Faced with high rates of infection in the summer, Calderdale developed a local contact tracing service in partnership with and as part of NHS Test and Trace, which went live in the middle of August. This case study is part of a series on local contact tracing.
Calderdale launched its service in mid August
A team of 20 has been recruited drawn from council staff and from the community
Calderdale says the importance of going door-to-door cannot be underestimated as it has helped them reach people who previously refused to engage on the phone
Calderdale had relatively low rates of coronavirus infections all the way through the national lockdown.
But that began to change for the West Yorkshire borough – home to around 200,000 residents - as restrictions began to ease. By late July the area found itself among the top 10 areas for infection rates.
Local restrictions came into force in Calderdale in late July. When the three tier system was introduced in October, the borough was placed in tier two. This led to easing of some restrictions and tightening of others.
What was done
Faced with high rates of infection in the summer, Calderdale developed a local contact tracing service in partnership with and as part of NHS Test and Trace, which went live in the middle of August.
It operates seven days a week – although the hours of operation are shorter at the weekend.
Depending on the information the team has, residents receive a text message and/or an email ahead of the call to let them know the local contact tracing service will be ringing them and a local 01422 number is available for residents to call back on if they miss the call.
Twenty contact tracers have been recruited – drawn from both the council’s own staff and people from the local community.
Public Health Consultant Ben Leaman, who has overseen the creation of the service, said: “We wanted to create a flexible pool of staff. The council staff know their way around the council and the community volunteers know there way around the community.
“We have worked with our local voluntary sector organisations to recruit people from the community, who can speak a range of community languages, and have supplemented those with a range of council staff. We have found people really want to help out.
“So we have people who work part-time for the council in other roles and then make themselves available for contact tracing outside of that. We have also used some of our bikeability trainers and other staff who are not on fixed hours contracts.
“They all work in partnership – there is no hierarchy. It is about having people who are trusted and have a range of skills.”
The team is dealing with an increasing number of cases, said Mr Leaman. “It reflects what has been happening with infection levels. At the start we would have some days where we did not have any cases, but that never happens now. We generally get at least 10, sometimes 30 cases or more. It does vary from day to day.”
The service has consistently reached between 80 and 90 per cent of the cases that are passed on by the national team.
“It is a real team effort. We have the contact tracers, but also a team of people behind the scenes analysing the data and pulling records and contact details off our systems for the contact tracers during the week and at weekends.
“The performance has been really good and illustrates the value of having a local service. NHS Test and Trace sometimes gets negative press but we need both national and local and we are in this together.
“We don’t have the skills or capacity to run a whole Test and Trace service on our own, but our unique understanding of our local communities can really enhance the national programme.”
Mr Leaman said the importance of door-to-door contact tracing, which is done from within the team, has become very clear in recent months.
“Sometimes people who are not cooperative on the phone are much more obliging face-to-face. You should not assume just because someone refuses to engage when you speak to them that that is it.
“The benefit of face-to-face contact is that it also allows you to explore what support these individuals need to help them isolate. That is a crucial part of the process. There is no point reaching people if after all that they are not going to isolate.
“There are a variety of reasons people may not. Finances is obviously one and we can help them access the £500 one-off grant. There are also other issues such as accessing food and medicine, who is going to walk the dog and simply fearing having no-one to talk to. We have resources to help with that.”
Alongside the local testing and tracing services, Calderdale has developed a support hub in partnership with the voluntary and community sector. It means anyone who is self-isolating, either because of a positive test or because they are a contact of a case, can ask for help. It can be accessed online or via the phone.
There have, however, been some problems that Calderdale wants to work with NHS Test and Trace to improve.
In September, the council’s team received the details of positive cases on average eight days since they had the test. Mr Leaman said: “This means people may be towards the end of their 10-day self-isolation period, so our offer of support to them to isolate may be too late. It also delays us identifying the people they may have infected so they don’t know to isolate and may inadvertently infect others.”
And he added: “Sometimes the data we get from national Test and Trace is incomplete or incorrect. Quite often either the full name, the address or phone number will be missing. When this happens we check the details with other records we hold and we are usually able to reach the person, but that adds more delay into the process.”
The service is evolving all the time. Initially the shift patterns were 9.30am to 2.30pm and 2pm to 7pm during the week. But these have been changed to reflect the fact the transfer of cases from the national team does not happen until mid morning. Shifts now run from 10.30a to 3.00pm and 2.30 to 7pm. The overlap allows those working on shifts to discuss cases and seek peer support as well as touch base with the team leader.
The service is also starting to recruit more contact tracers, Mr Leaman. “We want to get up to 30. We know we have more cases now and we have to be careful about fatigue. We are also exploring with the national team whether we can have more of a role in terms of contacting close contacts.
“Some will be outside our boundaries, but a significant proportion are household contacts. But because of the way the system works we cannot currently open case files for them and advise them to isolate.
“They get passed back to the national team who then do follow up calls. That is why we hear of families getting multiple calls. It is not ideal ”
Public Health Consultant,Calderdale Council