Newham launched its contact tracing service at the beginning of September. Environmental health officers have staffed the service, which has been run from Monday to Friday. This case study is part of a series on local contact tracing.
- Service launched in late August, staffed by environmental health officers initially
- Permanent team now being recruited and improved IT systems developed
- Work shows the importance of prototyping – getting something launched and learning as you go
The local context
The east London borough is home to 350,000 residents. It is one of the most deprived in the capital.
It was badly affected in the first wave, but like the rest of the capital, has seen relatively low rates since, certainly in comparison to areas in the north of England.
Its current infection rate is broadly in line with the national average. All London boroughs were placed in tier two of the regional Covid alert system in mid October before the national lockdown.
What was done
Newham launched its contact tracing service at the beginning of September. Environmental health officers have staffed the service, which has been run from Monday to Friday.
Assistant Public Health Strategist Lizzie Owen said: “We get a variety of cases. Some are people who have simply missed the calls made in the first 24 hours – and they are quite straight-forward to contact.
“There are others where the contact details we have are wrong or incomplete. Some just have a first name – and there is a limit to what we can do with those.
“But one advantage we have is that we store all of our council information in a data warehouse which can be accessed, based on strict security permissions, to extract a fuller and more accurate data set. This allows us to contact and provide support to many residents who otherwise wouldn’t be reached.
“Most people we contact appreciate our call and value the fact that their local council is getting in touch. However, some people are reluctant to share the contact details of close contacts outside of their household. A minority of people are reticent to engage with the service at all.
“However, I think one advantage we have as a local service is that we have local knowledge. We can tap into local resources such as the Newham Food Alliance and Chat Newham to help resident’s access food and support while isolating. We can help them access financial support including the £500 isolation support grant.
“In fact, we start off conversations like that, asking in a friendly way how they are managing and what they need in terms of support. It really helps build trust.”
The team normally gets around 15 cases a day, which one or two people are tasked with chasing up. Although because a backlog builds up over the weekend, three people staff the service on Mondays as there can be 40 to 50 people to trace.
The team has been averaging around a 60 per cent success. Around 10 per cent deemed not contactable because of incomplete contact details and a proportion simply do not want to engage. Overall, it means that 90 percent of all Newham cases are now being reached.
A recent case of a resident in her 60s illustrates the kind of success Newham’s service is having. The woman had not been able to be contacted, but Newham’s data warehouse provided a different telephone number and the resident was reached by the team. The resident had tested positive seven days previously.
Until the call she had no idea of her positive status and had been out and about meeting family and friends. Her husband had also been working as a delivery driver.
The resident did not speak English as a first language, but the contact tracer managed to convey the importance of staying home and translation support was brought in.
The family was given advice about isolating and information about statutory sick pay for the husband. Details about the husband’s place of work and other close contacts were collected.
Ms Owen added: “It is really satisfying when we reach cases. By reaching residents we are able to provide advice and support, and ultimately make an impact on breaking the chains of transmission.”
IT problems have been a challenge. For some time, the team did not have access to CTAS and so could not upload the completed cases and pass their close contacts to the national team to call. The team still has to download the information from Public Health England every day and sort and arrange the data so that it can be used by the contact tracing team.
The limited access to the CTAS system – they can only log in details of the cases they have reached - has meant the council is now in the process of building its own customer relationships management system.
At the moment, the team is working from spreadsheets to keep its own records alongside submitting the data on to CTAS. The team will still have to log completed cases into CTAS, but the new CRM will be more automated and useful, particularly should demand rise.
Ms Owen said: “Ideally, we would want to be able to use CTAS as a case management system to drive efficiencies across the work flow. But that isn’t possible. So right now, we would like to identify a way that locally supported contact tracing systems can interface with the national system.”
Ms Owen said she has found support among her local government colleagues. “We borrowed Blackburn with Darwen’s training materials and now we are developing a customer relationship management system we will be happy to share that. We are all trying to do this – and are proactively sharing information.
“My number one piece of advice though would be to prototype and get something up and running. This will allow you to identify what works for your community and what is not needed. Draw from the experiences of others and learn from it. That is what we are doing.”
What is happening next?
Newham is now looking to recruit a permanent team of five full-time equivalent contact tracers and two coordinators as the environmental health team has been fulfilling the role on top of their day jobs. The team plans to move to a seven-day service.
These are being recruited from other council departments, including the community neighbourhoods team and workforce. Some of the roles are being backfilled, but not all.
The service also plans to recruit a bank of staff that have been trained and can be pulled in when the demand arises.
Director of Public Health Jason Strelitz said: “Recruiting staff is much more challenging now. During the peak in the spring a lot of services stopped so we could draw in staff from lots of different areas with the work we were doing.”
Mr Strelitz said the council would be willing to take on more of the workload from the national team, estimating that Newham’s team is tracing only around a fifth of cases at the moment. But he said it would need to be gradually phased in, adequately resourced and developed collaboratively between national and local authorities.
He explained, “We are adding value to Test and Trace. We know our communities and so far we have received a very positive response to the calls that we have made.
“However, many of the current challenges with the system could have been avoided if local authorities had been involved earlier.”
“The national system does now seem to recognise the value of local knowledge and understanding of community priorities. We are determined to work together to ensure we have a better test, trace and isolate system.”
Lizzie Owen, Assistant Public Health Strategist