The national system ………….
NHS Test and Trace is a collaborative partnership between national and local Public Health experts, the NHS, specially-trained call handlers and local health protection teams and was officially launched on 28th May 2020. It relies on everyone with symptoms, however mild, getting tested and providing detailed information on who they have come into contact with and then self-isolating to break the chain of transmission and stop the spread of the virus. It has been widely reported that only somewhere between 50% and 60% of contacts of known cases are being advised to isolate by the national test and trace service, yet the government’s Scientific Advisory Group for Emergencies (SAGE) has suggested that for a contact tracing system to be effective, it needs to trace around 80% of contacts.
A local approach to a national challenge ………….
In response to rising rates of Covid-19 in Blackburn with Darwen, and given that the national test and trace service were unable to make contact with a significant number of residents who had tested positive for Covid-19, the Local Authority set-up a local enhanced contact tracing service – and we were among the first in England to do so!
Our test, trace and isolate team works seven days a week contacting residents between the hours of 8am and 8pm Monday to Friday and 10am to 1pm each weekend - and have been doing so since go-live on 29th July 2020. In addition, a management structure was implemented with responsibilities including the allocation of cases, data analysis and performance reporting. In total there are 20 contact tracers who work on a shift pattern across the week and resource is scaled-up dependent on the volume of cases received each day. Initially, a small group of employees attended a [virtual] national training session in order to understand the national test and trace service, how cases would be devolved to the Local Authority for enhanced tracing and to obtain a working overview of the national Contact Tracing IT system (CTAS). This evolved in to a bespoke local training package, which was delivered to contact tracers and has been shared with a number of Local Authorities across the country to be adapted to meet their needs.
Every day the Local Authority receives data regarding Blackburn with Darwen residents who have tested positive for Covid-19 and where the national test and trace service have been unable to make contact within 24 hours, in order to help control and manage outbreaks in the borough. All data is fed into the same IT system (CTAS) by both the national service and our local team to ensure there is an holistic view of how the overall service is working and how the virus might be spreading. It further enables us to gather local intelligence around settings that residents may have attended, whether it be their place of work, an education setting or their place of worship – we provide this information to our local Public Health department so this crucial local intelligence can inform the wider outbreak management process which deals with preventing and controlling potential outbreaks in Blackburn with Darwen.
Our contact tracing system does not replace the national system; it complements it - whilst, at the same time, offering local support to people who need to quarantine. Through collaboration, by combining the national and local ways of working, and by using our unrivalled local knowledge of our communities and residents it is quite feasible to suggest we’ve prevented a large outbreak, a full borough-wide lockdown and kept our local economy going.
What our process looks like …………..
We receive cases from Public Health England each morning which provides us with the details of residents who have a positive Covid-19 test result and the national test and trace service have been unable to contact within 24 hours. Within an hour of the case data being received the resident is sent an SMS text message from the Local Authority advising we need to speak to them. The SMS also provides links to Covid-19 guidelines and advice and contact details for Blackburn with Darwen’s Help Hub - which since March 2020 has been providing advice, support and signposting to our residents whether it be food provision, debt management or dealing with the social impact of the pandemic, such as loneliness.
Our contact tracers are assigned cases daily with all calls being made from a local (01254) number as intelligence gathered suggested by doing so we would improve the pick-up rate - compared to the national service who call from an 0300 number - and when the resident answers the phone they hear a local accent which again intelligence suggests improves positive engagement. Once a call is connected one of our contact tracers will carefully guide the resident through the necessary questions and input all of the information in to the Contact Tracing system (CTAS), however, in circumstances where we have been unable to make contact with a resident within 48 hours of trying the case is referred to Blackburn with Darwen’s Public Protection Service. At this point one of our specially trained Public Protection Officers will attend the property (wearing the required PPE and adhering to social distancing guidelines) to inform them of their positive test and to arrange a convenient time for them to speak to one of our contact tracers.
What have we achieved ………….
We have set-up effective working relationships with colleagues from Public Health England, collaborated and shared best practice (and lessons learnt!) with other Local Authorities from across England. We have accessed other organisations IT systems to ensure we have a quick and efficient access to our residents data held by national bodies such as Public Health England.
As of 12th October we have had 593 cases devolved to the Local Authority by the national test and trace service. Due to the hard work, enthusiasm and dedication by our Local Authority employees and crucial collaboration across public sector bodies we have been able to contact 89% of the residents, enabling us to provide them with information on how to safeguard themselves, their loved ones and their communities.
Due to the volume of positive Covid-19 cases in Blackburn with Darwen we have been at the forefront of this national challenge for some time and due to the expert execution of our test, trace and isolate team our model has been used as an exemplar by numerous other Local Authorities across the country who were keen to adopt our processes, methodologies and service structure.