Emergency Preparedness, Resilience and Response Annual Report

Transcription

1 Report to: Board of Directors (Public) Paper number: 4.6 Report for: Information Report type: Operational Date: 28 April 2016 Report author: John Griffin, Head of Emergency Planning, Response and Resilience Report of: Paul Calaminus, Deputy Chief Executive/ Chief Operating Officer FoI status: Report can be made public Title: Emergency Preparedness, Resilience and Response Annual Report Executive Summary 1. This paper provides a report to the Board on the Trust s activity in relation to Emergency Preparedness, Resilience and response. 2. It discusses the planning progress over the past year, looks at the training and exercising programme, and gives a summary of instances in which the Trust has had to respond to extraordinary circumstances. Recommendation to the Board The Board of Directors is requested to: RECEIVE and ACCEPT the contents of this report. Trust Strategic Priorities Supported by this Paper: Excellence Continually improve the quality and safety of service delivery, service user experience and improving outcomes. Risk Implications EPRR planning is intended to provide some preparation for instances of particularly high risk to the Trust s operations.

2 Legal and Compliance Implications The Trust is governed by the requirements of the Civil Contingencies Act, and associated NHS guidance. Finance Implications There is a small EPRR budget to enable actions as part of the response to major incidents. A major incident affecting Trust services would have an impact on Trust operations and finances. Single Equalities Impact Assessment No issues identified. Requirement of External Assessor The EPRR arrangements are peer reviewed through the NHSE (London) assurance process on an annual basis. 2

3 Emergency Preparedness, Resilience and Response Annual Report March Introduction 1.1. This paper provides a report on the Trust s emergency preparedness in order to meet the requirements of the Civil Contingencies Act 2004 and the NHS Commissioning Board, Emergency Preparedness Framework The Trust has a mature suite of plans to deal with Major Incidents and Business Continuity issues. These conform to the CCA (2004), ISO and current NHS-wide guidance. All plans have been developed in consultation with regional stakeholders to ensure cohesion with their plans The paper reports on the training and exercising programme and details the developments of the emergency planning arrangements and plans. The report gives a summary of instances in which the Trust has had to respond to extraordinary circumstances. 2. Background 2.1. The Civil Contingencies Act 2004 outlines a single framework for civil protection in the United Kingdom. Part 1 of the Act establishes a clear set of roles and responsibilities for those involved in emergency preparedness and response at the local level. As a category one responder, the Trust is subject to the following civil protection duties: assess the risk of emergencies occurring and use this to inform contingency planning; put in place emergency plans; put in place business continuity management arrangements; put in place arrangements to make information available to the public about civil protection matters and maintain arrangements to warn, inform and advise the public in the event of an emergency; share information with other local responders to enhance co-ordination; and co-operate with other local responders to enhance co-ordination and efficiency. 3. Risk Assessment 3.1. The Civil Contingencies Act 2004 places a legal duty on responders to undertake risk assessments and publish risks in a Community Risk Register. The purpose of the Community Risk Register is to reassure the community that the risk of potential hazards has been assessed, and that preparation arrangements are undertaken and response plans exist. Those risks currently identified on both Camden and Islington Community Risk Registers with a rating of very high include: influenza-type disease (pandemic); fuel shortage; low temperatures and heavy snow; storms and gales; flooding; local accident on motorways and major trunk roads; international disruption to the oil supply; and foreign nuclear activity affecting the UK. CIFT EPRR Annual Report

4 4. Planning Sector Reports 4.1. The following sections provide an area-by-area report on developments over the past year and planning for next year. 5. Major Incident Policy 5.1. This Policy details the Trust s actions in the event of an external major incident (e.g., transport crash, floods, or a terrorist attack). Such an event will require the hospital to employ a different method of working in order to manage the situation. The Policy is supplemented with unit-level plans (held locally) that detail the actions required of individual units to ensure that the corporate plan is achieved. In addition to conventional incidents, the policy details how the Trust will manage Chemical, Biological, Radiological and Nuclear (and Explosive) incidents. The Policy plans for the management of mass casualties The Major Incident Plan was revised and updated in Version in November Business Continuity Management Policy 6.1. Business Continuity Management is a management process that helps to manage the risks to the smooth running of an organisation or delivery of a service, ensuring that the business can continue in the event of a disruption. These risks can be from the external environment (e.g., power failures or severe weather) or from within an organisation (e.g., systems failures or loss of key staff). A business continuity event is any incident requiring the implementation of special arrangements within an NHS organisation in order to maintain or restore services. For NHS organisations, there may be a long tail to an emergency event, e.g., loss of facilities, provision of services to patients injured or affected in the event, etc The Policy is comprised of a corporate-level policy and supported by service-level plans. These service-level plans detail what would be required for the service to continue; which less-critical services or functions could be suspended and for how long in order to maintain critical services; which other services are required for that service to function; and which services rely on that service being operational Version 2.1 of the Policy was revised in December The Policy aligns to British Standard ISO Table 1 shows the Division s progress on developing service continuity plans The Trust needs to undertake more training and exercising on business continuity issues. To enable this, a series of on-line training and exercising packs have been produced for the services. 7. Pandemic Influenza Policy 7.1. The Trust has developed a policy to manage an outbreak of pandemic influenza. The Policy was produced in partnership with other health and social care organisations across Camden, Islington and the London region to ensure that all of the individual plans work collectively to manage the pandemic The Trust Policy was last revised in August 2015 (Version 2.9.1) The prime objectives of the Policy are to save lives, reduce the need for hospital admissions, reduce the health impact, and minimise disruption to health and other essential services whilst maintaining business continuity and reducing the general disruption that is likely to ensue. The Trust s preparations take into account a wide range of scenarios, considering a range of clinical attack rates. The Trust has considered how the virus could affect different age groups differently. The Policy also looks at the management of vulnerable groups, such as homeless people.

5 7.4. Following consultation with key stakeholders, the decision it is intended to move the Influenza Pandemic Policy to an annexe of the Business Continuity Management Policy. The rationale for this is that Pandemic Influenza planning is predominantly business continuity management with some specific operational elements. 8 Policy Review 8.1 The following policies have been revised during the year. These were approved by the Trust Management Executive on 28 August. A summary of changes made to the documents is detailed below: Policy name: Major Incident Business Continuity Management Hospital Evacuation Influenza Pandemic Action taken: Revised throughout to ensure all data are current and that the Policy fits the current organisational structure. Rationalisation of appendices Revised throughout to ensure all data is current, fully complies with current reference documents and guidance, and that the policy fits the current organisational structure. Revised throughout to ensure all data are current and that the policy fits the current organisational structure. Revised throughout to ensure all data are current and that the policy fits the current organisational structure. Updated in light of the NHS England Pandemic Influenza Guidelines Audits 9.1. During 2015, NHS England (London) conducted its annual assurance process regarding the Trust s preparedness in relation to the core standards for EPRR. The Trust was required to assess itself against these core standards during May Camden & Islington NHS Foundation Trust was then subject to peer review in October 2015, being assessed by NHS London, and representatives from Islington CCG and East London NHS foundation Trust : 9.2. This self-assessment was examined and accepted by NHS England London in November They commented The Trust has made great improvements in its resilience, EPRR governance and preparedness capabilities, reflected in the improved scores since 2014/15 assurance process 9.3. In May 2015, NHS London issued amended guidance in relation to the initial treatment of self- presenting casualties from a CBRN(e) incident. This guidance is known as the Initial Operational Response (IOR). Principally designed for application in critical care trusts, it presented some challenges as to its application in a mental health setting. The Trust contributed to a working party chaired by NHS (London) to ensure fitness for purpose in a mental health and/or community health setting. As a result of the work done by this cooperative group the guidance is now fit for purpose, and has been introduced with appropriate training support to front line reception staff. CIFT EPRR Annual Report

6 10. Testing and Exercising 10.1 The Trust has a rolling programme of live, table-top and communications exercises that are designed to test and develop our plans. The Trust is required to hold a live test every three years, a table-top test every year, and a communications cascade every six months. Whenever possible, the Trust strives to ensure that our testing is held in a multi-agency context. This is to provide familiarisation with other organisations and to assist with benchmarking our response with our partners In September 2015 the trust hosted the Islington multi-agency major exercise; participants included local authorities, police, fire, ambulance, and the voluntary sector, as well as representatives from NHS London. The incident fully tested the various agencies response to a multiple hostile shooter scenario, the relevance of which became clear because of subsequent events in Paris 10.3 As required by the EPRR Core Standards, all corporate-level training and exercising is based on and referenced to the National Occupation Standards for Civil Contingencies In line with these core standards during October 2015 strategic level Gold Command training was provided to executive members and senior directors who perform the on-call Gold function on behalf of the trust. Similarly in December 2015 Silver Command tactical level training was provided to senior managers who perform the on-call Silver function on behalf of the Trust. 11. Live Events 11.1 During 2015/16, C&I experienced a number of internal events relating to issues including power supply, IT, telephony, and fire. In October 2015 a potential serious problem with IT provision was identified, with service to three separate trusts being potentially affected. It was decided to respond to this problem as a pre-planned major incident. A Gold group was formed and an analysis of the scale, duration, and impact of the problem undertaken, the external stakeholders were consulted using the structure of the Emergency Planning Operational Delivery Group (EPODG) and dealt with as major incidents. As a consequence of the stakeholders combined efforts the work was completed at a time and in a manner that had minimal effect on the provision of services to service users. A debrief were held after the incident and action plans for the Major Incident and Business Continuity plans development were produced Similarly during the reporting period Highview rehabilitation Service, experienced a power outage when Network Power conducted urgent network repair work in the Sunnyside road area. The outage was actively managed in conjunction with Network power by the trust, and business continuity plans activated. These measures ensured that the unit was connected to standby generating capacity, and as a consequence the total absence of electrical power was limited to just a few minutes. 12. Debriefing From Live Events and Exercises 12.1 Following live events and exercises, debriefs are undertaken in order to capture learning points. Lessons identified from live events and exercises are subsequently incorporated into major incident plans and business continuity plans, and also shared with partner organisations.

7 13. Partnership Working 13.1 The Trust works in collaboration with a range of partner agencies through formal standing meetings and ad hoc arrangements. Formal committees of which the Trust is a member include the Local Health Resilience Partnership and both the Camden and Islington Resilience Groups. The purpose of these groups is to ensure that effective and coordinated arrangements are in place for multi- agency emergency preparedness and response in accordance with national policy and direction from NHS England. 14. Summary 14.1 The past year has seen good developments in the Trust s resilience arrangements; however, more work is required at the service level to achieve full resilience The Trust should be undertaking a more detailed and comprehensive training and exercising programme; however, this requires resourcing. 15. Recommendations 15.1 The Board is asked to receive the annual report on Emergency Preparedness. Paul Calaminus, Chief Operations Officer John Griffin, Head of Emergency Planning, Response & Resilience April 2016 CIFT EPRR Annual Report