, LCRC*All outbreaks and received cases Data from HP zone extractred by FS

input into Hpzone

Information from SGSS and HPzone combined

LCRC reports includes results from FS reports includes results from

Pillar 1 and Pillar 2 Pillar 1 ONLY (at the moment)

From LCRC From FS

Daily summary Exceedance reports

Daily Individual data

Weekly reports: Weekly summaries of the above data Weekly reports Summary of surveillance systems reports

* care home residents, schools and connected workplaces are mandatory fields for data entry.

Care homes, schools and other situations are escalated as per protocol

Postcode and workplace "coincidences" are picked up by CTAS and HP zone and reviewed

Regular surveillance reports reviewed by PHE LCRC/ FS

Line listing to all boroughs of new cases with

postcode and age

Reports to DPH in local authorities, some to wider

stakeholders

Re

sult

sA

ssim

ilati

on

REP

OR

TIN

G

PHE Daily

Surveillance reports

- Graph of age and sex distribution of total cases (pillar 1

only, from SGSS)

All postive results reported into the SGSS (second generation surveillance system)

- Number of new outbreaks of suspected or confirmed

COVID-19 in care homes for prior week and cumulative

total (from HP-Zone)

Daily new cases reported with statistical assessment of

impact on trend, localities where number of new cases

exceed expected trend are highlighted

- Number of new and cumulative cases (pillar 1 only, from

SGSS)

- List of new situations e.g. care homes created

by LCRC (from HP-Zone, gives name of

establishment, daily list)

- Number of new and cumulative cases (pillar 1

and 2, from SGSS)

- Complex cases and situations notified from

Tier 2 contact tracing

- Cumulative number of situations by type

(from HP-Zone)

- Cumulative number of confirmed and

suspected deaths of care home residents (from

HP-Zone)

SINGLE CASE IN A SETTING

Hospital

hostel/homeless

services

community

clusters

Arrange IMT with

setting and

relevant

stakeholders

including

Healthcare, MoJ

or Home Office.

Info

rmat

ion

rece

ived

Ri

sk a

sses

smen

t

London Coronavirus Response Cell (Tier 1) receive notification/information/query from setting, LA or GP

or referral from Tier 2

Notifications from GP or other

healthcare settings

All positive results reported into the SGSS (second

generation surveillance system). Results flow into CTAS.

Complex case or setting identified at Tier 2 and referred

to Tier 1

Query from settings or

member of the public

re. school, workplace,

prison, hostel, care

home

Information from Local

Authority, Other

PHEregions, Devolved

Adm, International

office

Out

brea

k m

anag

emen

t

Information on case, outbreak or community cluster uploaded to HPZone (PHE case

management system)

Clinical team gather information and conduct risk assessment with the case or setting

OUTBREAK (2 OR MORE CASES) IN A SETTING OR A CASE

IN A COMPLEX SETTING

school/educationa

l settings

care homes and

other care settings

workplaces

Arrange incident management meeting when required with setting and relevant stakeholders

including Local Authority (DPH, EHOs, adult social care, children and young persons services)

Coordination and lead for outbreak agreed

RESPONSE - case finding, contact tracing, isolation, testing (if appropriate by PHE/NHS pillar 1, 2, MTU or Find

and Treat), decontamination, advice and communication

faith and other

settings

Clinical team provide advice and manage contacts,

testing and infection control

Clinical team provide information materials to the

setting

Clinical team recommend ongoing control measures

DPH notified

Hospital lead outbreak

response; LCRC provide

advice and support

Prison and

prescribed places

of detention

Data flows for

Outbreak

Management

Communication and Engagement

Communications strategy to target three distinct themes 1 2 3 4 5 6 7

These support all 7 areas of the local outbreak control plan.

1. Build on prevention messages (link with town centres campaign on reopening local businesses).

2. Raise awareness of test and trace (pan-London campaign in development to be adapted to meet local objectives).

3. Support LOCPs – Reactive communications actions rooted in area action plans.

Objectives include:

• Fulfil our legal duties of warning and informing (as set out in the Civil Contingencies Act 2004) and any other legislation

introduced

• Ensure we provide a single point of truth in terms of communications for key partner organisations locally and that all

groups remain on message

• Identify risks and vulnerabilities that could impact on our communications work

• Scope opportunities to address misinformation

• Ensure communications and actions around contact tracing are linked in with wider work being done by the Council on the

digital divide.

Build on prevention messages1 2 3 4 5 6 7

Current activity

• Town centre and Heathway campaign: Working with

businesses to safely reopen. Social distancing /

prevention is being heavily promoted

• External comms: Prevention messages continue to be

shared via social media and digital channels such as

One Borough newsletter

• Internal comms: The internal team continue to provide

messaging around staying safe in and outside of the

workplace on Yammer, and via staff news letters

Next steps

Consider wider dissemination of prevention messages via

print and digital channels.

Raise awareness of test and trace 1 2 3 4 5 6 7

Current activity

• Limited information on testing on /covid19 hub.

Weekly promotion of mobile testing unit.

• Pan-London comms group has completed

research on test and trace attitudes in London.

Only 44% of people would know how to get a test

(less amongst over 65s and BAME groups) 35%

know little or nothing about test and trace (higher

amongst younger and BAME groups).

• Pan-London campaign (Keep London safe) is

being developed with a communications toolkit for

use. Core script for frontline services should be

ready w/c 22 June along with a 40 second video

script.

• Visuals will also be focus grouped ready to be

issued by end of month.

Next steps

• To address trust issues and encourage compliance we

will need to ensure the pan-London campaign is

adapted to reach Barking and Dagenham specific

audiences. Activity should be highly targeted using local

advocates and partner channels to reach our

audiences.

• Develop a stakeholder map that breaks down audience

specific channels and advocates.

• Adapt the core script for Barking & Dagenham and

update key channels / share with partners.

• Create area specific videos with partners.

Support area outbreak plan 1 2 3 4 5 6 7

Next steps

Using the insight and stakeholder mapping from the London test and trace

campaign we will identify communications actions that need to support the area

action plans.

As part of the wider toolkit content will be packaged and ready to go in the event

of an outbreak.

Keep London Safe campaign is in development

Risk Matrix

Risks and threats 1 2 3 4 5 6 7

The Council is responsible for addressing issues of low-take up and engagement with hard-to-reach groups and

communities. Our challenge is that the assumption that most of the contact and engagement with the testing and tracing

regime will be managed through the app, website and phone and direct engagement with the public.

There are potentially several barriers to users successfully engaging with the proposed national model, which will be

particularly relevant to Barking and Dagenham:

• Gaining local communities’ trust with regards to national contact tracing initiative

• Digitally excluded groups being missed

• Residents without access to an email account being disadvantaged

• Residents facing financial hardship as a result of Covid-19, who would usually have access to a smartphone, but no

internet connection (due to insufficient funds)

• Demand for tests exceeds the number of tests available

• Tracing programme is unable to meet demand

• Exacerbating existing inequalities through the (method of) delivery of messages

• Access issues beyond our control are reflected negatively on the Council

• Those concerned about surveillance/ data protection may not engage with the contact tracing programme

• Covid-19-related fraud and scams undermining trust in the national programme and individual representatives

Risk matrix (to be populated further)

• Outbreaks in care settings, shared living, HMOs, special schools, school transport

• Places of worship such as churches, mosques

• Lack of engagement with NHS Test and Trace and inability to contain local spread

• Outbreaks in people with substance misuse, hostels, DV Refuge and refugee

• Data sharing and publishing data to engage communities

• Outbreaks in workplaces such as Town Hall, Roycraft or Frizlands

HIGH RISK

MEDIUM

RISK

STANDARD

RISK

LIK

ELIH

OO

D

HIGH

LOW