Birmingham has its own Test and Trace team, which has a variety of roles from data analysis and complex contact tracing to communications and community engagement. This case study is part of a series on local contact tracing.
- Birmingham has its own 30-strong Test and Trace team, which is responsible for everything from community engagement and data analysis to complex contact tracing
- The team took on responsibility for local contact tracing in mid-September
- The integrated approach was invaluable and put Birmingham in a strong position to deal with the university outbreaks seen in early autumn
Birmingham is home to more than 1.1m people, making it the largest unitary local authority area in terms of population in England.
The city saw cases rising rapidly from early September and by the end of October more than 270 cases per 100,000 people were being seen each week.
When second national lockdown was announced, Birmingham was in tier two of the regional Covid alert system.
What was done
Birmingham has its own Test and Trace team, which has a variety of roles from data analysis and complex contact tracing to communications and community engagement.
It is staffed by a combination of public health practitioners and environmental health officers working alongside staff drawn from other areas of the council, as well as external recruits, and supported by the customer contact centre.
When councils were encouraged to develop local contact tracing teams in late summer, Birmingham developed a contact tracing element from within this team, which has now expanded to include 30 staff.
Assistant Director of Public Health Dr Mary Orhewere, who leads the Test and Trace team, said: “We have a range of skills in the team that were perfectly suited to local contact tracing. We have been doing infection control work, liaising with schools and dealing with some of the complex outbreaks alongside regional Public Health England colleagues.”
Local contact tracing was launched in mid-September. It runs seven days a week from 8am to 7pm with shorter hours at weekends. Cases are downloaded from Public Health England’s Power BI system each morning.
Dr Orhewere said: “The first step is some data cleansing. Once that is done, we allocate the cases to the team members designated as contact tracers that day. We have kept it flexible so we can rota on different people as and when we need them.”
Birmingham’s team enjoyed immediate success reaching 48 per cent of cases they have taken on from the national team.
Dr Orhewere said: “The success we have had has been really pleasing. These are cases the national team have not been able to reach within 24 hours.
“But this has not just been done on a Birmingham footprint. Several areas in the West Midlands have also set up similar services and are making progress.
“We have worked closely with them and regional Public Health England to make sure the standards we are applying are consistent. For example, that we are interpreting close contacts or the infectious period in the same way. I think that is important for people to have confidence in the systems that are being set up.”
Each day team leaders have a debrief with the call handlers to see what themes and issues have emerged.
Dr Orhewere said: “It provides vital intelligence about what is happening. For example, we have nine universities in the city and when students started term, we were seeing a lot of cases among students.
“The way they were being taught was not the issue, instead it related more to their living arrangements and leisure activities. We were able to feed this back to universities and help them to reduce the risk. Having this feedback loop is really important.”
Another key step is recruiting the right people to work in the team, Dr Orhewere said. “We have got people with public health training and we have got people from elsewhere. All come with a range of skills. But when it comes to contact tracing what is particularly important is people who can communicate, who can put people at ease, but are willing to probe in a gentle way.
“We have scripts that act as prompts. But you must be able to spot when things don’t quite add up and dig a bit deeper. Then we can give the correct advice.”
While Birmingham has had success in local contact tracing, it has just taken the difficult decision to pause the service. “We had a real problem with the data quality. We were getting a lot of cases that were categorised as not having been contacted when they had.
“We were ringing up our residents and they were telling us they had received multiple calls. They were obviously very frustrated, so we have just decided to pause it. We are working with the national team to understand how best we can address this.
“I want to make sure we are having the maximum public health benefit we can. I am hopeful we can restart soon. We expect winter to be challenging. We may have a lot of cases and we are preparing for this. The staffing of the team is always changing – we rotate people in and out – which means we have a pool of staff outside of the team with the skills we need.
“If it gets really busy, we can pull them into the team. But we also want to make sure we are doing all the other stuff that the team is responsible for. The community engagement is important. We have a growing network of Covid Champions - these are residents who tell us how things really are for the people of Birmingham. We also have regular meetings with faith leaders, business and community groups, and interactive webinars with our schools.”
Dr Mary Orhewere
Assistant Director of Public Health (Test and Trace)
Birmingham City Council