National Assembly for Wales

Diolch, Cadeirydd. Good morning, all. Clearly, we have local restrictions in place now in several counties across Wales, and particularly south Wales. Last week we heard from the technical advisory group that there are some trigger figures that are used sometimes to look at identifying those county boroughs that may be at risk or may need intervention. One of them was given that, for example, at 20 to 50 you were put on amber, a watch alert, and, above 50, you would actually want to take action. Do you recognise those figures, and are those figures actually what's being used to decide upon which county boroughs would need action taken and restrictions placed upon them? 

Thank you. Quentin, if you'd like to respond.

Yes. I do recognise those figures, thank you. Public Health Wales met with Welsh Government officials two weeks ago to discuss the thresholds and criteria, which are as you reported. We considered those in the context of local restrictions. We were very clear that we needed a separate discussion to talk about the national restrictions, as additional factors would need to be considered if we were looking at that context. So, we do recognise the numbers. We also, alongside those numbers, looked at positivity rates as trigger thresholds as well, and those have been applied in consideration of the application of the restrictions to date. 

Can you clarify, then? Because I understand those figures, and you talked about the positivity rate, which I also acknowledge, but I looked at the figures yesterday and, for example, Newport was actually one of the ones not above 50—it was 39 per 100,000. So, how do you look at these figures and how do you decide? Is there a trend analysis also being considered? So, how do you decide which authorities are on the watchlist and which authorities are 'action required', because Newport was 39 per 100,000? 

Yes. You mentioned Newport. So, the first thing that should be said is that we were already aware of concerns in Newport, brought to our attention by the health and local authorities there at least 10 days earlier, and we'd been engaged in discussions with them. But, to answer your question, we don't simply wait for the number to reach a trigger point; we look at the trend, and the trend in Newport was going up. We had a good understanding of the reasons for that, and our determination of the actions appropriate to that area—which were, in fact, recommendations arising from the local incident management team, bringing together all the partners in that area—was based on that assessment that we were heading in a direction that would warrant intervention, taking account of what we already knew about the position in Newport. 

So, just to clarify, it's the number and the trend towards that number, local knowledge, local intelligence on the clusters that may be happening and how community transmission may be spreading—it's a combination of all those that actually is taken into consideration to decide—[Inaudible.]

Absolutely, yes. 

Okay, that's helpful. Thank you. But how big does an area have to be, then? Because, obviously, Newport's a city, but take Carmarthenshire, which I think is on the watchlist. Carmarthenshire is a large area—you have major towns such as Carmarthen and Llanelli, for example. How big an area could you go down to, if you want local restrictions imposed, or how small an area—

Well, you mentioned—. Apologies, I interrupted you. You mentioned Carmarthenshire and, indeed, looking at the position in Carmarthenshire, we do see quite significant variation within that county area, with the highest figures of concern in the Llanelli area. So, in fact, that is where we're paying particular attention within Carmarthenshire, so we are able to go down to a sub-county local level in terms of our considerations, and that is what we're actively doing. 

And that's the smallest type of area you would go down to. Because we've been told about postcodes, but postcodes are so small and within such a tight community, sometimes, it seems strange to go by postcode area. But you would look perhaps at a town or locality, rather than a county borough as a totality. 

We look at natural communities or defined jurisdictional boundaries, rather than just simply a postcode. 

Okay. You've mentioned national action as well. Clearly, none of us want to see national action, if possible, because there could be areas, as the First Minister has indicated, that have very low figures and are not actually under threat at this point in time of wider community transmission. So, how do you balance the difference between a national restriction and a local restriction? 

Well, I would suggest we start with first principles, and what I think we've observed over the last three weeks is, if you like, the population generally dropping its guard on some basic things like social distancing. So, what we'd want to emphasise are those fundamental first principles of hygiene, social distancing, the application of—use of, rather—face coverings in shops or on public transport, that sort of thing. And, then, you are right; what we need to do is we need to respect those areas where the rates are low—perhaps even the trend might be even decreasing in those areas—and not take a blunt approach. That involves multi-agency discussion, which we conduct either through the IMTs at a local level, or at regional level through our strategic co-ordinating groups. So, it's about, really, looking at the entire picture and asking ourselves what are the generic core messages we want all the population to practice and demonstrate, regardless of their infection rates, and, then, when we look at particular areas, what are the particular circumstances in those areas that might warrant additional consideration. 

And at what point do you think local lockdowns or local restrictions will have failed and you need to impose a national restriction?

Well, I think what we can see at the moment is, for example, in Caerphilly, how the early application of local restrictions is beginning, I think, to demonstrate some effect on those rates. We've seen those rates go down over the last two or three days, and we're hopeful that early intervention will mitigate the need for us to take a much broader approach, which we would rather avoid if we could possibly do so. 

Do you think the evidence from Caerphilly—because, obviously, that was the first one that went into local restrictions—do you think the evidence from Caerphilly is demonstrating that local people are actually now responding to the challenges that are being faced because of coronavirus return? Let's be blunt: over the summer, many people probably thought that it'd gone away and life was getting back to normality, as they thought, and yet here it is, coming back to bite us in the backside, basically, very severely. So, are the people responding in a way you would expect them to respond, and do you therefore believe that local restrictions will deliver in those areas that have now been identified?

Well, the evidence we're getting from feedback from the local IMT is that people are responding. Now, there are a few people who are choosing to ignore, or wilfully ignoring, and we're mindful of that, and agencies, police and others, are giving consideration about whether any particular action might need to be taken against specific individuals or groups. But, by and large, the evidence we're getting is that people are responding and that is now beginning to demonstrate an effect. And, therefore, we should, I think, as long as we're able to act quickly and secure public support and confidence, use the approach of local restrictions as far as possible, but, clearly, not to the extent, ultimately, that—. If the picture across Wales were to become, I don't know, at a situation where we needed to think nationally, we won't hesitate to do so. But, clearly, just to remind the committee, we contribute to the assessment of the situation locally. Locally, partners put forward recommendations to Welsh Government, and then Welsh Government and Ministers make the decisions. 

I appreciate that. I was going to come on to the point as to the criteria you would assume, or you would consider to be looking at as to the easing of local restrictions. So, I think that's an important point. I want to understand the role Public Health Wales plays with local authorities in this position. How do you make sure that the communication and the messaging is the right messaging out to the communities, and how—do you work closely with local authorities to achieve that?

So, we provide the local authorities with information—indeed, all our strategic partners; the health boards and the local authorities, police and others—with epidemiological information. So, we share our intelligence with them. The health boards and local authorities lead for test, trace, protect locally, and they convene incident management teams, which we support. We might chair them; often they're chaired locally by a director of public protection or a director of public health. But we support those committees with specialist advice, epidemiological advice. Those committees then take account of the information that we can provide, as well as local knowledge and intelligence, to reach an informed position. That, then, is shared with political leaders, who contribute into the discussion and then agree a position that then goes forward to Welsh Government. That is considered in Welsh Government—

Who's responsible for communication? Is the IMT responsible for the communication?

The IMT takes the lead, or the OCT, the outbreak control team, will take the lead for communications, yes. 

Okay. So, that will come from those decisions then. Okay.

Yes.

As I said, just on the previous question, what criteria do you think is important now for easing restrictions? You said in Caerphilly you're seeing a response; you're seeing people's behaviour to a point where you think it's working. At what point will you, and what criteria are you looking for, be able to advise the Welsh Government that these restrictions have worked and they may no longer be needed in this local area?

Well, clearly, we've got the thresholds, and we want to be assured that the trend downwards is clearly heading toward the threshold that takes us out of a requirement for intervention. Obviously, looking at the range of restrictions applied, those that we placed in that area, we will look at those individually now in the context of the position that has been set out by the First Minister last night—for example, about closing times for pubs. So, for example, we are not going to suggest that we revert to a position where we would allow later closing times, but that we would work back towards the general restrictions that are in place locally. But we need to be mindful also of what else is happening across Wales. And so, for example, if we're talking about movements of people across jurisdictional boundaries, we need to respect the fact that other areas adjacent may have still quite high rates, and the restrictions applicable to those areas would therefore still apply to Caerphilly residents, even if they were 'released', if you like, from their own local restrictions.

Okay. One final question from me. You've talked about the watch list, and you've identified some of the counties, authorities, that will be on that watch list. But we've also this week got the students coming in, in large areas, numbers, in particular cities. Are you looking also at those particular cities, because, for example, there was a situation yesterday where Swansea University identified 12 cases? Are you also looking closely at the university towns to ensure that they are also monitored? Clearly, that is a situation where we could see large numbers of people in social gatherings, coming from outside of Wales, who may not understand the rules within Wales at this point in time. So, are they now on your watch list as well?

We've been very mindful of and anticipating the return of students to universities across Wales. That has been a part of our discussions in our TTP programme board over the last several weeks. But specifically now, and within the last few days, we have been having conversations with Welsh Government and with the health boards and local authority leaders, in Cardiff and Swansea in particular, because of our concerns not only on the point that you're making about the return of students more broadly, but their proximity to the other areas already subject to restrictions.

Thank you. And I just forgot one point—on local restrictions, if they're being eased, do you anticipate them to be eased in stages? For example, I know at the moment that families can't necessarily meet indoors, and that's a very serious challenge for many families, and particularly for families who have children where grandparents look after the children whilst they go to work. Do you see the incremental removal of some of these restrictions, rather than a whole-hearted, one-go time?

Well, ultimately, as I repeat, Welsh Government will assess the recommendation and advice that we and others present to them, and make the decision. We have, up to now, indicated that an incremental approach—if you like, in reverse to the position we've reached now, in terms of easement, backwards—makes sense. And it would make sense then to reapply the easement in an incremental way forward, at an appropriate time where that can be demonstrated as justified by the epidemiological evidence.

Thank you. Even though it's a decision for the politicians, your advice, obviously, is very influential in that decision making, so thank you for that answer.

Andrew R.T., you have a supplementary on this issue.

Thank you, Chair. Just on the students returning to university—for many students, the first time that they're going to university—I'd just like to understand what recommendations you are making to Government about measures that can be put in place, because the Minister yesterday, in his statement, had a specific line in that statement that referred to measures to protect the local population. So, is it greater isolation of students on campus? Am I to read that into those sorts of lines that the Minister has been talking about, or have you other ideas that you've been putting forward around the protection of local communities, but also students themselves, because what we've got to remember as well is the mental health of students, and if we start isolating more and more students in tighter and tighter bubbles, that has a real public health issue for us to address as well?

You're absolutely right, and it is a balance between these different factors that you highlighted. So, clearly, we need to protect the students who are coming to Cardiff and will be meeting other students from other places that they've not mixed with before. So, we will be starting with first principles: reinforcing the importance of social distancing and other behavioural actions that we should all be taking but they need to be very mindful of in the context I've just described. 

In addition to that, of course, we want to make sure that students, and the population in which they live, are protected, hence we would be suggesting that universities provide information to their students about how they socialise and the context in which they socialise, recognising that some of our challenges more recently have occurred with people coming together in parties or meeting in hospitality settings and perhaps not always observing proper distancing. So, we'll want to reinforce those basic messages to students, that they can come to Cardiff, that they can enjoy their experience—or Swansea or wherever—but, in order to do that, for their own safety and the safety of the population that they'll be living in, there are just some basic things that they, and we the population, need to do.

Okay. Who wants to kick off? Tracey?

Thank you. Giri.

Yes. So, the test, trace, protect programme is developing every day since it commenced. So, the systems and processes are bedding in and there's a good feel for what is required—people who've been trained to do this job are getting better as they get more experienced. So, the performance data from test, trace, protect certainly indicate that we've been able to reach over 90 per cent of the contacts very quickly—certainly at least 80 and above percentage have been reached within 24 hours and the number of contacts per case has remained relatively low over the summer periods. But, since the beginning of September, we are noticing that the number of contacts per case is going up. That is actually adding to the workload, as we have all seen data: the three months' worth of cases that we saw in June, July and August—just over 3,500 cases—we have seen the same amount of cases in just three weeks of September. So, clearly the system is being stress-tested for that. We know that it is a sustainable model that we want to do. We were mindful that it needs system-wide resilience and that more and more people need to be trained in it. So, at the moment, it is delivering what it is supposed to deliver, but, in anticipating the reasonable worst-case scenario ahead of us, I think it would benefit from further resilience system wide. But it is absolutely important to recognise that the system, right from the local tier to the regional tier to the national tier, has absolutely been doing a fantastic job to get a good contact trace. 

And describe how that added resilience could be built in. 

So, there are a number of ways. So, I know local governments and health boards are in receipt of Government funding for additional recruitment because, in the early days, there were a number of colleagues who had been redeployed into other roles, and now there is a need for them to be brought back in; additional automation in the form of the databases that we use; and, more importantly, it's about recognising the level of skill that is needed at certain levels, as people, initially, were a little bit hesitant to undertake complex contact tracing at local levels and needed more specialist input. As the system has evolved, people have got a level of confidence and comfort that they can still deal with either clusters in care homes or educational institutions. So, through a combination of upskilling the existing staff and recruiting more staff into it, the resilience can be improved. 

And describe to me how Public Health Wales fits into that nationwide model, given that these tracing teams are delivered on a local authority level, but through regional partnerships. 

Public Health Wales inputs at various stages. At the regional tier, we are providing the specialist input for health protection, which will mainly be for risk assessment of complex situations, communication and strategy decision making for the local plans. At a national level, we are supporting the 'once for Wales' approach of trying to do consistent standard operating procedures, action cards, SOPs. And, on a third front, in terms of developing the informatic capability for the system, we are inputting very closely into the technical requirements of the database that goes into it. On a fourth point, we are also monitoring the data, providing surveillance reports and evaluation reports to feed back into the local and regional tiers. 

Thank you for that. And one question perhaps for Dr Cooper: there are questions about how much influence Public Health Wales has had over testing—and we'll come on to testing in a minute—but, on the tracing element, are you satisfied that Public Health Wales has the influence that you need over how testing is operating? Or are there some improvements to, I guess you'd call it, the 'governance' of testing in Wales that would, from your point of view, help?  

Yes, from the outset, the committee will recall, last time we were with you, we talked about the public health protection response plan. So, as far as how it hangs together around test, trace, protect, that's the operational model and that was the model that we advised to Government. So, that, in essence, as Giri's described, is what's being implemented. As to the informatics solution—the customer relationship management system—we're influencing that on an iterative basis around the specialist public health protection elements of that. And, as to the testing elements, and I'm sure we'll come on to talk about that, we've been working very closely over the last number of weeks and months, as you know, with Welsh Government about how we really exploit all the available capacity for Wales, whether it's domestic capacity or through lighthouse labs. 

It's fair to say that, over the last couple of months, we have increased our engagement with Welsh Government. So, we meet with the test, trace, protect programme board, and are a part of that, three times a week, working through what's coming locally, what we need to do differently, what is the UK position. So, yes, we're working very closely with them, and as required, really. 

Just thinking about that, you mentioned some of your contacts. How often do you meet the health Minister? How often does your chair meet the health Minister? Because this is a pretty high level pandemic, where the leaders of various organisations, chief medical officer, head of the NHS are key figures. Do you meet the Minister regularly? 

Yes, we're in a number of meetings during the month with the Minister. I have regular meetings with Andrew Goodall, as director general; in fact, I had a catch up with him yesterday. We meet three times a week with the chief medical officer. I'll give you an example: on Thursday, last week alone, there were two meetings happening with three or four different cabinet members. Two different meetings, one in the morning, one in the afternoon. And then, similarly, yesterday, we were with cabinet members at meetings. So, as any public health body needs to be, obviously, decisions and policy are for Government, but how we can help support and inform that is becoming increasingly so, actually, the engagement has increased.

So, you, personally, and your chair would meet Vaughan Gething pretty regularly.

There's a regular, if you like, battle rhythm during the month, where there are meetings that happen, set meetings with the Minister, which we're engaged in, as well as ad hoc meetings as and when we need to, depending on the state of the nation at any given time.

The reason I ask is that I just want to know that you feel that you have enough influence on the political decision makers at the heart of this.

On to testing then, an issue of major concern to all of us as committee members in our constituencies and regions, because of all of the people contacting us to say how difficult they're finding it to get tests at the moment. What's your take on what appears, to me, to be a collapse in the system that we had in place?

It's unfortunate in the last couple of weeks, because, obviously, we're talking about lighthouse labs that are the UK Government resourced and delivered testing. As colleagues and Senedd Members will know, since the end of June into July a large amount of samples or the swabs from Wales go through the lighthouse labs, and up until a few weeks ago, that was working actually pretty well. In fact, some of their turnaround was better at that point than some of our domestic turnaround. We would support the reasoning to exploit as much capacity as we can get, be it domestic or otherwise—UK in this context. It has deteriorated—we're all concerned about that—over the last number of weeks. The turnaround times for testing through the lighthouse labs are [Inaudible.] very closely with Welsh [Inaudible.] to [Inaudible.]

I'll try to ask you a question to see if we can converse.

Sorry, I missed the last minute or so. Are you able to see me and hear me okay?

We can hear you, Dr Cooper. So, if it's okay with you, I will try to go on with another question and see if we can pursue this.

Apologies.

I know that lighthouse is delivered by UK Government, but what's your involvement? Do you know what's happening with lighthouse in Wales, for example? Can you tell me if the lighthouse lab in Newport is up and running? It was meant to be open by the end of August.

Aha—this isn't working.

Shall I come in there? It's Quentin.

Yes, if you want to, Dr Sandifer.

I'm really sorry. So, you're right: the Imperial Park 5 development, which we mentioned to you at our last meeting, that has now transferred to the UK Department of Health and Social Care for development, as you say, as a lighthouse lab, and we're expecting that to open very shortly.

That hasn't opened, then?

My understanding was that it's—. No, it's not yet open, but my understanding was and is that it is working towards opening in the very near future. I'm unable to give you an exact date on that, but that is the intention.

And then, as you are all aware, alongside that, Public Health Wales is developing an additional laboratory at what we're calling Laboratory 2, which we hope will begin to open from the end of November, beginning of December.

These are big delays, of course, and maybe it goes to explain why we're in the hole we're in currently, if that lab in Newport still hasn't opened and we're still waiting for things to happen towards the end of November. Let me ask you this—

Sorry, if I could just remind the committee, of course, that that is being managed by the UK Department of Health and Social Care through a contract with Welsh Government; Public Health Wales is not involved in the implementation of that laboratory.

Thank you very much for making that point; clearly we're aware of that. I'm more concerned about the stress that that's putting on our resources here in Wales, including Public Health Wales, because that lighthouse laboratory that was meant to be open by the end of August still hasn't been opened.

We got a statement from the health Minister yesterday in relation to the frustrations over testing capacity. He said this:

'Building on the work that has already taken place to supplement capacity from Lighthouse labs with those operated by PHW. We are now able to process an additional 28,000 tests per week, with further capacity available to manage outbreaks across Wales.'

I can't read my own handwriting here. Do you recognise that 28,000 and how are you delivering 28,000 additional tests?

Can I come in? Apologies. Can you hear me now? 

Yes, indeed, Tracey.

Sorry. It disconnected and reconnected. So, currently we're doing around about 2,500 tests per day, coming through the Welsh system. We can comfortably do 5,500; we can scale up to 8,000 to 10,000 a day if we need to. We actually have the testing chemical reagent capacity to do 15,000 a day, and you will have seen the Minister announced the £32 million back in August. So, we're in rapid recruitment to bring about 170 people in right across Wales, which we can come back to. So, that's really about exploiting the capacity that we have, so that equates to around 4,000 additional samples diverted from lighthouse labs to come into our Welsh lab, which would give us an additional 28,000 during that week.

So, you're now, as a result of the development over the past few days or week, processing 4,000 more tests per day than you were previously and there's room for that to increase further. 

Yes. So, that hasn't translated in as yet, so we can do it very easily, obviously, if the samples come to us, but it's probably worth just sharing with committee members that there's a number of actions going on at the moment to try and exploit our capacity. So, we're looking at putting additional lanes into the mass sampling centres like Abercynon, like Llandudno, so that instead of a two swab, which is a nose and a throat going to lighthouse labs in addition, it's a single swab that can be diverted into our labs.

Also, the Welsh Ambulance Services NHS Trust resource a number of mobile testing units across Wales that we've been using for outbreaks for rapid testing. So, we're going to divert five that the department of health are running into WAST-run, so that, again, those will divert with us and we're working closely with colleagues also in Cardiff and Vale to see if we can expand the space to accommodate some of our larger pieces of equipment to do the mass scales.

What I would say, though, if I may, is that throughout the last number of months, as committee members will have seen, various outbreaks and incidents happening across Wales, our focus has been very much about the emergency response, the agility. So, you'll have seen, for example, in Merthyr, working in partnership with Merthyr local authority, with Cwm Taf Morgannwg University Health Board, with WAST, we've been able to do some mass sampling. So earlier on in an outbreak in Kepak, 800 people were swabbed on a Saturday and then by 11 o'clock on the Sunday morning, 799—I'm not sure what happened to the eight hundredth—we were able to return the results on those.

And then, as we've seen in the last fortnight alone—and the leader of RCT has been understandably very clear in engaging—we had difficulty in turning around samples because the capacity had been capped from the lighthouse labs. So, this is how the Welsh system can work: partners mobilised, we did walk-ins—[Interruption.] Apologies: there's a standard fire drill at our end. So, we can surge, in short answer, up to 8,000 to 10,000 and we're building that so that we can have it as a sustainable increase progressively over the next weeks and months.

Yes, how much time have I got, Chair? Do we need to press on?

We do need to press on, and I'm glad to see that Dr Cooper is not engulfed in smoke.

Yet. [Laughter.]

Yes. There's always time. Jayne Bryant, on the same sort of testing sort of issues, I think.

Thank you, Chair. Just to follow on from the questions from Rhun, really. As you've said, we haven't seen the lighthouse laboratory open in Newport, which was promised for August, I think, and there's no explanation as to why that delay has come about. But I'd just like to get an understanding of how things are working in Newport and areas like Newport, which has had the local restrictions in terms of testing and capacity. Because obviously, in Newport, we have the critical workers driving to Rodney Parade and I think just an understanding about how testing capacity—. You know, when there's an outbreak or a cluster forming, obviously the demand for tests goes up, but obviously getting those tests back as quickly as possible, and having people sent here, there and everywhere, which I know is not down to Public Health Wales in terms of the lighthouse laboratories, but it does impact on these clusters, and if you can't—. I know, for example, that people are being sent to different parts of Wales even, and they struggle to get a test and then they come back not having been able to have a test for some reason. And then, unless you're persistent, there are people who are just going about their daily business, really, which obviously they shouldn't be doing, but they feel they've tried and they haven't got a test and then they just don't get that test. How do you get involved in those sorts of things?

Yes, thank you and I'll invite Giri in—I'm sure he may want to say something in a moment. When there are incidents or clusters or outbreaks, mobilising Wales as a system—and what I mean by that is pop-up testing, mobile testing or sampler units—diverting those into Welsh labs to do a rapid turnaround hasn't been a problem. In Newport, obviously, as Quentin and Giri have mentioned earlier, we have been very closely involved in all of the discussions with Newport, particularly over the last number of weeks, with leaders, with chief executives, and with Gwent region. These discussions are part of those. Rodney Parade in Newport actually has an additional lane where we can divert those samples straight through into Welsh labs and Aneurin Bevan does actually have a lab as well, in addition to a Public Health Wales lab. And constantly part of the conversation at the incident management teams is: do we need to put more in for the sampling testing for that outbreak? So, it's really, the lighthouse—. So, we can direct and exploit the Welsh capacity actually more easily for outbreaks, incidents and clusters than we can, if you like, the mass testing of home testing and care homes. But, Giri, did you want to add to that?

Yes, thanks, Tracey. Just to add, I'll give you a couple of examples. When we were seeing the increased numbers of cases in Caerphilly and we wanted to provide additional testing capacity, within a very short period of time we were able to set up a walk-in testing centre in the civic centre and also an additional drive-through centre, plus a mobile testing unit. In the early days of those operations, anywhere between 300 and 350 samples from each of those testing centres, per day, came to Public Health Wales labs. We had protected the capacity to offer a rapid turnaround on those, and over 95 per cent of those samples were tested and the results returned within 24 hours, so that really helped us to get on top of understanding what was happening in Caerphilly in terms of the test positivity rate, and that actually was a crucial piece of information that helped to inform the decision on the local lockdown.

Thank you. In our committee's first report looking at the impact of COVID on health and social care services, testing performance was one of the key points that we raised. Inside hospitals, the percentage of test results delivered within one day is still only under 90 per cent, and for community tests around 74 per cent. Dr Shankar, you've talked about a sustainable model and system-wide resilience; what are the plans to improve those percentages of test results delivered within that one day? 

Obviously, the whole end-to-end process involves a number of steps, starting from the symptom onset, onto when a person applies for a test, and when the sampling happens. So, the sampling is predominantly managed by health boards, and we, in the public health labs, come into the picture when the samples actually reach the lab. So, in between that, there are a number of steps, including transportation and courier issues. When the samples arrive in the lab, the turnaround time is calculated from the time that it is booked at the sample reception, and then the end of that pathway is when the results get authorised. So, that is the in-lab part of it; that is what we have control over.

Obviously, every time we are looking at the data and optimising the available reagents and the platforms to process as many samples as possible in as quick a time. Clearly, working with the chief operating officer of TTP, we will be looking at the performance data and we have mobilised additional staff. And, as our chief exec mentioned earlier, we are still recruiting people and we'll be offering rapid turnaround through these 16 rapid turnaround new labs where we've got funding for reagents. So, we will be able to turnaround those tests in less than four hours from when we can get that. 

Added to that, newer platforms are also becoming available, such as the lateral flow devices that also give test results very quickly. So that, I think, will help us enormously to improve those. So, still, I accept that there are things in the pathway that can be made more efficient, particularly in the sample collection, sample transport and optimisation, but it's definitely getting better.

Thank you.

Okay, Jayne?

Does Tracey want to—?

If I may just build on what Giri's just said. So, the £32 million that the Minister announced is for up to 170 staff. We already have nine what we call 'hot labs', which are rapid turnaround. So, we've got machines that can turn around tests within up to a maximum of four hours, sometimes one hour. There'll be six new coming into Wales, which we hope will be fully functional—and obviously, it's incremental—by the end of November. However, in addition, we'll be moving our regional labs in Cardiff, Swansea and Rhyl to 24/7 functioning with those additional staff, and that'll kick in at the end of October. And this is all for the purpose of rapid turnaround, resilience across Wales. Because we've talked before at committee meetings about turnaround times in north Wales, and how do we make sure, right across Wales, we've got equity and access. But what's important to us is that we can then use that as a hybrid. So, when the lighthouse labs come back online, we need that mass testing capacity, but it needs to be efficient and effective. But, in addition, we need our own Welsh capacity to be agile and adapt. So, I think that will be positive, and we'd be happy to come back in and give you an update on that in the future.

Thank you. And just finally from me, Chair, over the summer, we saw an incident where passengers from the flight from the Greek islands to Cardiff Airport tested positive. There was a lot of criticism for Public Health Wales there in terms of the time it took to contact those affected, and the lack of quarantine. What lessons have you learnt from that?

Quentin.

If I could just summarise briefly the approach that has been taken to border control, returning passengers, quarantine and our involvement. So, the requirement for returning passengers to quarantine began from 8 June, and exemptions came into force from 10 July. Now, our role throughout this has been to provide information. We receive data from the Home Office border control; that data then enables us to make sure that we can reach out and communicate with those who've been advised to quarantine, who, on arrival, will have received a letter from Public Health Wales. We don't enforce that—our role isn't enforcement—and of course for capacity reasons we can only directly communicate with a proportion of those who are quarantining. But, that is the general approach we've taken.

Now, as you rightly said, there was a period of about two or three weeks where there was particular concern with flights returning from some Greek islands, and what we quickly learnt from that is that we needed a system response. It isn't just simply about making sure that we're aware of a flight coming in and giving them a letter. So, we worked with the system to look at making sure that the information that we got from the Home Office was distributed to the different TTP programmes across Wales so that those programmes themselves could reach out to those individuals and make sure that they're getting tested as they're required and following up with any positive confirmed cases. 

Okay, Jayne? Turning now—we've got some questions from Andrew R.T. Davies about tech and data support, an area of special interest and expertise of Andrew's. So, Andrew. 

Technical and data support is not something I read in bed at night, I have to say, Chair. But I'm grateful for the evidence so far, team. Thank you very much.

I want to go back a step or two, if I may, before I ask my principal questions. I don't think I heard why hasn't the lighthouse lab opened in Newport, because I think we were given a date at the end of August. Was there an issue in the handover to the lighthouse organisation or NHS England? Is there some reasonable explanation why there's been this delay?

I'll repeat my point that this is being managed by UK DHSC, and I think there's a combination of ongoing recruitment and validation of the laboratory, which hasn't yet completed. I'm not able to give you more specific information because I'm not privy to it, I'm afraid. 

That type of information, I appreciate, is managed by the UK Government and their organisation, but as a public health body here in Wales, in the meetings you have across the UK, that would be a reasonable question to try and find information out on when you're in those meetings, to find out why this lab hasn't come online.

As I say to you, we have inquired, and it's our understanding that there are a combination of factors, including still ongoing recruitment and matters to do with the validation of the laboratory before it can go live. 

Okay. Thank you for that. That's helpful. If I could ask you about the app that they're running—the contract tracing app that's going to be launched on 24 September. I think I'm correct with the information I've got in front of me and the date that's been given to me. How confident are you that this will be a valued tool in the public health campaign to contain the virus?

Giri.

Thanks. The app builds on the earlier learning from the pilot that came about from the earlier version of the app—it was called the NHSX app, it's now known as the NHS COVID-19 app. This app won't be a substitute to the contact tracing, but it will be a value-added supplement to it.

It has got six main features on it. Two features relate to the individual, which are the feature of alerting, and also the feature of check-in. There are three features that are mainly for wider society and for wider community purposes. They include symptom assessment—what proportion of people using the app are showing symptoms—people can book a test on the app, and they can also get instructions to self-isolate from the app. Then, there's another feature about contact tracing, which is a combination for both the individual and society. So, those features, we believe, are going to definitely add value.

Again, with all of these things, I think once the actual launch happens and people start to use it, we will get real-time data, and I think the alert function, the check-in function especially, is really helpful because social mixing is quite complex and when we want to trace people back about their movements and their congregations, often it relies on people having a good memory recall of where they've been, whereas the check-in function in this app acts as a digital diary and it can record all the locations that a particular individual has been during the period in question. It also helps us to identify what proportion of app users are symptomatic and gives us an approximate indication of potential COVID symptoms in the population. So, it has been designed to have all the features that will supplement it and we are confident that, if it works the way it is meant to work, it will be a good value-added tool. 

So, it will be a value-added tool, but it will depend on, obviously, the quality of information that people put into it, I'm assuming. Is that a critical component—the quality of the information?

Undoubtedly. I think all the app can extract at the other end is what goes in at the user end. So, the quality of information that we get out is directly dependent on the quality of information that goes in.

So, the quality of information that the user puts in is imperative, but the user has to have confidence that the organisation that holds that data is a competent organisation, otherwise you won't provide that personal data. We know full well that you've just had a personal data breach of 18,000 individuals—basically, every single person who's had COVID in Wales since the outbreak started. How can you give me and others confidence that you are a competent organisation to handle that personal data given your track record?

Tracey, do you want to—?

Yes, if I can respond. Firstly, the customer relationship management data is separate to Public Health Wales, but I just want to—. Thank you for asking the question. I just want to apologise again. I mean, we are genuinely devastated that this has happened. We do take our data protection responsibilities really seriously. We've got a number of different information systems, some that we publish, some that we don't. So, it is really important for us. We wanted to get as much information as we could out in the public domain, because we wanted people to come forward. We've had 21 people—18 have e-mailed and three have rung us. We'd still urge people, if they want to have more information or want to check their status, to contact us.

I think the important thing is, obviously, we've got to earn confidence back—you're absolutely right. We did take immediate action; we have continued to take immediate action to prevent it happening. As I said last week, we've commissioned an independent investigation. Obviously, we'd want to publish that report, but it's going to take a couple of weeks to do it properly. And we've also asked the investigators to look at our other information systems that we also make public just to make sure that we've got every single step in place.

My problem with this is—I don't think anyone does this deliberately and I take it at face value that this was a genuine accident, most probably down to human error. But, where I have difficulty now is knowing that when the alert system kicked in, nothing happened until the following morning. No-one within the organisation, within the alert structure that you've got, felt it important to respond despite it being flagged, and that's a failure of management.

I agree. We had a member of the public first contact us by e-mail on our 'raising concerns' e-mail in the evening on that Sunday, the thirtieth, but unfortunately, our 'raising concerns' e-mail isn't monitored out of hours. And then we had a member of staff from the Vale of Glamorgan also e-mailing us and one of our staff picked that e-mail up. As you rightly say, they didn't follow our serious incident reporting process and it wasn't until the following day that it was taken down. So, these are parts that are obviously incorporated into the investigation to look at, and obviously, we've reflected on those systems. So, it should've been taken down earlier—I totally agree.

So, why wasn't it? Is that just sloppiness? 

No. I mean, obviously, the individual who received the report, the alert, obviously, we've engaged with that individual. They did not appreciate the extent of what had happened, put plainly. They didn't appreciate the extent of what had happened. And so, again, the fact that it came in as it did should have triggered our serious untoward incident reporting escalation—that should have happened that evening. And you're right, it should've been taken down at that time. So, there was an avoidable delay between that alert coming in that evening and us taking it down the following morning.

I appreciate that this data breach was a Public Health Wales data breach, but what we do know is that obviously you alerted the Welsh Government on 2 September and the Minister was informed on 3 September. In a previous line of questioning, from another member of the committee, you were asked about your meetings with the Minister. We now know that it became public a week last Monday. So, in that intervening 10 days' time, from when you alerted the Welsh Government, the Minister became aware and the public were informed, what action did you take, or what activities in engagement with Welsh Government did you have, to iron this problem out and obviously bring it to the attention of the public?

Yes, so, as you say, obviously, the incident happened on 30 and 31—the 31 was the bank holiday Monday. So, during the Tuesday—I was on leave that week, but during the Tuesday—the team got to the bottom of exactly what had happened, because we needed to understand what had happened. So, we submitted a serious incident report into Welsh Government on the afternoon of the second, and we also informed, as we must, the Information Commissioner's Office on the second. And then, during that week, there were various—and the following—various discussions with the Welsh Government. So, my deputy chief executive, on the third, spoke to one of the Welsh Government officials, and I understand that discussion informed a briefing into the Minister for Health and Social Services, who, as you said, had said that he was informed on the third. There were a number of discussions that then took place over the course of the days. I also spoke to the director general, when I was back the following week.

It is important, though, just to clarify what happened during those two weeks. So, not only were we trying to get to the bottom of what happened, we had the requirement to notify, as I said, the Information Commissioner's Office, and we kept close to Welsh Government colleagues. But we also needed to risk assess, because we needed to understand the extent of this and the risk to people's identity being disclosed as a result of the data breach, and part of that was engaging with 32 other organisations. So, as part of TTP, we are party to a data-sharing agreement, and that requires us, and all of the partners, when there is a breach, to meet with those partners, talk it through, identify what's happened and understand what actions people need to take. So, we had to meet with, a couple of times, all the data protection officers across the local authorities and the health board and share our views and what our findings were, and the risk assessments. And then, as we got closer to the time that we made it public, we wanted to make sure that we had the maximum information we could share with the public. We weren't sure what the response was going to be. We wanted people to come forward, for obvious reasons, so we needed to make sure that we had a helpline that was appropriately staffed, that we had e-mails that people would be monitoring 24/7, but also our partners locally wanted to know how would they respond if a member of the public contacted Ceredigion local authority as part of the data sharing. So, there were quite a lot of steps that we needed to put in place and that we statutorily needed to undertake. But, more importantly, we needed to get ourselves ready so that as soon as the public responded and contacted us, we were able to give them as much information as we could.

Chair, my final question: just in that two-week period between it becoming known to you as an organisation and the Welsh Government and the public being informed, neither you nor your chairmen met with the Minister to discuss this.

Not directly; we worked through the officials. So, the director general was keeping the Minister informed. On that Thursday, 3 September, that I mentioned, my deputy chief executive was engaging with one of the officials in Welsh Government, and, that evening, the individual briefed the Minister. So, as would often be the case, it's the officials who would be doing that regular briefing. I'm sure if the Minister had wanted, at any time, to have a direct conversation, obviously he would have contacted us, but we were keeping Welsh Government officials closely involved all the way through to make sure that the Minister was updated.

As you said, if he'd wanted to have a conversation, he could have, but he chose not to.

Well, I think the reality is that the risk assessment, albeit—. As I say, we were devastated that this happened, and we can understand how people were, or are, obviously anxious. We do deem the risk to be low—it is slightly higher for the 1,926 that we alluded to—and we took immediate action. We were informing the Information Commissioner's Office, so we were getting on top of this literally in real time, as it was happening, and it was important for us, linking through the Minister's officials, to keep him up to date, and that's exactly what happened. That would be normal for us, on a range of activities for us.

Thank you, Chair.

Can I just come in to add a supplementary point, to say what corrective actions we have taken and put in place from that incident? We have reviewed all the SOPs, and we have undertaken refreshed, new training for those staff. We have now got double authorisations before anything is put in place, and then, once the reports that need to be on the public-facing website are put, we go back and double-check from a user point of view to make sure that it's there. The SOP revision is a constant item now that we will be reviewing regularly. So, we have strengthened the process internally and also reinforced staff training on that. Thanks.

Great. Thank you for that clarification. Turning to our final section, which is a very important issue, highlighted also in your written submission, the seasonal flu vaccination. Lynne Neagle.

Thank you, Chair. Good morning, everyone. As the Chair said, my questions are about the seasonal flu vaccine. Can I start by asking you about the Welsh Government's target of 75 per cent amongst the most vulnerable people as well as health and social care workers to be vaccinated? Is that an achievable target, do you think?

Quentin.

Yes. So, in ordinary times, we would aspire to a 75 per cent flu vaccination uptake in eligible groups. That is the sort of threshold that we would hope to achieve, given that the vaccine, year on year, varies in its efficacy, often somewhere between about 30 per cent and 60 per cent. So, to maximise the protective effect, that is the usual target that we aim for. Now, we have achieved 70 per cent in the last year or two, and our hope is that in the context now of the pandemic and the public understanding of the importance of the flu vaccine to protect not just themselves from flu, but to protect the system from flu as a confounding diagnosis that will add to pressures on the health and social care system, the public will respond very positively, and 75 per cent, in my view, is an achievable figure.

Okay, thank you. The Welsh Government has said that if there's enough vaccine available, then the plan would be to vaccinate the over-50s, who, obviously, don't normally fall within the group targeted. Do you think that that's likely to be possible?

Now, of course, all of that is dependent on sufficient supplies. Just to take you back, the normal process is that we begin the ordering for a year's flu vaccination programme at the beginning of the year, in January. Of course, at the time we started that process, COVID-19 was relatively new and the impacts of it weren't properly understood. But, by the end of March, it was declared a pandemic of global significance, and everybody recognised that it wasn't going to resolve quickly, and UK Government did place additional orders. Now, during May and June, we began the planning for the flu campaign this year, and we took into consideration there the advantages of extending, if there were additional supplies, the programme, and that has now been communicated out, as you've just said. So, subject to supplies being available, we will, of course, prioritise in the first instance the current priorities—the over-65s and those with co-existing conditions—but then we will very quickly want, by the beginning of December, I would hope, if sufficient supplies are available, to extend the flu vaccine offer on the NHS down to those over the age of 50.

Okay, thank you. In usual years, people would still be having the flu vaccine as late as November or even December, but this year that's likely to coincide with the peak of the COVID second wave. How has COVID impacted on your planning for the timing of the vaccine this year, because presumably we need to get them out of the way as quickly as possible?

In one word, it's made it very complicated, and it will be very challenging. Normally—and the Chair of the committee will be familiar with this—we do have a roll-out that normally starts about the third week of September, with the expectation that we've rolled out to all our target groups by the end of November in a planned and phased way. Of course, now we've got to take into account that we've got to make this safe for the public who are receiving the vaccine, and we've got to make it safe for the staff administering the vaccine. They will have to undertake it under quite challenging and different circumstances. Our primary care facilities will need to be able to deliver vaccination sessions that are COVID compliant, and we estimate that that could extend, if you like, the turnaround time, very crudely, for giving a vaccine to an individual up to three hundredfold—so it could take up to three times longer to deliver each vaccine. And of course, as case numbers increase, it may be that those who are invited will not be well enough to receive that vaccine on the particular day, or we may find even that some of our staff who have been recruited, or who normally would deliver that vaccine, are themselves unable to do so because they're unwell.

So, this is hugely complicated. The way we're managing this is Welsh Government are leading—a senior official within the chief medical officer's team chairs a committee that we support—and we ourselves co-ordinate action through immunisation co-ordinators in each of the health boards, and the health boards have been required to produce flu vaccination plans for this specific season that are COVID compliant. We've looked at those plans and we will continue to work with the health boards to advise and strengthen those plans, and we've also done a number of tabletop exercises to begin to rehearse and plan for the implementation of the campaign this year.

Okay, thank you. In terms of a COVID vaccine, the earliest it's been anticipated one would be likely to come on stream would be the end of this year, which would of course coincide with when you are still probably dealing with the flu vaccines. Your paper highlights the fact that it would need to be a different workforce to deliver the two vaccines in the event of a COVID one becoming available. What planning are you doing to manage that, so that if we have got a vaccine for COVID we can start to take advantage of it?

Absolutely. So, we've been doing COVID-19 vaccine delivery planning since June, and we're doing it in parallel with the flu vaccine planning. So, what we need to do is we need the two to align and not conflict with one another, and we've paid particular attention to that. So, we do know that we're going to need to think about, perhaps, different approaches, and maybe doing mass COVID-19 vaccinations for healthcare and social care workers as priority groups, and setting aside specific arrangements to enable us to do that. But it is going to be challenging, and what makes it even more challenging is that the candidate vaccines that appear to be the front runners will need to be delivered as two doses 28 days apart, and that will need to be choreographed with the flu vaccine. So, it's complicated to a square root.

Okay, thank you.

Andrew R.T.'s got a final question.

Just taking that point on a little further about the logistics around a COVID vaccine—and I appreciate it's debatable when there might be one, if indeed there ever is one—from discussions I've had, it's not just a 28-day period and the two jabs that you'd have to have, there is a huge debate and discussion about the infrastructure that you require. I think I've been told that the Oxford trial vaccine, for example, has to be stored at anything north of -70, -80 degrees C. Now, that's something that you wouldn't find in your average GP's surgery. So, in your planning and your preparation, what type of infrastructure, given the information you're working to to date, do you anticipate having to put in place that would allow a vaccination programme to start and get off the ground?

You're making a really good point there. In fact, I'm willing to be corrected, but I believe it's not the Oxford vaccine that would require deep freezing, if you like, it's another vaccine that is also coming through. But you're right, there are very few places that hold freezer facilities or can store at -74 degrees C, which this particular candidate vaccine—. And that is now actively being discussed as part of our planning at the moment. We don't have a definitive answer to that, but you are correct: that has introduced, more recently, an additional complexity to the whole planning process. 

Diolch, Cadeirydd. Morning, all. Perhaps I can start with Andrew in a sense, because it affects both his local authority and the WLGA in general. We've seen local restrictions being put into place, initially in Caerphilly, followed by RCT, and now we have Bridgend, Merthyr, Newport and—. I can't think—[Interruption.] Thank you, Blaenau Gwent.

So, first of all, before I ask about the local restrictions, can I ask the question as to whether you think the voluntary measures that were put into place initially by RCT and Merthyr were an effective approach to dealing with the issues before, and perhaps could have avoided a restriction being placed by the Welsh Government? 

Councillor Morgan.

Okay, thanks. In relation to that question, as you'll be aware, RCT and Merthyr council—along with the local health board, we put out a request about a week before we went into the additional restrictions, asking voluntarily for residents to follow a set of procedures. At that point—we'd seen a significant increase in cases over the last 14 days up to that point. However, while I would say a lot of the residents did heed the advice we issued—we did see an increase in mask wearing before it was mandatory—I think, unfortunately, over that weekend, from the Thursday when we initially announced our informal requests, by the Monday, the numbers had more than doubled again in the space of five days in terms of the daily positivity rate and also the daily cases. So, the difficulty we have is—and I was on a call again yesterday with Public Health Wales and officials—is that, when you introduce measures, you are looking at least seven to 10 days before you see any noticeable difference in the community. So, unfortunately, I think it probably was too late to avoid a lockdown at that point, because, over the space of five days, the numbers just increased by such a large volume, really.

Thank you. David.

The reason I asked, obviously, as you quite rightly pointed out, is that it takes several days before it works through the system, and there are several other authorities now on the watch list. Whereas Welsh Government has put certain restrictions across all of Wales, for example, pubs closing at 10 p.m. in the evenings, could local authorities that are on the watch list—should they now be putting voluntary requests in to their communities to ensure that they are now minimising the impact?

Councillor Morgan.

At this point, I can't speak on behalf of those authorities, but my view would be, 'Absolutely, yes.' I would also say that I'm already aware, if you just look at some of the social media activity, some local authorities, and I'll just name Cardiff, for example—they are already putting out a huge amount of messaging, very similar to what Rhondda Cynon Taf and Merthyr did with the health board before we had the Welsh Government restrictions. But I would urge—and I think, in fairness, all council leaders across Wales, our view is that we need to take action as quickly as possible now, because we've seen how it was Caerphilly initially, then RCT; we now have six local authorities. And if things continue to escalate, we could see others being added very quickly.

Okay. What are your views as to the restrictions that have been introduced? Are they strong enough? Do they go far enough to ensure—? I know we haven't seen the results yet, and Caerphilly can't really give us results as it's only been two weeks, but are they strong enough, or should we be doing stronger action, and could local authorities add to those locally as well?

Who wants to take that one? Andrew.

I think they're proportionate at present. Certainly, for my authority, I think they're proportionate. However, the focus has to be now—and the conversations yesterday with the First Minister and chief constables that a number of council leaders across south Wales were on the line with—we have to tackle those who are simply not following the rules, let alone the guidance. So, there is a very small minority, and I think that, if we are to continue to have the public's support, which I would say is—well, 95 per cent of the public are following the rules. If we are to continue to have their support, we have to tackle those who are simply ignoring it willfully.

However, in terms of additional measures, I can say that in Rhondda Cynon Taf we are considering further measures, which we are now considering taking. I have agreed yesterday that we are closing one of our facilities, which is the Rhondda Heritage Park, in terms of a visitor attraction, because it is an underground facility, which is at the higher risk. However, the pressure on our contact tracing teams right now is starting to grow, and therefore we will consider reducing some other services other the next week if necessary, not only to minimise the community interaction but also to free up additional staff to support the contact tracing teams.

Can I ask, then, Andrew—I'll come back to Huw in a minute, because obviously Bridgend has just come into this scenario now—but can I ask—? I understand there's a lot going on in the lower Rhondda area, and the restrictions apply to the whole of the authority—should we be focusing more on smaller local communities or do you think it is appropriate that a larger authority takes on the whole restrictions?

I think there's been some misunderstanding and misinformation with this. So, while originally there was a larger cluster and the main focus was on the lower Rhondda—when we started seeing the pattern develop about two to three weeks ago now, probably about three weeks ago, there were about half a dozen clusters with a small handful of cases across the county, but at that time there was a much larger cluster in the southern Rhondda area. However, it is really difficult, and I have to say I advocated for county restrictions if they were needed, mainly because, for example, in the Rhondda, it wasn't just the lower Rhondda, it was actually that cases, a significant proportion, are in the mid Rhondda.

The mid Rhondda—everybody in the north of the county has to travel through mid Rhondda to get out. The shopping patterns in terms of supermarkets—. So, the large—well, the only—Tesco, for example, available, a large supermarket, is in the south area. In the Rhondda Fach, we only have one supermarket—large supermarket, I should say, sorry—in Asda; people in the Rhondda Fach travel by the free bus over the Maerdy mountain to Aberdare to shop in the Tesco.

So, because of the way the Valleys are made up, I have to say, we considered it with our officers and it just wasn't suitable, we don't think, because of the travel restrictions and the travel impact. If we are to contain the virus, we have to do it slightly differently. But that might not be the same in every local authority. So, I'm not against these hyperlocal lockdowns, as have been described by some, I just felt that, when we discussed it with officers, it wasn't appropriate for us in the Valleys because of the geography, mainly.

Okay. Because Llinos, in your area, clearly, you've had a hyperlocal scenario, where the food processing factory—it was that small community that was, effectively, restricted. 

Yes, we had that, but also there were small clusters in other authorities with that, and we were able to just condense it into a small area, and that's with the community support, but, at that time, we were still in the lockdown as well, so the situation was different to what it is now and everybody was living in lockdown rules, but, now, society is moving about a bit more.

Okay. I suppose we're talking very much about causes and community transmission, and pubs have been used as an argument, very often, in the case that that's where some of the community transmissions occur. What are your views regarding the situation of pubs? The Welsh Government has made the decision to close them at 10 o'clock and closing off-licences at 10 o'clock. Is that going to be an effective measure, do you believe, in trying to reduce some of the community transmission, because of the pub situation?

Who wants that? Andrew?

Are you happy for me to go first on this?

Yes.

Yes. We'll have Huw then.

Huw's nodding, so it's okay.

I just want to say that it needs to be proportionate. I know that I've had to explain to an awful lot of residents in Rhondda Cynon Taf, because we were pushing on this as well with Welsh Government initially. The issue is that if you were to close pubs first of all altogether, there is real concern that the social distancing would go out the window in that it will move underground to people's houses; they'll have friends around. They will have no opportunity at all to have that kind of interaction, even if you've got to socially distance—sit at separate tables in a pub, et cetera. But also there would no track and trace, there would be no hand sanitiser or the other measures in place, so that's partly the reason.

But the other reason that we were very much keen on is because pubs have different closing times. Although Cardiff was bandied in the press around what happened outside the Coyote Ugly Saloon and other pubs, it's very similar in lots of Valleys' towns where you have a number of pubs that do close earlier and a small number of pubs that stay open later, and what we are finding is that people then migrate to the small number of pubs that are open later and it becomes really difficult to social distance and for staff to maintain it inside the venue, and then you get the crowds outside. So, it is a difficult one. I know that I've been lobbied an awful lot about why we're not closing pubs, but I think it has to be proportionate in terms of the overall mix.

But it will have an impact. We're already seeing fewer people now going out socialising and more people are being—. I think all these changes are now making people think differently and, hopefully, we'll get a higher level of compliance across the board, because people are seeing these new measures come on line.

Okay—[Inaudible.] Councillor David?

Can I just raise one point? I'll let Huw come back in a minute, but one question: you mentioned some pubs closing earlier and others going on to other pubs. So, that blanket 10 o'clock closure across Wales should, therefore, be beneficial in stopping that transfer from a pub that is closing now to perhaps a pub that closes at maybe 1 o'clock in the morning.

Yes. So, originally, I know, 11 o'clock was the agreement, but obviously they've done a UK-wide agreement now, which is much better. But it was very much about closing pubs all at the same time, reducing the closing hours so that you didn't have, for example, in Pontypridd, two venues open until gone 1 o'clock and lots of the other venues close before 12 and what we were finding were queues outside those two venues late at night. But, also, I think it's unfair on staff at the premises to be able to try to control social distancing inside when everybody is trying to get into those venues. So, I think it is proportionate, what's now been brought forward.

Okay. Huw.

Thanks, Chair. I think the evidence early on, certainly in Bridgend, was that pubs and clubs were not a primary cause of transmission. The key problem has been homes and people having house parties and going to meet friends and family when they have symptoms, when they have the virus, and that's why the local restrictions that have been imposed in areas of south Wales are very important, because we know that that's been one of the key drivers in terms of transmission.

We need to recognise that most pubs and clubs have acted responsibly, have worked very closely with us. There is a minority where pubs and clubs have not taken the action that we've wanted them to take and we've responded to that through our enforcement powers and services.

Can I ask, then: do you think that you're going to be able to stop people going to house parties? Because if you believe that it wasn't the pubs, but it was people going back to house parties, or having barbecues and house parties afterwards, are you able to stop that? Are people acting responsibly and not doing that now? I don't mind which one of you answers.

Councillor David.

That is going to be more difficult, much more difficult to enforce and much more difficult to police, but it is vital, if we're going to stop the spread of the virus, that people behave far more responsibly. So, the vast majority of people are sticking to the rules very rigidly. They've made big sacrifices, haven't they, many of them?

Huw, you've just gone into, Bridgend has just gone into, restrictions, literally last night; Andrew, you have been there a little bit longer, although it was only last week, but you did—[Inaudible.] Have you seen a change in behaviour, or are you hearing of evidence of a change in behaviour, within RCT?

So, if I were to say, first of all, we focused on the supermarkets because that was a huge amount of concern. Generally, the feedback is there's been a huge shift not just in the way the supermarkets' management are acting in terms of their staff, but also the way people are now acting as well. Certainly, I think, the face masks being worn is a reminder in everybody's face right now that this issue hasn't gone away. So, we've had positive feedback there. However, we are still getting one or two complaints where we are following up. But what I would just say is we are increasing, right across Wales now, our enforcement teams. So, there was a bid put forward to Welsh Government, which I understand has been approved. I think it was in the region of approving around 120 additional officers across Wales. We are, certainly in Rhondda Cynon Taf, in the process of increasing our enforcement staff, and I know, from conversations this morning with the police, that they are also now putting more additional offices in. But there has been really good close working with licensing officers across the police, et cetera, and where we've had calls about people having occasional house parties. So, I think it is a step-by-step process, but, certainly, people's attitudes are changing, but that comes back to the very small minority who are not following the rules. If we don't tackle this problem—I'm not one for being heavy handed with enforcement—and if we don't take action on this, I think the 95 per cent of the public who are following the rules will lose confidence in us.

Chris Llewelyn.

I think there's an element of trial and error with all of these policies as well. As Andrew was saying, whilst authorities were alert to concerns about some of the measures not being conformed to, as regards social distancing or other aspects of the regulations, then campaigns, local campaigns, have been initiated. So, first of all, there was concern about supermarkets, and enforcement activity picked up. There were other concerns, then, about the hospitality sector, and, again, reiterating the regulation guidelines and what should be observed was undertaken by authorities.

As to the pub closures, it is a contestable issue. We consulted the 22 leaders about the issue of having an 11 o'clock curfew, and then 10 o'clock, and the majority favoured 11 o'clock. But the truth is it is contestable, and views do differ, and circumstances differ as well. In densely populated urban areas, then the approach probably needs to be different from sparsely populated areas. In some sparsely populated areas, where there are small urban settings, then a different approach is needed from the more densely populated urban authorities—so, sort of, RCT and Gwynedd or Anglesey might need a different approach. And, as I say, there is a strong element of trial and error and looking at what impact different interventions have, and then responding and reacting accordingly.

David.

Can I ask you, then, Chris, on the basis of that—I appreciate there are differences across different authorities, different densities, a different lay of the land, effectively, across different authorities—are all authorities learning from the experiences of places like RCT, because there are several on the watch list in north and south Wales, and in the west? Are they looking at the situation with supermarkets? Are they now inputting into those discussions, those enforcements? I can tell you now, I go into my local Tesco and the staff on the tills have a screen between them but they're not wearing masks. So, there's clearly a situation where there are still challenges across different authorities, and particularly ones that are not in restrictions at this point in time. So, are the local leaders putting in place similar voluntary approaches whilst they're not in restriction?

I think you'd be surprised at the extent to which the discussion that is taking place—. So, the directors of public protection, for example, they have a network and they speak on a daily basis in terms of updating each other on the position, what's happening, how people are reacting and so on. During the course of the last few days, as soon as any authority has gone into a localised lockdown, we've had meetings, this week, between the chief executives and the leaders to share experiences. Llinos in Anglesey, Mark Pritchard in Wrexham, Caerphilly, RCT, and every authority—with every change and every development, then we get the leaders and the chief executives together and discuss how things are progressing, what lessons need to be learned, how people's experiences can inform and educate other people as they go into similar situations. As I say, all of these professional networks liaise with each other as well. Andrew mentioned the increased capacity going into enforcement. Because of the concerns we had as a consequence of sharing experiences, we put a bid into the Welsh Government for additional funding to recruit more enforcement officers, and that's something we do on an ongoing basis with every additional development within this crisis.

Thank you for that—

Okay, David?

My only concern about the additional officers is the time taken to get those people in place, trained up and ready to deliver, because we are in a position now where we need them but we won't have them yet for probably several more weeks, if not months, in that situation.

Finally from me, then, what are you hearing from—Caerphilly is not represented today—Caerphilly as to how it is going there? They were the first ones into local restrictions. Have you heard whether it is actually being effective, even if it's in small, incremental steps? Have you heard how the local authority staff are viewing it—never mind politicians, but how the people on the ground are seeing it?

Who wants to take that? Andrew.

If I can just touch on that, I had a short briefing yesterday ahead of our meeting, and they're cautiously optimistic that things are now improving. The numbers are coming down. The positivity rate is the main measure, not so much the numbers. The numbers of cases are almost immaterial in terms of the increased testing; it's the positivity rate and the walk-in centres. They are optimistic that that is going in the right direction. However, the thing I need to just be cautious about is that if you have one cluster—so, you could easily have an outbreak at a workplace, at a school, at another venue where you could have 20 or 30 cases—that would push it back into the same position it was in at the end of last week. But, at present, they are cautiously optimistic that for, I think it's the last three days now—today possibly will be the fourth day—they've seen the positivity rate declining, the number of cases declining. So, it does appear that they may be turning a corner.

I think, partly, as I come back to it, it's not just the measures that are introduced, but I think it's the mindset of the public, understanding that these measures are coming in and, potentially, more measures may be needed if we don't change, and so it is making the public see this as a real concern and something that they need to act on. We are seeing the vast majority now changing, going back to what we were like three or four months ago, because I think people have perhaps just become that little bit relaxed, thinking COVID has almost gone away, and a lot of people have reverted back to six and nine months ago, before the pandemic started.

Can I ask you then, Andrew, is the mindset of the public more driven and more strongly driven by the fact that there are restrictions, rather than by voluntary actions?

On the evidence I've seen, I probably have to say 'yes', but it is that point, I think, getting through. Unfortunately, I have to say that one of the biggest problems I think we all face is the COVID deniers, the social media people who basically say it's not an issue. I've had people saying to me, 'Why are we having restrictions in RCT, because we're not seeing huge numbers of deaths?' And when I explain to them, 'Well, the deaths normally come about three weeks after we see high numbers of cases going into hospital', I say, 'Do you want us to wait until we get those deaths in hospital and then bring in restrictions?' I'm just concerned that the messaging sometimes is lost on some, but the vast majority, as I say, are trying to stick to the rules.

There's been an awful lot of support, as well, not for the individual restrictions but, actually, support for the Governments and for local authorities and various people trying to get the message through. So, I would go back to saying that 95 per cent of people are changing their habits, changing the way they do things and they are listening now.

Okay, that's all from me. Before I go, can I just pass on my thanks to all your staff, because I know they're doing a fantastic job in very difficult times, and I appreciate what you're doing?

Can I come in on that, please, Chair? It's just to say that I welcome David's comments, because I think that the way local authority staff have responded has been incredible, and the pressure they're under in terms of the capacity they've got, and the way senior staff as well have to redeploy and use the capacity as effectively as they can, is absolutely outstanding. I think one of the lessons of the crisis hitherto, and going forward as well, is the way local authority staff have responded, the way they work so effectively with other partners, whether in the health sector or community groups, and the close working between authorities at an operational level with the voluntary sector and with community groups I think has been magnificent. It is outstanding.

Thank you, Chair. And I would certainly echo those comments abut local government. I think local government has been an absolute shining light, really, in this crisis. We've touched on enforcement already and the issues around compliance, and I really welcome the work that you've done, Andrew, in RCT with the supermarkets. Can I just ask you, is there anything else you need? We've talked about the extra staff, but is there anything else you need from Welsh Government that would help you now to ensure compliance? Any more powers, any changes, anything at all?

If I could say that, in fairness, we have had that offer from Welsh Government. I don't think at present there is. The one thing that I did press again yesterday in a meeting we had with Ministers and all the officials and other council leaders from south Wales is around the messaging from people. I almost said that we need to go back 24 hours, rip up all the restrictions, and then re-tell people the restrictions as of today. Because I'm still getting people saying, 'Well, I read four weeks ago this was the rule', but of course it's now changed—it may have changed on an all-Wales basis, it may have changed on a UK basis, and where we have the local lockdown restrictions, it's changed again there. So, we just need to be clear, because even sports clubs this morning were asking me if the UK Government announcement or Welsh Government announcement last night impacted on them.

So, we've done some helpful online chat sessions on Twitter and Facebook last week, and we answered about a hundred various questions with my officers. I know that the health Minister's done it. It's just trying to get through the clarity of what is the position for people to understand, and what are the rules for people to follow today, not what they read a week ago or two weeks ago, or what rules apply for Llinos in north Wales, which are different to the rules now in the restricted areas. I think getting that concise, easy to understand message out has to be a priority for all of us right now, because we can't expect the public to follow the rules if we're not clear ourselves on what they are. So it's that messaging, I think, that is the big one right now.

Okay, thank you. And in terms of the extra enforcement staff, which is welcome news, is it enough? Do you need more? Is it enough, what you've been allocated now, do you think?

In fairness, on the allocation of funding, my understanding is, and Chris can confirm this, it's based, actually, on what we as local authorities put in. So, we put forward for additional staff—for example, in RCT I think they've actually recruited the first five. I think they were recruited last week, because some of this work has been going on for a number of weeks, but a bid was then put in to cover the costs, and I think there's enough funding for 120 additional staff. It is to support our licensing, our trading standards officers, the various teams who are going into the shops, the businesses, the pubs, and working with the police now in small core teams that are being set up.

So, I think at present what has been agreed in terms of finances is sufficient. We need to act now to recruit the staff across Wales. I know every local authority's trying to do that, but they are being recruited on the health board footprints. So, for example, although RCT is trying to recruit potentially up to 20 staff, those 20 are not for RCT—they will work across the Cwm Taf Morgannwg footprint providing the support that's needed wherever the pressures are.

Okay, thank you. We've talked a bit about the challenges of communication and I completely recognise what you're saying about COVID deniers and problems with social media. Is there anything else, or any examples of good practice in terms of communication, that you'd like to share with the committee in terms of getting that message through to the public?

Who wants to lead on that one?

I was wondering if one of my colleagues would like to answer that one. I'm mindful I've answered quite a lot of them.  

Can I just say something? In terms of sharing good practice, the WLGA on its website is highlighting the good practice that is taking place across authorities. So, again, there is a considerable amount of sharing information taking place. It is sometimes overlooked, and maybe people don't realise that, in these circumstances, because they are so challenging, there is a recognition within local government of the importance of sharing information as quickly and as easily as possible. And then one of the things that we do as an organisation is we try to highlight and identify where things are going well as quickly as we can so that all authorities can benefit from that. So, a lot of that is taking place, albeit maybe not in as public a way as people might like. 

Can I ask specifically about young people, then, because we're told that the behaviour of young people is helping to drive the resurgence of the virus? Is local government doing anything to specifically target young people so that they change their behaviour?

Lynne. 

Okay, thank you. Finally from me, then, on contact tracing: how sustainable do you feel the contact tracing arrangements are? We know that it's involved the redeployment of staff for some local authorities. Can you just give us a flavour of the kind of percentages involved and also how sustainable you think it's going to be, given that we face a difficult winter?

If I could take that question first, just to say that our contact tracing across the Cwm Taf Morgannwg area was in the high 90 per cent of contacts—I think that was on Friday, at the briefing. Over the weekend, because we saw such a significant increase in cases over the weekend, our contact tracing has probably fallen now into the 80 per cents; it's in the mid-80s. So, I think it was on Monday I agreed with my head of public health and head of environmental health and we signed off a request for mutual assistance for the Cwm Taf Morgannwg area, where authorities in mid and north Wales have been asked to assist us at present. We do have options to increase our staff complement, so that is something, first of all, all local authorities—so Merthyr, Rhondda Cynon Taf and Bridgend—have been asked if they can provide additional staff. I've just agreed that we are closing one facility down in Rhondda Cynon Taf to redeploy staff. We may have to consider doing that but also at the same time we've had the message from the Welsh Government that if we want to recruit additional external staff for contract tracing, we can continue to do that.

We're mindful that while the process is fairly robust at present, where we have other local authorities that can provide mutual assistance, as the numbers are growing we're seeing what's happening in the Gwent area, we're seeing now what's happening in Cwm Taf—there's very real concern that if we find another two or three health regions finding themselves in difficulty in terms of the numbers, then mutual assistance across the local authorities, for which we have had good plans in place over a number of years, wouldn't be possible to continue. So, that's why we need to plan now for the next month, six weeks, eight weeks ahead and not just consider what support we can get here and now, but where we will be in a few months' time. I would much rather recruit and deploy more staff to test and trace than what we need, and have that spare capacity, than finding in a month's time we're overwhelmed and then we have no time to get additional staff in. And the Welsh Government has given us the go-ahead—if we want to recruit more external staff, we can do that immediately. 

I think this is a critical time for the contact tracing system. Up until now, I think we've been incredibly successful—the speed with which arrangements were put in place, and I think the collaboration and the close working between local authorities and the health board has been really commendable, and it's worked exceptionally well. In terms of the various elements—we may come on to it—there have been concerns about testing as the crisis has progressed and in terms of the capacity in the system for the lab analysis of the tests. The contact tracing part is the part that local authorities are most involved with, and there are—. As we enter this next phase, there will be capacity issues, so it's important that we try and plan and address those as quickly as we can. As Andrew said, I think that mutual aid is going to be a key factor here for all authorities and the health board regions working together closely, and being able to recruit staff as quickly as possible. 

The Welsh Government have said that the capacity will be made available to authorities, but I think as David was alluding to earlier, in his point about enforcement officers, we need to be able to get additional capacity into the system as quickly as possible when it's needed, and try and minimise any time lag. So, I think the next—. We've got a meeting with the leaders and with chief executives later this week, and I'll be writing to them all later today just to check that we're planning and we've got the capacity in the system for when we get this growing surge. 

Okay. Are you done? 

Yes, thank you, Chair. 

If I was to be honest, I'd say it's not good at present. So, the first priority in terms of testing when we started seeing the problems back just before we went to the official restrictions, when they were brought in voluntarily—we asked for the same measures to be introduced in terms of Caerphilly. So, that's where all care homes, both clients and staff, are tested weekly. That obviously does use up significant capacity. They're doing that across the Cwm Taf Morgannwg footprint, but I think it's over 80 establishments, independent and council-run facilities, so that's a significant amount of testing being done in our care homes on a weekly basis.

Some of the testing is over five days. In one or two cases, I'm aware it's taken a week to come back, which is a difficulty similar to what Llinos has outlined. In terms of the public testing, the biggest problem, I have to say, with the public testing is the fact that the testing system is part of a national booking system. We have really pressed—. I have pressed Welsh Government, who have been having calls with the department of health at a UK level. I've done it myself; I've had the local MPs to raise it. The problem is, as part of that national booking system, it allocates you to the nearest test available. So, for example, in Abercynon, at the temporary testing centre, which was set up because of the community transmission and we needed to understand the local numbers, at one point, it was considered that, out of 60 people in a queue, two were from RCT, two were from outside RCT in Wales, and, at one point, over 50 people were from England. That has quietened down quite significantly, and we've done an awful lot of social media messaging locally, trying to encourage it to be a local testing centre.

However, there's been discussions ongoing that, as much as we're trying to press them to hand over the running, the UK Government still wants to keep hold of the control of the Serco testing centres. It's not just the large one in Abercynon; we have the temporary one in Abercynon and the temporary one in Clydach. We're hoping to get agreement—I was hoping it would have been agreed by today—that the UK Government are looking to possibly hand over one of the local testing centres for Public Health Wales and the local health board with us to run. That would mean then that those tests, around 300 to 400 tests a day, could be diverted then to the Public Health Wales laboratories, where we are getting test results back within 24 to 48 hours. That would be beneficial to the UK Government, to take that small amount of pressure off the lighthouse labs. It would be beneficial for residents here because, then, we could have our own testing system.

The only place, I have to say, that the testing has been the best, and I wish we could have it, which we haven't got at present, is with the WAST service—so, the Welsh ambulance service and Public Health Wales and the local health board. They are currently in Merthyr, and I also believe they're deployed in Caerphilly. Those testing centres are only for local residents, where you can either walk up without an appointment, or you can book through a local system. They are then going through the Public Health Wales laboratories, where the tests are coming back—. Yesterday, for example, I saw that an ITV Wales reporter was tweeting that she had her test results back in 24 hours. So, it is a significant improvement through those venues.

They were able to deploy to RCT on that weekend, which was the weekend before last, if I'm correct, when we were initially told, late in the evening, that the Serco centres were being cut to at 60 tests. So, on the Saturday and Sunday, the ambulance service were able to deploy, with Public Health Wales and the local health board—they were able to do in excess of 700 tests over that weekend, in addition to the Serco tests, which were improved to 120 from the original cap of 60, and have now been improved to 300. But these temporary testing sites have the capacity to do up to 500 tests. So I have to say, when I hear Ministers—and I think it was Matt Hancock I heard yesterday morning—saying that there is no cap now on them, that is not correct. The cap is set at 300 tests per site for Northern Ireland, Scotland and Wales, whereas the test capacity at each site could be up to 500. 

Do you think the communication is clear enough on where the problem is, whether it's on the tests being able to be taken, the samples being taken in—whether it's Aberdare or elsewhere—or whether it's in the labs? Because we've been told this morning that the lighthouse lab in Newport that was due to be open by the end of August is still closed, it's not operational. That doesn't help.

It's absolutely the testing capacity, not on site. I know people refer to test sites, but these are obviously the swabbing sites. If you go to Abercynon now, there's a five-lane, or four-lane, drive-through. I would imagine that 50 per cent of that at present is not being used. It is because they would be swabbing people today, but they would not be getting their tests done. And that is the issue—it is the test capacity in the laboratory, not on site. We could set up with our own staff, with Public Health Wales and the local health board, two or three testing stations tomorrow. The problem is that, at present, the swabs would not be able to be analysed in the laboratory.

Councillor David, perhaps, to lead on that one.

We have seen a more frequent testing now of care workers and residents in areas where additional restrictions have been introduced because of the rise in cases. We've certainly called for more frequent testing of domiciliary care workers, and any workers who are caring for people who are at particular risk of the virus, and I know that is being looked at by the Welsh Government.

Are you surprised it's taken so long? I'm told that people are really nervous about going into people's homes—not for fear of getting the virus themselves, but the real fear of passing it on to the people that they're caring for.

Additional measures have obviously been put in place in terms of PPE et cetera and people are managing those risks and I'm sure this is something that Welsh Government are looking at very carefully as we speak, particularly as the number of cases rise, because we need to take all the precautions that we can to protect people.

We need some agility and fleetness of foot now, as time is marching on in terms of the agenda. The very embodiment of agility and fleetness of both feet is Andrew R.T. Davies.

I'm glad you have that confidence about my agility, Chair. Thank you all for your evidence so far, leaders. I do declare an interest, being a member of a local authority, just for the record. I was going to ask a question about finances, but I noticed that Andrew touched on that briefly in one of his submissions to the committee in answer to an earlier question, when he said that the settlement to date has been sufficient. So, I'm assuming—and bear in mind that this is the health and social care committee rather than the local government committee—that that sufficiency has given you the firepower financially to deal with the problems that you've had to deal with so far. That's an open question to any member who'd like to respond.

Can I just clarify first? Recently, the Welsh Government announced an additional £264 million of support for local government. That was in addition to about £190 million, which was the first tranche. This is funding to support us with increased cost pressures and also lost income, which we are still experiencing—significant cost pressures. As part of that, some of that is for social care, because that is a pressure area for us. In particular, children's social services during the pandemic has been a real issue, unfortunately, because we haven't been able to have some of those placements in terms of fostering and adoption services et cetera, so there's been some real pressure in the system on children's services that has cost us a lot of money and we've been supported.

Going into the winter, though, we are keen in terms of bringing forward now the plans in terms of winter preparedness through the regional partnership boards. The partnerships are looking at what interventions we should be doing with social care and the health service et cetera. We are expecting and hoping that there will be an announcement of funding imminently on that.

Each year, the Welsh Government normally gives local authorities somewhere between £10 million and £14 million—that has been the norm for the last three or four years now—of additional funding that is dedicated for us to use in terms of helping with the winter pressures. I've raised it with the Ministers and other leaders in various meetings and we understand that there will be some sort of support coming, but we're expecting some announcement now within the next few weeks. But the sooner we get an announcement on the additional funding, the sooner then we can put those plans in place to help with any peak pressures, because I'm sure all committee members are aware, we face pressures going into the winter with social care irrespective of what's happening with COVID right now.

What we don't know is that, if we do have this second wave, as has been described—if this was replicated right across Wales and if it was sustained for a period of time—then I'm sure our costs would also significantly increase, and yes, we would probably then need further funding. Because our concern is that we've got—. And at present, our claims and our additional lost income is being funded and is being worked through—it is a process and it isn't a case of just handing us what we asked for. There is money at present, but our biggest worry is that, if we get to the end of the financial year and there's a black hole, it's all very well us being funded, maybe up to January and February, but what happens in March? So, we are in discussion with Ministers that, potentially, we could see an extra £10 million or £20 million a month being needed, if this second wave comes as some are suggesting. So, we are monitoring it. We are obviously very concerned about what happens over the coming months now.

Okay. Andrew.

Can I just ask on that point—? Obviously, the funding model that you have at the moment is very much dealing with the issues in the here and now. But just by virtue of not having a vaccine, one would say that you get through the second spike, you go into the third spike. Because, at the moment, as I understand the regulations—and I'm not an epidemiologist—we are trying to suppress the numbers of infections. So, logic says that when you unlock again, then obviously infection rates restart again and you end up put into another lockdown. How does your financial model, as local authorities, stack up in that particular scenario? Because, again, I'll stand to be corrected by more medically informed individuals, but I just see this as part of a pattern now where we unlock, we go back in, we unlock, we go back in, in the absence of a vaccine. 

Could I just say that, if you consider the money that's already been agreed—the £264 million—about £190 million was the first tranche with some other support, we're probably getting close to £0.5 billion of extra money for local government. However, that's just in one financial year, at present. And you are correct: the cycle appears to be that it's trying to suppress the number of cases so that we don't overload the NHS, there isn't pressure on beds, ventilators et cetera.

However, if we don't see the vaccine, and unless people change the way they live indefinitely until there is a vaccine, or something happens, you're obviously correct that we do run the risk of further spikes, but the costs associated with that could be huge. So, I think we're relatively confident at present that we have money to the end of this financial year, but clearly if there is a case of no vaccine, and we are going to continue to have a wavy effect going forward in the next 12/24 months, then the cost pressures on local authorities could be huge, and we would absolutely need additional support.

If you consider Rhondda Cynon Taf, as my own authority, our cost pressures during this period are in excess of £40 million. If that £40 million wasn't met by Welsh Government—. The vast bulk of my expenditure in the authority is on staff, and £40 million—. We use a figure of roughly 35 staff per million. You can work out the significant numbers of staff. I'd have to lose well over 1,000 staff to be able to balance my budget. So, this year, we're in a fine position. I think that the additional funding is there, but we are really concerned and cautious that, going forward into future years, if there is a continuing cycle with COVID, unless we do have additional support from Welsh and UK Governments, we are at significant risk of significant job losses. 

So, is it fair to say, then, that if we do enter this model of 'lockdown, unlock, lockdown, unlock' the funding models of local authority will have to change? 

It's a hypothetical question, but we would have to do something quite significant, yes. But I would hope that, even if the vaccine is delayed and it doesn't come when we would hope, by people changing their behaviour—. If you consider Rhondda Cynon Taf, although we came out of lockdown, for the best part of eight weeks or so, with nearly all the restrictions lifted, we were having on some days one or two cases. I think in one week we had five days with no new cases. So, for about eight weeks, when we first relaxed the measures and it was step by step, we saw the cases dramatically reduce.

But I do think that because that kind of messaging has gone, that people maybe think, 'Well, there are now hardly any cases, the hospital admissions are not in the news every day, there aren't people on ventilators and people are not dying in huge numbers', and I think that people's behaviour has changed back similar to what it was. So, what I would say is that if we get people back into that same mindset and to say, 'Well, actually, even if we don't have hospitals full of people, we still need to change our behaviour', we can change this wave or the peak, and the third, the fourth, the fifth wave. We can change people's behaviour, we can change that outlook and, therefore, even without a vaccine in the short to medium term, we can also change how we would be impacted in terms of our public finances. 

My one final point, if I may, Chair, is on the specific funding pot that you, as local authorities have been distributing, which is the £500, as I understand it, to care workers from Welsh Government. Has that been completed—that funding stream—for the care workers who qualify for it? Or are there some authorities with some considerable way to go before all that money is distributed?

Andrew.

I think it hasn't all been completed; I think you would be correct. I'm wondering if Chris Llewelyn has the all-Wales picture. I'm not sure of the latest data. Certainly, when we talked about it a couple of weeks ago that would've been the picture—that that wasn't the case. Unless there's a further update, we'd have to get back to you with the latest position. I haven't had an update, sorry, for the last, probably, week to 10 days at least. 

Okay. Chris Llewelyn.

No, I'm sorry, I can't give an up-to-date position now, but I can provide the committee with the latest position after the meeting if that would help.

I think I heard Huw say that Bridgend have completed that payment.

We're making very good progress. It's a complicated scheme, but we'll certainly come back with information on that in terms of the whole-Wales picture as soon as possible.

Thank you.

Thank you, Chair. First of all, can I put on record all my thanks to all of you working in local authorities and all the staff who've put in a huge effort over the last year in particular, and particularly in my own authority in Newport?

Just moving on to issues around care homes and the trauma experienced by care home residents and staff, which has been significant, and particularly those residents who have dementia, I'm thinking about the authorities now that are going into local restrictions, and visits to care homes stopping and just the importance of those compassionate visits for those residents. In your view, what can and should be done to help mitigate the trauma faced by residents and staff? 

Care homes. Councillor David, do you want to lead on that one?

Yes, thanks, Chair. That's a really good question. It's a very difficult time for family members and for residents, and I know that care homes right across Wales have worked really hard to ensure that that contact is maintained in a different way. So, lots of care homes have tablets and other devices that can be used so that residents can have FaceTime or Skype calls with their families, and that's been an invaluable way of maintaining contact, but that's no substitute for face-to-face contact, particularly for some people who are really struggling with that type of contact with their family members. It's something that we obviously weighed up in terms of that impact and balancing that against the risk to residents. But the risk to residents is so great from the virus that the decision has been made, quite rightly, to stop visits for the time being. But, of course, we will review that and look at different ways of maintaining that contact with families.

Okay.

Could I just add to that that when Rhondda Cynon Taf introduced that as part of our voluntary measure on that Thursday—Caerphilly had also done the same at that point—I did have a call with Chris Llewelyn and with the Older People's Commissioner for Wales to talk through our rationale? I know that there have been concerns raised about visits, so, at that point, we were allowing external visits but no internal visits. Subsequently, we have now moved to no visits at all. I know that that is really difficult and challenging for families. I know that we've installed in council facilities and within private homes iPads, et cetera, so that they can have FaceTime with residents, but the risk that we face, I think, at present, is that I really don't want to be back in a position where Rhondda Cynon Taf was one of those authorities that did suffer significant deaths, unfortunately, in homes across the county and across the Cwm Taf Morgannwg area during the first wave of the pandemic. We can't guarantee, because, obviously, staff live at home, they go shopping and there's the potential that staff could pick it up and take it into a home, but we have to try and do everything that we can.

And I would just say that, as much as it is a difficult message, the vast majority of families have been really supportive. They are concerned, especially about end-of-life, and we have agreed that there will still be visits for end-of-life, with PPE, et cetera. So we are accommodating that. But I would just say that—and I say this to all committee members, respectfully—we have to try and make sure we don't get back into a situation where we have significant loss of life in a care home, because once it enters a care home it is incredibly difficult to self-isolate people and stop it spreading. And I think that has to be the overriding position.

The main thing I would say is that it needs to be as short a period as possible, so I think all the effort should be on getting the increasing cases back down, so that we can lift these measures. I would just reiterate that point—that it is a difficult one, but it is one that I would 100 per cent defend. And I did say to the Older People's Commissioner for Wales that I want to make sure in my own mind I have done everything to make sure that residents are safe, and that's the reason we've taken the decision, and the Welsh Government has now supported it, in the lockdown areas.

Okay. Jayne.

Okay, thank you. Just moving on to local authority care and support now, in July, the Deputy Minister said there had been limited use of the powers to modify care and support duties by local authorities, and that 460 care packages had been withdrawn or reduced. Do you have an update on that, and what's likely to happen in the autumn/winter period?

Can I just touch on that to say that, again, in that call with the older people's commissioner that I had, with Chris Llewelyn, we did discuss this in one of our regular meetings? So, throughout the pandemic, I and Huw David and Chris Llewelyn have had regular meetings with the older people's commissioner to discuss the latest position. I know the older people's commissioner's position is around revoking that, asking that that authority is taken away. I'm not aware of any local authorities that have had to use it to a significant level, in terms of care packages—certainly not removing care packages. However, what we did say is that it has to be taken into perspective that, in the event that we had a further increase to what happened in the height of the first round of the pandemic, we have to limit what care we can provide to ensure that those who are most vulnerable are cared for.

Now, the plan that all local authorities drew up—which many of us didn't have to use or, thankfully, look at during the pandemic then—was that those who had a family support network, we were contacting them to see, in the event we had to reduce hours or reduce care packages, whether there were family members local, available who could step up and do something. Because the priority would have to be making sure that staff were maintained in care homes. In care homes, if a significant number of staff in one home went down with the virus, you cannot just leave those residents to fend for themselves; we have a statutory duty to look after them. So, therefore, with people who are only supported to live at home, and some maybe having only a few hours a week, they were the ones where we were asking whether family and friends and other support networks, including the voluntary sector, the third sector, if they were needed, could step up and take on some responsibility short term, to allow us to reallocate staff? We've talked that through with the older people's commissioner and she does understand where we are coming from. But I think local government probably would say that we would still like that measure to be in place, should it be needed. I hope none of us would need to use it, but we are asking for that measure to remain in place.

I think, as you said, we do understand the stress that everybody feels and the pressure that's on local authorities—earlier on this year and will likely continue to autumn/winter. But, as you said, that also puts a lot of pressure on people who will become unpaid carers, and perhaps people who've been caring at home, and then your added pressure of being at home without any respite, without any other support. And, obviously, at the start of the year, feeling that we'd be getting to a summer, it was very difficult for people, and the end of that. But, going into this winter as well, I'm sure there'd be a lot of people who are already unpaid carers, or who have caring responsibility, feeling under a great lot of pressure. How can local authorities play their part in recognising and supporting the challenges that are faced by those unpaid carers?

I think, first of all, just to reassure carers, this is absolutely the last resort. Those powers were only put in place because, in the very worst-case scenarios, we had to assume that up to one in five of our workers would have been infected by the virus and off work or self-isolating, and we anticipated a very large increase in demand for our services, and there simply, in that scenario, may not have been the staff available to provide that care. However, we would, and do, prioritise people who need the care the most. And, for example, what we do in the first instance, if we reach that scenario, is look at reducing care packages so that people would still receive a minimum level of care—not the level of care that we'd want to provide, but would receive the very minimum level of care to ensure that the essential care that they needed continues to be delivered.

We have put in place across Wales steps to provide additional support for carers. So, for example, in my local area, we've now got a 24/7 hotline that we've set up for carers, recognising the pressures that they are under, because the pressures are huge. So, what we did see at the start of the pandemic, for example, is that lots of carers came to us and actually said, 'We don't want domiciliary care workers visiting us, because we want to minimise the risk to our loved ones of transmission', and that happened in quite a high number of cases, initially, but, after two or three months, of course, those same families were coming back and saying to us, 'Well, we're really, really struggling. We need that care package to be put back in place', and we put it back in place. But it is a reminder of how fragile many of our carers are and the need to continue to support them as best we can. I know that Welsh Government have made additional funding available to provide more support to carers and we'd welcome any additional investment that is made in that service.

Final question, Jayne.

Thank you, Chair. Just finally from me: we've seen the Welsh Government's winter protection plan—what preparations are local authorities making to deal with the pandemic during winter?

Right. Who wants to kick off on that one? We've gone all shy all of a sudden, have we?

I was on mute—apologies. We're working very, very closely with health board colleagues and colleagues in the third sector on how we respond to the winter pressures, because this will be our hardest winter yet, won't it? And none of us underestimate the scale of the challenge ahead of us, and we're keen to see the funding come through. We've seen that commitment from Ministers that there will be additional resources and we are looking to see how we can mobilise whatever we can to respond to what is going to be a very, very difficult period ahead.

Can I just say, Chair, I was glad that you were on mute, because I was getting really worried then for a second, when nobody answered, after that long pause? It didn't sound very encouraging. [Laughter.]

No, no. Always blame the technology, I say. David Rees. 

Thank you, Chair. I suppose I'm going to be a bit nasty now. You didn't quite answer the question. You mentioned you're working with Welsh Government Ministers and everything else, but do you think the plan has weaknesses? Are there areas of the plan, if you analysed it, to show, 'Well, actually there's a gap here we need to address.' 

There's a huge amount of detail that is being worked through at the moment. So, the plan is a high-level plan. What we need, and we're working on now, and is being finalised, is the detail and the action plan that follows on from the overall strategy. 

So, when do you think you'll be in a position to actually have that detail ready? 

Can I just say, this is going through our RPBs? So, I know Llinos will probably confirm, because I think it's due to go to hers shortly as well. So, the regional partnership boards are working through now on the detail of delivery for it, and, as Huw has alluded, while the overall plan is in place, some of the delivery actions now are being worked through between our staff partners, in terms of health boards, social services management teams—third sector as well, in particular, because an allocation of the funding, through RPBs, is to the voluntary and third sector. So, that work is ongoing. It's being signed off. I'm not sure if ours, in Cwm Taf Morgannwg, have just been signed off or are due to be signed off, but they are being signed off now by the regional partnership boards, in terms of how these plans now will be implemented locally, because, obviously, while it's a national plan, we will have slightly different pressures in different areas. And I know Llinos probably can update on her area as well. 

Llinos Medi. 

Thank you.