Community testing in Waltham Forest

This is part of a series of case-studies published on 12 February 2021

Combined with other asymptomatic and symptomatic testing happening across the borough, community testing has ensured we have continuously achieved a higher rate of testing than the London average, identifying cases quickly and preventing the spread of the virus.

The challenge

COVID-19 cases have been very high in every area of Waltham Forest. The borough experienced some of the highest infection rates by the time new, tougher national restrictions in England were introduced in the first week of November.

Throughout December and January, Waltham Forest has had comparatively high rates of cases per 100,000 when compared with other boroughs in London and England.

The state of the pandemic in Waltham Forest has been critical and without decisive local action to drive down prevalence and transmission, pressures on health and social care services would lead to both being overwhelmed.

The solution

Community testing presented an essential addition to testing options in Waltham Forest. Alongside the already operational Mobile Test Sites, set up at various locations to offer tests for residents with symptoms, and our testing programme for key workers, aligned with national policy to keep them safe and ensure they do not spread the virus, the community testing programme has been introduced to allow large-scale testing to asymptomatic individuals, with results on the same day.

Within 10 days, our first community testing site opened at Chingford Assembly Hall on 18 December. This site was where our highest infection levels were identified, and where a greater majority of our older residents live, who are more vulnerable to the virus. We opened a second site on 23 December, ensuring a greater number of residents could get tested prior to Christmas. By the end of January, Waltham Forest had five testing sites running. We are now at a point where we have seven community testing sites across the borough serving our communities.

Our community testing centres are strategically located in the heart of communities, prioritising locations where there are higher rates of transmission. Our sites have good coverage, nearly all residents now live within a 15-minute walk radius. This draws on our ambition to create 15-minute neighbourhoods, helping ensure people's daily needs can be met within a short distance and learning from what residents have told us about how we can support them closer to home during the pandemic. Making it easier for people to have a test has been key to our strategy, alongside clear and consistent messaging about the importance of testing for those who do not have symptoms. Asymptomatic testing for council staff has also been set up at a dedicated site within the Low Hall Depot. Regular workforce testing is crucial for protecting our staff, our services and for protecting our residents.

Our staff have played a crucial role in identifying the most appropriate locations for sites – selected based on suitability, proximity to areas of high rates of transmission and knowledge of our communities. It is testament to the diligence and commitment of staff that sites have been established and testing begun so quickly. Through the combined effort of staff members and an amazing group of local volunteers, the efficient running of sites has ensured that we have continuously achieved a higher rate of testing than the London average. It is also down to staff and volunteer commitment that we can continue to scope and establish additional sites to further support the rollout of community testing.

Communications and marketing have been crucial to the success of driving awareness and uptake of testing. We have created local messages to encourage people to take a test, to allay fears, build community trust and improve participation. This has involved tailored messages and targeting certain groups, particularly those that we know are at greater risk locally. Easily identifiable in their bright pink jackets, ‘Stay Safe Champions’ have been out in force across the Borough, increasing awareness of when and how to get a test and acting as a trusted presence within our communities.

The impact

We have seen an encouraging response locally to the community testing offer. Using rapid response lateral flow testing across multiple sites has meant we can test people who have no symptoms, at locations convenient to them, identifying cases quickly and preventing the spread of the virus.

Cases in Waltham Forest although high, have fallen significantly. The rate of infections per 100,000 population has fallen by over 70 per cent since it peaked in early January.

How is the new approach being sustained?

The community testing programme is delivered across several publicly accessible sites. Our strategy is now focused on continuing to increase uptake of these sites whilst we develop a more targeted approach to testing in other settings.

Testing in settings allows us to target certain cohorts and help them to set up and conduct testing regimes. In turn, this enables testing and support of our more vulnerable residents and key workers, and importantly, members of the community who we know would otherwise not access testing.

The priority settings that we have identified are; supported living and extra care settings, non-maintained early years settings, day opportunities, faith-based community settings and foodbanks. Training covering all aspects of the skills required to deliver testing will be provided so that settings have the competencies, knowledge and infrastructure to test their service users and communities.

Lessons learned

Community testing has been established quickly, efficiently and effectively in Waltham Forest. Not only have sites got up and running successfully, but there has been good awareness and uptake of testing across the borough. This is testament to the effect of communications and the response of local people.

We know that although people are staying at home, many will be asymptomatic. There is, therefore, a difficulty to ensure that we maintain take up of the testing offer. The challenge since lockdown is to be more targeted with our communications. With people staying at home more, our approach to testing has pivoted to ensuring our priority groups who are more at risk of the virus in spite of lockdown arrangements are encouraged and supported through testing. This includes groups such as key workers that are not able to work from home, carers, people living in multi-generational households, people sharing a house or support bubble with elderly relatives, and people living in housing estates.

We know how important communications are. Tailoring messages to ensure accessibility and language has been crucial to the success of community testing in Waltham Forest, as has identifying certain groups and ensuring this is driven by the latest public health data. Targeted work to ensure residents living around our community test sites has also been undertaken, with information leaflets posted to households. Another aspect of our communications has been additional work to promote the locations of sites that are rarely used and found in less prominent settings, including signage and banners around sites.

Contact

Ryan Brock, Strategic Co-ordination Lead, COVID Delivery Unit

London Borough of Waltham Forest