COVID-19 ICS update - 27 November 2020

This bulletin provides important information for people working in health and care across the North East and North Cumbria regarding guidance and actions being co-ordinated across our region to care for patients, staff and our communities in the light of COVID-19. We will do our best to keep you updated with the latest information and key decisions from the Health Co-ordinating Group. This group is led by Alan Foster, executive lead for the North East and North Cumbria Integrated Care System. If you have any questions or would like us to send vital information to partners through this bulletin, please contact us here.
Message from Alan Foster
Alan Foster
Tier announcements

Today local restriction tiers were announced and will be introduced on Wednesday 2 December. The North East now finds itself under tier 3 restrictions and North Cumbria in tier 2. These restrictions will remain in place until at least 16 December – when the first review is expected.

For many of our communities and businesses this will feel hard but we will get through this together. Ultimately, we all want the same thing which is to see rates comes down and to protect the most vulnerable in our communities so we can move to a tier with fewer restrictions.

We will get there. We are starting to see a decline in rates overall and we’re heading in the right direction. I would like to thank everyone for all they continue to do to keep us safe and to follow the rules.

For more information on the tiers, see here. You can read a statement from the seven local authorities in the north east here.

Christmas arrangements

Also this week UK-wide Christmas arrangements were announced, which means between 23 and 27 December people can form an exclusive ‘Christmas bubble’ of up to three households.

While we will all appreciate the opportunity to be with loved-ones, I am sure we are all mindful of the risks this still poses to ourselves and others, particularly those who are vulnerable. So, while this is news is welcome we will be reminding people of the importance of staying safe this Christmas while they enjoying some time with loved ones: and, of course, to look out for one another – especially vulnerable neighbours – as we know this can be a lonely time for people.

Delivering an NHS COVID-19 vaccination programme for the North East and North Cumbria

Lots in the news this week about COVID-19 vaccines which I am sure you’ve been following with interest.

In terms of what is happening across our patch - there’s lots of detailed planning now underway. This is building on the expertise and strong track record we already have in delivering immunisations like the annual flu vaccination programme, to ensure that a COVID-19 vaccination programme does not impact on other vital services.

As you know this is being supported by Newcastle upon Tyne Hospitals NHS Foundation Trust, who have a system wide co-ordination role. Over the last two weeks a large range of key meetings and briefings have taken place with key partners and organisations to help them develop their own plans, for example, staff vaccine programmes.

Nationally, the NHS is working closely with a number of partners across Government, each with their own roles and responsibilities. Our regional plans will be finalised based on decisions made by those bodies, including when and what vaccines are approved and who should receive them.

Locally and regionally, we are working collaboratively on a range of planning issues in anticipation of getting the finalised information about vaccines. We know that the successful vaccination of our communities will rely on us working together so we’ll share further information as soon as we are able to.

The clear message nationally and from the NENC ICS Vaccine Board (which has developed from the regional strategic flu board chaired by Dr Neil O’Brien) is the firm commitment to work together as a system to support a successful roll out.

To support this, it’s vital we continue to push the flu vaccination forward especially for our front line staff in health and care as well as those in the older age and clinical at risk groups. Doing this now means we will be in a much stronger position for when we are able to roll out a vaccine for COVID-19.

In the meantime, a huge thank you to everyone supporting this important programme. Our strength is, as ever, in working together and all playing our part to protect our staff and our local communities. For more information, we have included a few answers to frequent questions asked on the COVID vaccine programme in the 'other news and updates' section below.

Asymptomatic staff testing

As highlighted last week a huge number of lateral flow (LF) tests have been delivered to our trusts over the past couple of weeks to enable patient facing NHS staff to test themselves twice a week at home. All our trusts have received some if not all of their expected number of tests. Work continues this week to ensure full allocations are received by all organisations as quickly as possible. This has been a huge amount of work for everyone involved – thank you and well done.


We are continuing to do really well as a region but still need a big push to get our workforce vaccinated ahead of the COVID-19 vaccination programme going live.

We have seen a fantastic effort across our care homes with 80 per cent of residents being vaccinated. Great work everyone.

There continues to be lower uptake rates for those under 65 in at risk groups, children age 2-3 and women who are pregnant, so please do all you can to support us in sharing messages with these groups. Don’t forget the toolkits can be accessed here or you can contact your comms leads for support.

Last Friday, it was announced that the flu vaccination programme would now be rolled out to those aged 50-64. There’s been lots of interest already from the public about this with GP surgeries receiving lots of calls. We will be reinforcing messages on social media and on other channels to ask people to be patient and assure them that vaccines will be available throughout December and into the new year.

Integrating care – next steps to building strong and effective integrated care systems across England

As you know there’s an expectation for every health and care system to be ready to operate as an integrated care system (ICS) from April 2021.

Today, the Board of NHS England and NHS Improvement (NHSE/I) discussed this report which sets out proposals for legislative reform and opens up a discussion with the NHS, and its partners, about how ICSs could be embedded in legislation or guidance.

There are lots to work through but we will continue to work collaboratively with partners over the coming months as we do this.

We are all able to give feedback on the policy by submitting responses to or alternatively, you can also contact or write to NHS England, PO Box 16738, Redditch, B97 9PT by Friday 8 January.

Good and outstanding ratings for our CCGs

Clinical Commissioning Group performance ratings have been launched this week and across the North East and North Cumbria we have been rated as either good or outstanding. This is a real credit to everyone – especially given the huge challenges we have faced this year. Well done, you can read more here.


As ever there is lots happening and things are moving at pace. I can’t thank you all enough for everything you and your teams are doing. Keep going.

Best wishes, Alan

Alan Foster is the executive lead for the North East and North Cumbria Integrated Care System

Other news and updates

Here are a few answers to frequent questions asked on the COVID vaccine programme

What vaccine will be available when?
While there are a number of different candidate vaccines being developed and trialled, with support and oversight from the Department for Business, Energy and Industrial Strategy and the National Institute for Health Research, we don’t yet know which will be approved for use by the Medicines and Healthcare products Regulatory Agency (MHRA), or when this might happen for each.

As clinical trials progress and we understand more about the requirements of different vaccines – such as storage, transportation and how it is administered – we will continue to refine our plans to ensure we have the right resources in the right place. The MHRA will also decide how and where vaccines can be used – this is an important consideration and will directly inform how local and regional plans are rolled out.

Who will get the vaccine?
The Joint Committee on Vaccination and Immunisation (JCVI) have recently published updated interim advice on the priority groups to receive COVID-19 vaccine. These will be updated as and when pharmaceutical companies provide more information on conditions for use of any vaccines and where they are most effective.

The JCVI will continue to update this advice as more information becomes available on vaccine effectiveness, safety and clinical characteristics. This will in turn be reflected in the NHS’s plans – and this is the most important issue that directly influences local planning.

How will the NHS deliver the vaccine when it is available?
The NHS will be delivering the vaccine in three main ways: large scale vaccination sites; community/primary care led, and; NHS Trusts. The exact mix and how these will look will be subject to local decisions across the NHS and their partners. In general:

Hospital Hubs - NHS providers vaccinating onsite;
Local Vaccine Services - Community/primary care led services which could include using primary care facilities, retail, community facility or temporary structures or roving teams, and;
Vaccination Centres - Large sites, such as sports and conference venues set up for high volumes of people.

We will make regional location information available when we are able to.

How will people know if they’re eligible for a vaccine and how to get it?
Public-facing communications will be led by DHSC, working with the NHS, PHE and other Government departments, and they will be beginning initial communications on the safety and effectiveness of vaccines in general shortly. As is currently the case with flu and other vaccination campaigns, local organisations and their partners will also play an important part in adapting and amplifying these messages in their particular local communities.
However, in the early stages we will focus on health and care staff, and care home residents. We don’t expect wide ranging public campaigns until next year.

How will staff get the vaccine?
We are working with trusts, adult social care and primary care to establish the best way to ensure that both health and social care staff can get vaccinated as soon as possible. As is currently the case with the seasonal flu staff vaccination campaign, this is mainly led by individual employers, with additional arrangements in place for social care staff such as home carers.

The R number in the UK: The latest reproduction number (R) and growth rate of coronavirus (COVID-19) in the UK can be found here on GOV.UK.

Public Health England dashboard: The Public Health England (PHE) dashboard can be found here. Daily reporting includes deaths that have occurred in all settings where there has been a positive COVID-19 test, including hospitals, care homes and the wider community. The report also includes case rates per 100,000 resident population at lower-tier local authority level.

National flu and COVID-19 surveillance reports: A link to the weekly national flu and COVID-19 report, monitoring COVID-19 activity, seasonal flu and other seasonal respiratory illnesses can be found here.