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  • HRH Prince Philip the Duke of Edinburgh 10 June 1921 - 09 April 2021

Tier System Explained

Tier Restrictions

Following the statement by the Secretary of State for Health and Social Care in the House of Commons yesterday and the allocation of tiers to areas, all local authority leaders in the East Midlands were invited to join a ministerial conference call. In a presentation the principles for the allocation of areas to tiers were set out as follows:

"Areas have been allocated to Tiers based on analysis of the following:

  • Indicator 1: Case detection rates in all age groups.
  • Indicator 2: Case detection rates in the over 60s.
  • Indicator 3: The rate at which cases are rising or falling.
  • Indicator 4: Positivity rate (the number of positive cases detected as a percentage

of tests taken).

  • Indicator 5: Pressure on the NHS, including current and projected occupancy.

No rigid thresholds have been set because the key indicators need to be viewed in the context of how they interact with each-other as well as the wider context. A framework has been set out to show how areas have been allocated. This includes not just the underlying prevalence but also how the spread of the disease is changing in areas.

Areas have then been allocated using the following principles. This includes the principle that if an area is not showing an improvement in trajectory of key metrics it remains in Tier 3:

Trajectory

Prevalence

Very High

High

Medium/Low

Improving

Remain in Tier 3

or de-escalated

to Tier 2

Remain in Tier 2

or de-escalated

to Tier 1

Remain in Tier

1

Stable

Remain in Tier

3

Remain in Tier

2

Remain in Tier

1

Deteriorating

Remain in Tier

3

Escalate to

Tier 3

Escalate to Tier

2 or Tier 3

For subregions with conflicting data and/or trajectory by LTLA (lower tier local authority we reviewed the population size of the LTLAs and placed higher emphasis on larger LTLAs. Only in exceptional circumstances do we propose to split up a sub-region where a geographical split can be made between LTLAs with data suggesting different Tiers."

The link to a wider briefing on the "Epidemiological data and projection models used by the government to brief MPs on local restriction tiers" is given within the Director of Public Health's comments (below); East Midlands charts are on pages 10-16.

The presentation on the ministerial call also set out the following in relation to Leicester and Leicestershire:

"Sub-Region

Allocation

Commentary

Leicester and

Leicestershire

Very High

(Tier 3)

Improvements have been seen in overall case rates in all but one lower tier local authority, but remain very high at 355 per 100,000, including in over 60s at 250 per 100,000. The pressure on the local NHS remains very high."

Information in relation to the proposed restrictions in all tiers and in Tier 3 is contained within https://www.gov.uk/guidance/local-restriction-tiers-what-you-need-to-know

In his statement to the House of Commons, the Secretary of State had referred to the five indicators above:

"The indicators have been designed to give the Government a picture of what is happening with the virus in any area so that suitable action can be taken. These key indicators need to be viewed in the context of how they interact with each other as well as the wider context but provide an important framework for decision making – assessing the underlying prevalence in addition to how the spread of the disease is changing in areas. Given these sensitivities, it is not possible to set rigid thresholds for these indicators.

The regulations will require the Government to review the allocations every 14 days, with the first review complete by the end of 16 December."

Comments from the Director of Public Health (Friday, 27th November)

Leicestershire's rate of 284.5/100,000 population remains well above the national average of 209.1/100,000. All districts have a rate above the national average.

A slide deck outlining the current regional position in relation to the five indicators determining the tiers is included here:

https://www.gov.uk/government/publications/coronavirus-cases-in-england-26-november-2020

An initial delivery of lateral flow devices has now been received by the County Council which will enable the Council to begin targeted testing at scale. As described before, it is intended that these be used in those electoral divisions/wards with the highest rates and in outbreak settings, such as schools and workplaces.

The Secretary of State for Health and Social Care announced that areas in Tier 3 from 2nd December will have the opportunity to apply for support to deliver a 6-week rapid community testing programme, in whatever way best meets the needs of their citizens. Before deciding how to take this forward, there does need to be full learning from the Liverpool 'mass testing' pilot, and consideration of the technical and logistical limitations to such a programme.

Communications – Public Health Messaging

Communications have been stepped up further this week. Last Friday's press briefing with the Police, the City Council and the NHS resulted in widespread local media coverage, national broadcast and social media interest.

This has been supported by a 'local voices' video campaign which started on Monday, featuring the Lord Lieutenant, faith leaders, a local GP, taxi drivers and sports people, all asking the public to play their part.

The priorities for the next week include the reinforcing the guidance for Tier 3, developing a Covid health champions scheme, promoting the lateral flow test kits, development of a Christmas campaign and further targeted communications to young people and high risk groups.

Covid-19 Cases

The latest case data can be viewed here, national data and data for Leicestershire.

Please remember to keep up to date, including for the latest information on changes to services:

Twitter @LeicsCountyHall

https://www.leicestershire.gov.uk/coronavirus-covid-19


https://resources.leicestershire.gov.uk/adult-social-care-and-health/working-with-you-during-coronavirus

John Sinnott

Chief Executive

Leicestershire County Council

Last updated: Mon, 30 Nov 2020 13:26