July 2021 weekly updates from Cheshire and Merseyside’s Directors of Public Health

The Cheshire & Merseyside (C&M) Directors of Public Health (DsPH) currently meet for weekly calls. The key messages from July 2021 meetings are as follows:

23^rd July 2021

1. C&M Population Health Board year-end report – Eileen O’Meara, SRO for Population Health in C&M, updated DsPH on the Board’s achievements over the last year. Despite the pandemic, the Board has continued to focus on its priorities of CVD/Blood Pressure, reducing harm from alcohol and AMR whilst also working on physical activity, cancer screening and mental health and wellbeing. A more detailed feature will follow in the Champs “Collaborate” newsletter but the DsPH thanked everyone involved for their fantastic work and Eileen for her outstanding leadership.
2. Marmot initial indicators shared – The Marmot team presented some early indicators for their work on health inequalities following their recent review in C&M. They will now look to reduce down to a set of 12 high level indicators on the social determinants of health. DsPH will nominate a local lead for this work at a Place level and the local workshops to help shape this work will begin in September/October.
3. PHE COVID-19 update – Richard Jarvis of PHE North West updated that all areas had a high level of cases but they appear to be flattening out. One theory is that people are not getting tested now restrictions have been lifted. There are still issues in prisons, schools and in hospitality settings but schools should alleviate this somewhat during the summer holidays. The recent announcement on certain essential/critical workers not having to isolate is causing confusion with the public and DsPH and their teams are receiving requests and queries. DsPH will prepare a joint holding statement on these exceptions whilst the details are being worked out. They will also agree a common approach in C&M to this issue.
4. Good news and gratitude:
   1. Ifeoma Onyia has been appointed Interim Director of Public Health in Halton once Eileen O’Meara retires in August. Congratulations to Ifeoma from all DsPH.
   2. Eileen O’Meara has been asked to join the North West Inequalities Hub to support them for two days per week from October.
   3. Dave Bradburn raised that AnneMarie Carr, Vicky Snape and Carole Boyle from Warrington’s public health team are leaving this week to go onto pastures new. DsPH would like to thank them all for their hard work over many years and to wish them all the best.

16^th July 2021

1. New C&M DsPH joint statement for 19^thJuly – DsPH approved a joint statement containing guidance for those living and working in C&M from 19^th Read the statement here.
2. Post 19^thJuly guidance – The DsPH discussed the guidance being issued and it was agreed to raise key questions for clarification on the forthcoming Chief Medical Officer’s call.
3. System P intelligence led system– Joe Rafferty, CEO of Mersey Care presented the initial plans for the development of System P which will use integrated NHS, local authority and public health data to produce strategic and tactical intelligence to better target resources, particularly in tackling inequalities. The DsPH supported the system and will be part of a specialist advisory group set up to look at priorities, linking in with the Marmot team recommendations which are due next week.
4. PHE COVID-19 update– Evdokia Dardamissis from PHE North West updated that cases continue to rise in C&M with cases in younger people appearing to plateau. Hospital admissions are increasing but deaths are low. There are regular outbreaks in care homes, prisons, schools and workplaces. Evdokia raised the importance of students being vaccinated over the summer and winter planning. The Champs support team is working on a draft plan for DsPH regarding living with Covid.
5. Good news and gratitude– The DsPH shared items of good news:

• The new ‘Lower my drinking’ app successfully launched this week with good partner engagement. More information on the campaign and assets are available on the Trello Board here
• The second phase of social media activity for the ‘Spread the facts, not the virus’ campaign finished this week. This phase targeted 18-40 year olds with vaccination and testing messages. This phase has resulted in 3.9m impressions and 214k video views across social channels. To download the tool kit and promote the campaign visit spreadthefacts.co.uk
• The LCR wealth and wellbeing bid was shortlisted and presented to the Health Foundation this week, the outcome of which is expected next week.
• The four expressions of interest submitted to the ICS for prevention projects are currently being considered for a funding award.

9^th July 2021

1. C&M health protection model initial findings– Directors are working collaboratively on defining the vision and ambition for the future health protection model in the subregion, and heard a progress update following extensive engagement with the local public health system and key strategic leaders.
2. PHE exceedance report and strategic action– Cases of COVID-19 are high across the subregion and are expected to increase over the coming weeks. Directors are developing strategies to manage this and Sam Ghebrehewet from PHE has developed a discussion paper highlighting the key implications, risks and proposed actions for DsPH to consider.
3. C&M DsPH joint statement for 19^thJuly – A joint statement is being developed to advise C&M residents and businesses following the lifting of restrictions.
4. Schools thank you letter – A letter has been developed for DsPH to amend locally to thank school staff for all their efforts over the pandemic.
5. Good news and gratitude
   1. Directors thanked the Champs Support Team for organising the Building Back Fairer Marmot Community Launch event on Wednesday 7th July. Over 280 delegates attended the event to discuss inequalities and kick-start the subregion’s plans to become a Marmot Community.
   2. PHE NW have appointed two new Consultants in Health Protection to the C&M Health Protection Team, Wendi Shepherd will provide support to Wirral and Tanith Palmer will support Cheshire West and Chester.
   3. St Helens are to receive 50 additional staff to assist with surge testing; Warrington have also been allocated additional resource to support weekend surge testing and vaccine hesitancy over the next five weeks.
   4. The Cheshire West and Chester public health annual report has been issued taking the format of a 15 minute video.
   5. A pop up vaccination site is being held in Sefton park with capacity to offer up to 8,000 people a first or second dose of either the Pfizer or AstraZeneca vaccine.
   6. From 12^thJuly, Terry Whalley will be joining the Champs Support Team on a part-time basis to provide senior strategic leadership in working towards a integrated contact tracing system across Cheshire and Merseyside. He will oversee the delivery of the DHSC bid and support the work being led by Julie Webster as lead Director.

2^nd July 2021

1. COVID-19 vaccination programme – Directors were joined by Richard Preece of NHSE/I who updated them on progress of the vaccine roll out. It is good news that over three million vaccines have been delivered in C&M but inequalities exist. There is good uptake among over 50s and uptake among 18-29 year olds is going well but lower uptake in the 30-39 age group. DsPH raised concerns about those that remain unvaccinated. It was agreed to explore maximising community pharmacy delivery across Cheshire and Merseyside.
2. PHE North West COVID-19 update– Richard Jarvis of PHE North West updated that COVID rates are rising quickly especially in the younger 16-24 age group. There have been a few outbreaks in care homes, mainly with staff testing positive. Schools are a significant problem and outbreaks are being seen in primary schools as well as secondary schools. As a move to a vaccine only strategy post 19^th July looks likely, it means that some of the local population will not be protected. It was agreed to review the scenarios from the previous PHE workshops, along with health protection leads, to look at how the risk to these population groups can be mitigated.
3. C&M health protection system – Julie Webster and Thara Raj reported that the recent workshops with health protection leads and environmental health officers have taken place and also interviews with some key stakeholders. Tricordant, who are leading the stakeholder engagement, will present their initial findings back to DsPH on Friday 9 July.
4. New C&M health inequalities local authority research network – Ifeoma Onyia from Halton presented an overview of the proposal to develop this network which aims to link local authority public health with academia. The DsPH fully endorsed the proposal.
5. DsPH strategic planning session – Dawn Leicester provided an overview of the discussion at the session and the next steps, all of which were approved by the DsPH.  The DsPH lead roles list is currently being updated along with the list of participation in other groups, including senior public health leaders. A more detailed update from the session will appear in the next issue of Collaborate.
6. NHS prevention programme targeted funding projects– Eileen O’Meara provided an overview of the four draft expressions of interest (EOI), which were approved for submission by the DsPH. The EOIs included:
   • Street Doctors programme for young people affected by violence
   • Improving integration of care for patients with alcohol use disorders and co-morbid mental health diagnosis
   • Improving uptake of NHS Health Checks in C&M to tackle inequalities
   • Increasing uptake of preventative services through co-production and physical activity
7. Good news and gratitude

• It was confirmed by Eileen O’Meara that the diagnostic review by the Marmot team is close to completion and a set of indicators should be available by the third week of July to discuss with DsPH.
• Over 370 people have registered to attend Cheshire & Merseyside’s Marmot Community launch event taking place on Wednesday 7^th