Brent is an area which has been hit extremely hard by COVID-19. The borough has faced significant public health challenges caused by poverty, low wages and rocketing house prices which have led to pockets of deprivation across the borough. Brent is also the most ethnically diverse local authority in the country, with almost two thirds (65%) of the population made up of people from Black, Asian and minority ethnic (BAME) groups.

COVID-19 has amplified the existing health inequalities. Evidence shows that the COVID-19 death rate among people from BAME groups is twice that of white people and that the mortality rate from COVID-19 in deprived areas is more than double that in wealthier areas. All of this means that it's shocking but not surprising to see why Brent is recorded as having the highest death rate from COVID-19 in the UK.

DHThe Department for Health and Social Care is currently working with several councils to explore more flexible testing approaches and understand how best to enable vulnerable groups and those at risk of exclusion to access testing. They have opened prototype testing facilities in different areas around the country, but Brent is the first place to open a local COVID-19 testing site which is designed around the needs of the community. From the outset, we insisted that for this to be successful, the national model needed to be adapted to Brent's local circumstances.

Site selection was a key part of this for us. We chose a location for the testing site in the heart of Harlesden, an area which has experienced one of the highest death tolls in the country from COVID-19, with 36 deaths recorded in the neighbouring area of Church End alone. A large proportion of the population of Harlesden are from BAME groups, which we know puts them more at risk from this virus. We therefore wanted the testing site to be easily accessible, within a short walking distance for people in the local area and to attract those who don't have a car or who wouldn't travel to one of the other testing sites in the borough.

It was also really important to us that people didn't need to go online to book a test, so we set up a designated phone line to make the booking process easier and support residents who are digitally excluded. This also meant we've been able to provide a wraparound referral service for vulnerable residents when they call to book an appointment. By including questions in the script that will determine if they have additional needs, we can establish if there are any underlying issues that we need to address. For example, so far we've been able to provide welfare and welfare-to-work support, budgeting and debt advice, a befriending service and tailored support for people with individual mental health needs.

To promote the facility, we've used a mixture of traditional communication channels such as social media, e-Newsletters and our website with a more localised approach to help us reach our target audience. As well as implementing a targeted leaflet drop, we've worked closely with voluntary and community sector organisations, faith groups, local radio stations and commissioned services to ensure people are receiving the information from trusted sources in the community.

Moving forward, we'll continue to develop the site as we learn more from the people using it and the evolving needs of the local area, as well as responding to increasing demand for antibody testing which we know will reassure many people as we move through the next phase of the pandemic.

Dr Melanie Smith is director of public health at Brent LBC