Lewisham Council has published a COVID-19 Outbreak Prevention and Control Plan setting out how the Council will work with partners, including Public Health England, to prevent, identify and manage any COVID-19 outbreaks in Lewisham and ensure that residents and communities are protected.
Local authorities have been responsible for improving the health of their local population and for public health services including most sexual health services and services aimed at reducing drug and alcohol misuse since the Government transferred responsibility from the NHS in April 2013
As the public health service was transferred, Chancellor George Osbourne, with a sleight of hand cut £200 million in year from the public health budgets of local councils in June 2015. The Academy of Medical Royal Colleges said: “This cut will have a direct impact on people and communities who rely on this funding, and it will have a direct impact on the NHS which will have to pick up the pieces by treating preventable ill health. The Faculty of Public Health’s own analysis suggests the eventual ‘knock-on’ cost to the NHS could well be in excess of £1bn. By any measure then, the planned move is a false economy.”
At the time in Lewisham, Councillor Alan Hall wrote in response to the Government: “Plans to reduce public health allocations in year directly contradicts the statement in the NHS plan: ‘the future health of millions of children, the sustainability of the NHS, and the economic prosperity of Britain all now depend on a radical upgrade in prevention and public health.’
He added: “Imposing public health savings of this order within year will undermine our effectiveness and reduce our capacity to work with our NHS partners in prevention and public health and so will damage the long-term partnership needed to achieve public health goals.”
On top of this, many of the services delivered through the public health spend via Local Authorities fund clinical NHS care. Cutting this funding reduces NHS revenues so it is misleading to suggest that the NHS budget is being protected.
The tories continued to cut public health budgets but this March, in the midsts of the Covid-19 pandemic they belatedly announced an increase of £145 million on the public health grant 2019/20.
The Faculty of Public Health said: “Though an increase, further funding will be needed to reverse years of cuts to public health services and FPH has long called for a £1 billion increase for the public health budget. This will allow our members to restore public health services and protect and improve the health of the public, both during and beyond the current COVID-19 crisis.”
Lewisham Council’s public health service continues to provide a vital service. Their plans have defined “an outbreak” as is two or more suspected and/or confirmed cases associated with the same setting and with onset during a 14-day period.
A London-wide definition of a community cluster of COVID-19 is in the process of being
agreed. The following working definition has been adopted locally in Lewisham, in the interim:
“A community cluster is identified when 3 or more household member(s), living in the same
Middle Layer Super Output Area receive a positive test result for COVID-19 within a 7 day period and those people are not already known to be linked to a complex setting that is already the subject of an outbreak management plan (e.g. a care home, school, workplace etc).”
An outbreak in a complex setting can be regarded as taking place in a setting that has a number of complicating factors including:
- vulnerable staff/residents/communities affected
- the potential to result in a large number of cases/contacts
- likelihood of requiring prolonged support for ongoing outbreak management.
A number of action cards including standard operating procedures have been developed for
outbreak management in complex settings for London.
Lewisham Public Health team will be part of the NHS Test and Trace service. This will provide a vital infrastructure to support this existing outbreak prevention work by scaling up the capacity to test, trace and isolate cases and contacts of COVID-19. The service was launched on 28th May 2020, to provide a comprehensive national contact tracing service for COVID-19 in England involving national, regional and local partners.
The team have launched a 7 day COVID-19 case rate for Lewisham in comparison to London and England.
7 day COVID-19 case rate (per 100,000)
Reported from 8-14 August
Full details are here