Agenda item

Presentation by Ben Anderson, Director of Public Health

Ben Anderson, Director of Public Health, presented the Annual Report 2022 which had concentrated on understanding the impact of Covid-19 in Rotherham March, 2020-January, 2022:-

 

Section 1 - Covid-19 in Rotherham (as at 31^st January 2022)

-        2^nd March, 2020 – first case of Covid-19 confirmed in Rotherham

-        20^th March, 2020 – first death within 28 days of a positive Covid-19 test in Rotherham

-        79,615 Covid-19 infections officially recorded in Rotherham (of which 3,739 were possible reinfections)

-        992 deaths with Covid-19 recorded as a cause of death on the death certificate in Rotherham

-        547,994 doses of Covid-19 vaccine provided in Rotherham

-        85.7% of eligible people in Rotherham (aged 12 and over) had received at least one dose of a Covid-19 vaccine

 

Inequities and Covid-19

Deprivation

-        Mortality rates in the most deprived areas in England were more than double those in the least deprived areas as of April 2021

-        Rotherham was ranked 44^th most deprived authority in England making it amongst the 14% most deprived local authority area in England

 

Health

-        Covid-19 related morbidity and mortality was higher in people with underlying conditions including diabetes, obesity, chronic obstructive pulmonary disease, dementia and hypertensive diseases

-        All of these conditions were more prevalent in Rotherham than in all England

 

Employment

-        A relatively high proportion of the Rotherham population was employed in work that has a high risk of exposure to Covid-19 i.e. jobs which cannot be done from home, required working in close physical proximity to others, lower grade occupations and jobs disproportionately performed by Black, Asian and Minority Ethnic (BAME) people

 

Section 2 – Covid-19 and the individual

Physical and Mental Health

-        Physical Activity and Healthy Weight

·        Reduced activity levels: 32% of the local adult population was inactive from May, 2020-May, 2021 (an increase of 2.6%) vs 28% nationally

·        Increased sedentary behaviour and inactivity expected to result in a ‘deconditioning’ effect

·        Nationally, large increase in % of Reception and Year 6 children who were overweight/obese.  Expect this trend to be replicated in Rotherham where 27% of Reception aged children were obese before the pandemic)

·        Further widening of inequalities in obesity expected.

-        Mental Health

·        Young people in Rotherham reported a decline in overall mental health and increased levels of anxiety, stress, boredom and feeling sad/low in June 2021 as compared to the beginning of the pandemic

·        The pandemic heightened loneliness leading to a high volume of referrals for befriending support

·        Rotherham carers reported elevated levels of anxiety, isolation, worry and physical exhaustion during the pandemic

·        Suicide rates – initially fell slightly but still remain significantly higher than for all England.  January 2022 had seen a rise with 7 suicides reported, the highest number since 2019

 

Tobacco

-        Increase in successful attempt to quit in 2020/21

-        Some indications of a significant overall reduction in smoking

-        Increase in smoking prevalence amongst younger adults (18-21 years) and older teenagers

-        Possible exacerbation of inequalities in smoking prevalence between groups along economic lines

 

Alcohol and Substance Misuse

-        Changes in drinking behaviour observed at different stages in pandemic

Initially bulk buying of alcohol

Later, some evidence that as much as a third of people had reduced intake

Evidence that around a fifth of people drank increased alcohol consumption during lockdown

Alcohol-related hospital admissions initially fell but then surged following easing of lockdown restrictions

-        People who inject drugs reported reduced access to essential services including difficulties accessing HIV and hep C and safe injecting equipment

 

Education

-        Up to 8,417 Rotherham students were sent home per half term in academic year 2020/21

-        Approximately 183,198 days of education were lost in 2020/21 alone in Rotherham

-        Nationally, average educational attainment scores at 16 varied significantly according to deprivation level of local authorities

 

Section 3 - Covid-19 and our Communities

Community Cohesion

 

Volunteering

-           Decrease in formal regular volunteering undertaken locally

-           Unprecedented levels of community cohesion especially during the early stages of the pandemic

-           Community Hub responded to over 7,900 requests for support and 1,280 volunteers by January, 2022

 

Community responses to food poverty

·        Nationally 33% increase in the number of emergency food parcels distributed across the United Kingdom in 2020/21 vs 2019/20

·        Four fold increase in the number of parcels provided in Rotherham

·        19,466 parcels in 2020/21

·        Community partnerships and generosity key

 

Community Safety

Local experiences have broadly reflected the national picture

-        Crime in South Yorkshire reduced substantially following the implementation of lockdown 1.  Crime had been increasing towards pre-pandemic levels since national lockdown measures were lifted

-        Some offence types remain low e.g. burglary.  This was likely to be linked to changes in personal behaviours and routines including more people working from home

-        The number of domestic abuse reports in Rotherham had remained stable despite concerns of a major increase

 

Section 4:  Covid-19 and the Economy

Business:  Facts and Figures

-        Over 20% of local businesses reported having made redundancies since the start of Covid-19 by December, 2020.  This varied by industry with 50% of retail companies and 40% of construction companies reporting having made redundancies

-        44% of companies in the accommodation and food sectors reported they had less than 3 months’ worth of cash reserves remaining in December, 2020

-        31% of Rotherham residents were estimated to be working from home resulting in a net increase of 3,000 individuals based in Rotherham as fewer residents travelled outside the Borough for work.  This was highly localised with some Wards e.g. Rotherham Central and Wath upon Dearne experiencing a net outflow of workers

 

Business Debt and Financial Vulnerability

-        Overall, Small and Medium Enterprise (SME) indebtedness in England and Wales in June, 2020 was 40% higher than in 2019

-        Within Rotherham, SME indebtedness had increased by 59% by June, 2020 as compared to 2019

-        Indebtedness varied considerably by area within Rotherham

 

Employment

-        5.3% of the Rotherham population (8,590 people) claimed Universal Credit in December, 2021 vs 3.5% in December, 2019, pre-pandemic

-        Throughout the pandemic, Rotherham’s rate of Universal Credit claimants had been higher than the national or regional rate and varied by Ward

-        From late 2021, the number of pay-rolled employees nationally exceeded pre-pandemic numbers.  Driven by an upswing in employment amongst young people and jobs in hospitality and leisure sectors

 

Wages and Debt

-        After a sharp fall at the start of the pandemic, median pay per month had recovered and then grown nationally and locally

-        When adjusted for inflation, median weekly earnings for all jobs nationally were up 3.6% in April, 2021 compared with April, 2020 after a decrease of 0.9% in real terms between 2019 and 2020

-        However, evidence of widening inequalities in wealth

-        One-third of families in the top income quintile saved more than usual in the first 2 months of the pandemic whereas lower income families were more likely to have taken on additional debt

-        50% of people with savings under £1,000 had used them to cover everyday expenses

 

Recommendations

1.  Living safely with Covid-19 Recognising the high exposure risks to Covid-19 due to the nature of the local economy and the high prevalence of risk factors for poor Covid-19 within the Rotherham population, there was a need to minimise the ongoing impacts of Covid-19 by:-

-        Continuing to maximise Coronavirus vaccine take-up especially in vulnerable population groups

-        Maintaining Covid-Safe practices within Rotherham’s workplaces including support for workers to isolate when symptomatic

-        Continuing to focus on risk factor reduction to ensure a more resilient population both to Covid-19 and to other health conditions

-        Supporting those formally asked to shield and others who are perceived as vulnerable to regain confidence and to safely increase participation within their communities

 

2.  Access to Health and Social Care Restore equitable access to quality Health and Social Services by:-

-        Resuming services and equitably catching up with any backlogs that have been stalled by Covid-19 including screening programmes, long term condition management and health checks

-        Ensuring resilient Primary Care and maximising the benefits of virtual access models developed during the pandemic so that practices are sustainable and able to offer patients appropriate care

-        Stabilising and gradually bringing down waiting lists whilst ensuring harm reviews and equitable access for all those awaiting treatment

-        Reinstituting routine contacts with vulnerable individuals with a focus on Safeguarding

 

3. Mental Health work as a whole system to promote good mental health through evidence-based early intervention and prevention programmes and ensure equitable access to mental health support.  This will be achieved by:-

-        Addressing the wider determinants of poor mental health, loneliness, poor physical health, poor housing, unemployment and poor employment, debt and poverty

-        Promoting protective factors with a focus on community assets

-        Addressing inequalities by ensuring groups most disadvantaged by the pandemic, as evidenced through local health intelligence, were able to access mental health support at the right time

-        Building the capacity and capability across our workforce to prevent mental health problems and promote good mental health

-        Continuing to monitor changes in need, demand and rates of mental illness, self-harm and suicide to understand the longer term impacts of the pandemic

 

4. Physical Health Promote good physical health across the Borough with a particular focus on reducing health inequalities that have been exacerbated by the pandemic.  This will involve:-

-        Supporting people to live longer healthier lives by helping them to make healthier lifestyle choices particularly relating to diet, exercise, smoking and alcohol consumption

-        Developing a Prevention Pathway for Rotherham to identify and respond to risk factors at an early stage and support people to access prevention services where required

-        Identifying and treating illness at an earlier stage focusing on communities or groups with the highest level of need

 

5.  Education Work to support schools with the recovery of lost education with a particular focus on:-

-        Supporting disadvantaged groups to recover from the disproportionate effects of lost education including the Ofsted priority of reading through the Rotherham Readers Programme

-        Supporting pupil inclusion, maximising school attendance, balanced against the challenges of the pandemic and wellbeing of both students and staff

-        Providing opportunities for children and young people to catch up with their social and emotional development through extra-curricular activities and youth services

 

6. Health Inequalities Work in partnership to address the underlying health inequalities and the high rates of morbidity that have contributed to the disproportionate impact of Covid-19 in Rotherham through:-

-        Development and implementation of a prevention and health inequalities strategy

-        Continued understanding of the differing needs of Rotherham’s communities and the development of delivery models that equitably direct resources towards meeting those needs

-        Challenging ourselves to ensure that service quality and outcomes are of universally high standard for all communities in Rotherham

 

7. Economic Recovery

-        Continue to monitor and understand changes to Rotherham’s economy and build an inclusive economy for Rotherham

-        Work with partners to ensure employment and skills provision to support all sections of society to access learning and progress in work

-        Regeneration of the Borough.  Make use of Levelling Up and other regeneration funding to address the impacts of the pandemic and reduce inequities

-        Continue delivery of Rotherham’s Economic Strategy with a focus on developing secure sustainable employment opportunities in the Borough

 

Discussion ensued on the presentation with the following issues raised/clarified:-

 

-        Barnsley, Doncaster and Rotherham had very similar levels of deprivation with Sheffield having slightly less

-        Huge unemployment had been expected as a consequence of the pandemic, however, it was in fact difficult to recruit across a number of the sectors

-        Rotherham Town Centre had already started on its journey of restructuring so was not as reliant on office workers as other towns/cities in the area

-        Public transport had been hit badly in terms of passenger numbers and was reliant on Government funding in order to continue providing a service

-        In Primary Care the number of elderly patients requesting appointments had reduced, however, the reintroduction of face-to-face appointments was revealing significant health issues that required a lot of resources

-        Unrealistic expectations of what was currently available Primary Care wise – manage patient expectations

-        There was a feeling that the pandemic had ended and everything should be the same as it was before when in fact things were being delivered differently now

-        Key areas for the Foundation Trust were obesity in young people and the increase in smoking within the 18-21 year old age bracket

 

It was noted that the annual report would be presented at all Council Directorate Leadership Teams.

 

As of 16^th March, 2022, the infection rate was 310.6 per 100,000 and was increasing in Rotherham.  This was partly due to the removal of restrictions and those that had received their vaccinations first losing some of their immunity.

 

It was suggested that a themed meeting take place at the November Board meeting on the impacts and future planning/lessons learning from Covid-19. 

 

Resolved:-  (1)  That the annual report be noted.

 

(2)  That further discussions take place at the Executive Group with regard to themed meetings.