In many two tier areas, Preston County Council has taken the lead on setting up local contact tracing teams. Often they host the contact tracers, leaving the districts to do the home visits. This case study is part of a series on local contact tracing.
- In Lancashire the lower tier councils have taken charge of setting up their own contact tracing teams, supported by the public health department at the county
- Preston City Council was one of the first to take the step – and is now achieving positive results
- Most of the rest of the country have followed suit
Preston is one of 12 district and city councils that forms part of Lancashire county. There are also two unitary authorities – Blackburn with Darwen and Blackpool.
Preston is home to around 140,000 people. The city has seen high infection rates during the second wave along in common with much of the north west. At one point the city was recording over 400 cases per 100,000 people a week.
Before lockdown, it was in tier three of the regional Covid alert system. Cases have started to fall in recent weeks and the local authority fell out of the top 50 infection areas for the first time in months in mid November.
What was done
In many two tier areas, the county council has taken the lead on setting up local contact tracing teams. Often they host the contact tracers, leaving the districts to do the home visits.
But in Lancashire the county has supported the boroughs to set up their own teams by running online seminars and training and providing on-going support and advice.
Preston was one of the first lower tier authorities to take the step in Lancashire. It launched its contact tracing service at the end of August. Eight members of the customer service team were trained to do the phone calls, while visiting officers do the door-to-door tracing for cases where the call handlers are unable to get through.
Texts and emails are sent out in advance to let people know the Preston team will be calling or to invite them to call in themselves.
The service runs from 9am to 5pm Monday to Friday.
Business Support Manager Candice Lancaster, who is one of three supervisors for the service, said: “We have received fantastic support from the county council. At the start, they really helped with the training and setting everything up. Blackburn with Darwen had had a contact tracing service going for a little while so we learnt from that and adapted it for our needs.
“I think having both the call handlers and home visit elements at district level is of real benefit. It means you have smooth and quick communications between the teams and you are close to the population you are trying to reach.
“But whenever we need support we have the expertise of the public health team at Lancashire we can call on. We have regular phone calls and meeting digitally to share good practice across the region.
“And if we have problems, they are there for us. For example, we had a case the other day of a taxi driver who lived with his brother. His brother had tested positive, but did not tell the taxi driver. It ended up quite complex because the taxi driver had been working. The team at Lancashire helped us navigate our way through it.”
Preston is dealing with around 20 cases a day on average, although the numbers can vary from 10 to 40. It manages to trace around 70 per cent of cases that are handed down.
Ms Lancaster said: “These are cases the national team have not been able to contact, so we are really pleased with that level of performance. I think the fact that people are being contacted by local people, from a local number, makes a big difference.
“We can offer them support – if they need food or medicines delivery. The introduction of the £500 support grant has also made a difference. It has encouraged people to engage with the system. We certainly noticed after it was introduced at the end of September that people were more willing to take our calls.
“Most people now do understand what is expected of them and we do normally get a good response and positive engagement. But there are of course some who do not want to engage.”
When Preston first launched the service, it was using a withheld number. “It took us some time to get to the point where we could call and it would show the local number,” said Ms Lancaster.
“We found that once we did that it did make quite a significant difference in terms of people answering the call. Lots of people are reluctant to answer phone calls from withheld numbers so I would certainly advise others to invest in this.
“We also found we had to think about our staffing. At first we had enough call handlers on to make the calls, but we did not have spare capacity for people who called back. We changed this when it became clear we were missing calls from people. You have to be willing to adapt and learn as you go.
“We set the team up quickly and knew there would be things we would want to change and tweak as we went.”
The council has just recruited and trained eight new call handlers. They all used to work at community testing sites and will supplement the current team.
Ms Lancaster said: “Some of our customer services staff have to go back to their permanent jobs because they are needed. We are also thinking about extending the hours we staff the call centre so wanted a bank of casual staff we could call on.
“We are finding some people say they cannot talk until the evening so we think running it to 7pm or 7.30pm could make a difference. I don’t think it needs to be any later than that. We are also looking at what we can do at the weekends.”
Ms Lancaster would also like to be able to offer people the option of filling out their contact details online. “They get an opportunity to do this right at the start before the national team try to contact them.
“But once the time has lapsed, that option goes. We think it could help reach some of the people and so perhaps in the future when we send them the texts and email we will be able to provide them the option of filling in the details online again if they wanted.”
Lancashire Public Health Consultant Abdul Razaq said he is delighted with the progress Preston and others are making. Ten of the 12 districts in the county have now got contact tracing teams up-and-running.
"We know in Lancashire they are more responsive to local team than distant national team. People are fatigued and these are highly disadvantage communities, they are concerned about losing work and losing money. The support local councils can provide to them is essential in getting them to isolate and engage.”
Mr Razaq is also keen to expand what councils in Lancashire are doing in terms of contact tracing. “Like all local authorities, we are only doing the index case at the moment. But when we ring we know the rest of the household is there, but we cannot talk to them and close off the case. That is why people get multiple calls.
“It undermines what we are trying to do when that happens – we are asking whether we can start doing household contacts. It would make more sense and would be more efficient and when we have contact tracing going in all the local authorities it is something we would like to look at.”
Business Support Manager
Preston City Council