Local contact tracing: Solihull

Solihull's public health team launched a backward tracing service in early September. It is currently staffed by six public health staff who contact everybody who tests positive in the borough.

  • Solihull’s public health team has set up a backward tracing team
  • It has helped to identify the source of outbreaks as well as provide support to those who have tested positive
  • The council is now looking to add a contact tracing element to the service

Local context

The metropolitan borough of Solihull is situated in the West Midlands and is home to around 200,000 people.

During autumn, it has seen rising rates of infection and was placed in tier two of the Covid alert system when it was launched.

By the time the second lockdown was announced, it was seeing close to 250 cases per 100,000 each week - well above the national average.

What has been done

Solihull wanted to develop more soft intelligence about how the virus was spreading across the borough as well as providing support to help people isolate – research shows less than one in five people fully isolate after testing positive.

The public health team launched a backward tracing service in early September. It is currently staffed by six public health staff who contact everybody who tests positive in the borough.

People who have tested positive are sent letters reminding them of their legal obligation to isolate and about the additional support available during isolation, ranging from general advice to specific information about the £500 support payment.

Senior Public Health Specialist Nick Laws said: “We take a balanced approach. Although we remind people of their legal obligations, there is no point in simply lecturing people to isolate and threatening them with fines. We know some people need a wider range of help and support to isolate, so that is what we offer.”

This is followed up a few days later by a phone call from the backward tracing team.

Mr Laws, who has overseen the creation of the service, added: “Our backward tracing initiative is different from what Test and Trace does in that they are focussed on who an infected individual may have passed the infection on to, whereas we are looking at where they caught it and how it may have spread from there.”

The impact

Mr Laws said backward tracing has provided a rich source of soft intelligence about where the virus is spreading with the team handling around 75 cases a day on average, although the figure is rising.

He said: “One of the first cases we identified was really significant. We identified a potential source of infection to a hospitality venue – from there we found more than 20 positive cases.”

“There had been a really significant spread. We were able to talk to the venue about the processes that they had in place in order to prevent continued cases of infection. We work closely with our environmental health team so any intelligence we get, we pass onto them. They are then able to visit premises – whether it is pubs, restaurants, gyms or workplaces – to check their compliance and provide advice.

“We handle this very sensitively. We know it can have an impact on the local economy and viability of these businesses, but we also know it is an important part of the process to stem transmission.”

Lessons learned

The way people are approached is vitally important in getting them to co-operate, said Mr Laws.

“The key piece of learning so far has been the importance of ‘conversation’. Some of these people have been contacted multiple times by the national Test and Trace team so it is important that we have something different to offer.

“The first thing we do is ask them how they are and what support they need. People have been really grateful for that.

“We try to make it feel like a natural conversation - it helps get people talking. We ask where they may have caught the virus - a question that although perhaps obvious has proven valuable in assisting us to understand and identify where outbreaks are happening, and how the virus is spreading.”

Next steps

The team has recently started focussing on school to household transmission in order to understand the prevalence of transmission from school settings to homes and family members.

The backward tracing team is also going to start providing some local contact tracing support to the national team. Cases that are deemed lost to follow up – those that have not been able to be contacted within 72 hours – will be passed on to Solihull by NHS Test and Trace.

The expectation is there will be five to 10 cases a day on average to follow up.

Director of Public Health Ruth Tenant is delighted with what has been achieved. “In early September we had a sudden surge in cases and it wasn’t clear what was driving this. We set up the team in less than 24 hours and started phoning local cases. It proved its worth really quickly and we’ve been able to use the information we’ve been getting back from local residents to provide a more cohesive response to outbreaks and spot clusters of cases before they get bigger.

“The team has great local knowledge and can often link the information they get from cases to other soft intelligence we have. It gives great intelligence about local transmission routes and where we are seeing spread happen. This was really important and when we, with other parts of the region became an area of intervention, it helped us to understand where restrictions were most likely to add value.”

Contact details

Nick Laws
Senior Public Health Specialist
Solihull MBC