Agenda item

Vivien Cleary, Acting Head of Public Protection, presented the report and explained that it provided a summary of infectious disease notifications, outbreaks and health protection incidents that were managed by the North East and Central London Health Protection Team during 2014.  The full details were set out in the report, including a summary of the health protection challenges  and their implications for the Borough. 

The Board raised and discussed an number of issues, including:

·  Measles - There had been no confirmed cases of measles.

·  Pertussis (Whooping Cough) - The incidence of Whooping Cough had reduced, and this was thought to be a direct result of the maternal vaccination programme.

·  Tuberculosis (TB) - The incidence of TB had been increasing nationally since the 1980’s and its incidence rate had strong links with deprivation, homelessness and overcrowding.  The incidence trends in the Borough were shown on page 100 of the report and it could be seen that incidence of TB in the Borough was also rising over the London average.  There were often clusters in family units and the rates were higher in the Black and Asian communities.  Work was being undertaken to identify and treat people with latent TB.

Connor Burke suggested that Public Health talk to their peers in Redbridge about targeting adjoining health issue hot spots. 

It was noted that the NHS England had agreed to fund the consultant and screening costs.

·  Chlamydia - Detection rates and treatment rates were high in the Borough.  It was pointed out that this could be as a direct result of the Chlamydia awareness and treatment campaigns in the Borough recently.  Overall sexually transmitted infections were also increasing.  This indicated that unprotected sexual activity was a continuing problem in the Borough.

·  Health Care Associated Infections – MRSA infection rates in the community was higher than average.  The Clostridium Difficile infection rate was below the England average, but was one of the higher rates in North East London.

·  Immunisation – The results indicated an encouraging turn-around trend in childhood vaccinations.  The focus for the future would be in ensuring the follow up vaccinations were undertaken e.g. MMR.  Seasonal Influenza and HPV vaccinations had generally not improved but pneumococcal disease vaccinations for the over 65’s had achieved 65%. 

Matthew Cole advised that he would shortly undertake visits to the lower performing 21 GP Practices to see what could be done to improve both initial uptake and follow-up vaccination rates. 

Dr Mohi said that Partners need to reach people and encourage them to attend GPs and take up vaccination services.  The initial targeting during infancy was good but the impetus and response rates tended to reduce in later years.  Public engagement needed to be better.

Matthew Cole suggested that Health Visitors follow-up the infant vaccinations; it appeared that parents were attending for the first vaccination but not returning for the second and third doses.  This may be due to the parents not understanding the need for a multi doses to achieve full protection.  Partners need to be explaining this to the public, whilst also undertaking a proactive approach to improve return rates, especially in the BME communities.  Matthew added that it was necessary to understand how neighbouring practices, serving similar demographic communities, could be so variable in their performance and what the lower performers could do to improve catchment rates.

The Chair commented that whilst targets may not have been achieved yet, nobody should forget that there had been considerable improvements achieved in the last 5 to 6 years.  The number of people participating in unprotected sex was clearly associated with both the sexual infection and teenage pregnancy rates.  These had been targeted as major issues and despite this there still had not been a major decline in incidence rates.  The engagement and prevention techniques which had worked elsewhere do not seem to have had an effect here.

Having noted and discussed the contents of the report,

The Board:

(i)  Requested that NHS England provide quarterly performance reports on the arrangements it has put in place for 2015/16 to increase uptake of immunisation programmes by the eligible population of Barking and Dagenham;

(ii)  Requested that Council Officers, together with NHS England and Barking Havering and Redbridge University Hospitals NHS Trust consider the introduction of appropriate HIV rapid testing services, which was in line with national advice;

(iii)  Requested that North East London NHS Foundation Trust and local GPs work to ensure 100% uptake of the neonatal Hepatitis B course of 3 primary vaccinations and 1 booster at 12 months; and

(iv)  Requested that Health and Social Care Commissioners provide quarterly performance reports on the measures being taken to prevent Health Care Associated Infections within both the hospital and community settings.