ANEURIN BEVAN HEALTH BOARD. Civil Contingencies and Emergency Planning

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1 ANEURIN BEVAN HEALTH BOARD Civil Contingencies and Emergency Planning 1. Introduction The purpose of this report is to provide the Board with an overview of the current level of organisational emergency preparedness and a profile of current work programme. The Board is asked to note and consider this update. 2. Context Aneurin Bevan Health Board holds Category One status under the terms of the Civil Contingencies Act (2004). (For further detail on category status as defined by the Act please see Annex 1). The Act places responsibilities upon Category One responders to have mechanisms in place to achieve compliance with the following duties: Emergency Planning: the duty requires the development and maintenance of emergency plans. Co-operation: the duty requires responders to co-operate with partner agencies in planning for a wide range of emergencies. Information Sharing: the duty requires responders to share information with emergency response partners. Risk Assessment: the duty requires responders to have recorded an accurate and shared understanding of local risks. Business Continuity Management: the duty requires responders to maintain plans to ensure that they can continue to perform their functions in the event of an emergency. Warning and Informing - Communicating with the Public: the duty requires responders to make the public aware 1

2 of the risks of emergencies and how the organisation is prepared to deal with them if they occur. As part of the establishment of the new Health Board, ensuring the new organisation was prepared to take on its responsibilities, under the Act, was a key feature of the transition programme. Plans were put into place to ensure a smooth transition from the six previous organisations in order to enable Aneurin Bevan Health Board to fulfil its responsibilities from the outset. Civil contingencies, emergency and business continuity planning form part of the remit of the Director of Planning and Operations and are vested in the Planning and Service Improvement Division, where plans are underway to strengthen the role and capacity of the team. Work is also in hand in order to develop close working with the Localities and Operational Divisions in order to ensure that civil contingency and emergency planning preparedness are integrated into the operational functions within the organisation. The Health Board is a member of the multi-agency Local Resilience Forum (LRF) at both Chief Officer (Gold) level and Support Officer (Silver) levels. In addition, the Health Board contributes to all essential work-streams and training activity as part of its statutory duties. The Health Board is effectively the largest corporate member of the LRF and as such is expected to make a significant contribution to the work planning programme, training & exercising programme and funding of the joint Business Plan. 3. Current Position The Annual Operating Framework (AOF) 2010/2011 requires that the Health Board has a Civil Contingencies Local Service Plan (LSP) which sets out key actions for the year. The AOF directional statement requires that the Health Board must ensure that civil contingency arrangements are fit for purpose to deliver a robust response in the event of any incident/emergency. An Aneurin Bevan Health Board Civil Contingencies Strategy is currently being developed, together with an LSP which identifies 2

3 actions for 2010/11 to enable compliance and service progression. The aims of the LSP are to: Ensure the continuity of Health Board preparedness for all emergencies. Ensure efficient, compliance protection duties are met by the Health Board. Develop a civil contingencies strategy for Aneurin Bevan Health Board, which provides an integrated plan, supported by local arrangements. 4. Action Plan Key work streams have been identified for 2010/2011 from key drivers including the Civil Contingencies Act, the AOF and Healthcare Standards (HCS). Actions have also been developed in response to local direction emanating from the Local Resilience Forum and its sub-groups. The following sets out some of the key activities for 2010/2011: Civil Contingencies Strategy A draft Aneurin Bevan Health Board Civil Contingencies Strategy has been developed, and following consultation will be presented to the Board for ratification in July The Strategy outlines the vision for Civil Contingencies and Emergency Planning for the Health Board, building on the work of the six previous organisations. This takes an integrated approach to meeting statutory duties and outlines, expectations, planning, delivery, the internal and external group/committee structure for reporting and joint working. A work programme to achieve the identified objectives underpins the strategy. This is supported by a group structure which demonstrates how the Health Board will co-ordinate civil contingency and emergency planning activity both within and external to the organisation with partners. Civil Contingencies Policies and Procedures Several supporting policies and plans are in place to focus on specific requirements of delivering the civil contingency obligations, emergency planning and business continuity management agenda. These include: Major Emergency Response Policy; Major Incident Plans; Pandemic Influenza Plan; Bomb Alert Threat; Essential Supply Shortage (fuel); 3

4 Severe Weather Arrangements and the Heat-wave Response Plan. Some of these policies and procedures are in the process of being updated to encompass the needs of the new, integrated organisation and to ensure modernisation against current guidance and direction. Additional documents are also being developed including the Chemical Incident/CBRN Response Plan, Mass Decontamination Plan, Comprehensive Business Continuity Plan and On-Call Guidance Plan. Training and Exercising The Emergency Planning function maintains a schedule of training and exercise requirements in relation to major incident response at the receiving hospitals. Training is undertaken by the Emergency Planning Team, who also ensure that the Health Board participates in all multi-agency training and exercising. The requirement for such exercises as an internal initiative is one table-top event per annum, including a physical deployment of the Co-ordination Centre, and a full live exercise every three years. A communications cascade occurs every six months. Currently, the Health Board needs to programme both tabletops and a live event for later in the financial year; this work is now underway with the LRF Training & Exercise Group. The Emergency Planning Team has recently completed a new on-line learning package for major emergency awareness, which will be accessible to all Health Board staff via the Intranet. This is an innovative initiative and will be developed further, with more detailed modules to follow. This on-line training provides a mechanism to give all staff a basic level of awareness, which can be supplemented where appropriate by specialist input from the Emergency Planning Team or externally purchased courses, provided by the Emergency Planning College and other specialist agencies. MERIT Team The Health Board is required to maintain a MERIT 1 team (formerly Mobile Medical Teams) at both Royal Gwent & Nevill Hall Hospitals. The Health Board is a leader in Wales with MERIT team activity and the Emergency Planning Team contributing to 1 MERIT = Medical Emergency Response Incident Team 4

5 the National Committee for this highly specialised work. Cross border training also occurs in conjunction with Avon & Somerset NHS Training Partnership The Emergency Planning Team is working towards the setting up of a dedicated centre to provide MIMMS 2 and HMIMMS 3 training in the region. There will be funding implications to achieve this, to meet the strict criteria for such centres. Hosting a MIMMS centre would be very beneficial to the educational reputation of the Health Board and may be income generating. Business Continuity Planning Business Continuity plans are currently being reviewed across the new organisation, with a lead for each Locality and Operational Division being identified to progress this work with the Emergency Planning Team. Additional training will need to be provided in relation to Business Continuity Plans and this may be incorporated into annual tabletop events. On-call provision Work is underway to support a revised Executive and Senior Management on-call system, with associated training and development. A review is also being undertaken of the out of hours demands that can be resolved in hours, in order to minimise the requirements of the on-call system, thus enabling the senior role to focus on exceptional events and provide greater continuity of operational activity. This work is linked with the business continuity planning activity. Learning from major incidents Following major incidents and adverse events, debrief activities take place to capture feedback from those involved to ensure learning is optimised and utilised for reducing the impact of future occurrences. A recent example is that of the Health Board debrief learning event on Pandemic Swine Flu. These lessons learnt and experiences are fed into wider business continuity planning processes. 2 MIMMS = Major Incident Medical Management Support 3 HMIMMS = Hospital Major Incident Medical Management Support 5

6 Professional Advice and wider engagement The Emergency Planning Team undertake a wide range of activities to support the compliance of Aneurin Bevan Health Board with the Civil Contingencies Act. This activity includes provision of professional advice across the organisation, response management of live incidents, full external liaison with partner agencies, participation in the work-stream programme and national planning fora, training and exercise provision, infectious disease planning support, external liaison for New Threats and participation in a number of audit mechanisms. Additional developments There are a number of essential developments, which the Health Board needs to address to enhance the response capability of the organisation to new and emerging threats, including terrorism and extreme weather situations. As such plans are developed, these will form part of the wider service and capital planning programme. Current potential developments include: The purchase and installation of a purpose built Decontamination Unit based at Royal Gwent Hospital. The refurbishment of the major emergency equipment store facility at the Royal Gwent Hospital to ensure rapid and efficient deployment of either MERIT teams or Chemical Decontamination staff. The refurbishment of the Hospital Co-ordination Centre (HCC) at Nevill Hall Hospital, to enhance response capability. The revision of the Health Emergency Co-ordination Centre (HECC) at Mamhilad, to ensure that the Health Board can co- ordinate a county-wide health emergency. The Health Board also maintains a Risk Register, which incorporates Major Emergency risks. This element of the Register is compiled by internal professional specialists and takes account of the external multi-agency Gwent Community Risk Register (CRR). The Health Board contributes to the construction and maintenance of this statutory document. 5. Review The Local Service Plan generated from the AOF, together with Healthcare Standards requirements form part of the audit process to measure and capture performance. Additionally 6

7 progress is regularly reported to the Welsh Assembly Government and the Health Board contributes to the National Capabilities Survey, which is multi-agency, and UK wide. The National Occupational Standards for Civil Contingencies are a new development, and whilst not yet statutory, the Health Board is already engaged and will be ready to develop this further work when required. 6. Conclusion The Health Board s emergency preparedness is at a safe and acceptable level, with a programme in place to progress, continually improve and ensure responsiveness as new risks present. The support of the Board is fundamental to promoting the need for strong engagement in this statutory field. 7. Recommendation The Board is asked to note the current level of organisational emergency preparedness and profile of current work. A draft, Aneurin Bevan Health Board Civil Contingencies Strategy is currently under development and will be presented to the Board in July 2010 for approval. Report prepared by: Adrian Girvin, Emergency Planning Manager Wendy Warren, Pandemic Planning Lead Ruth Treharne, Assistant Director of Planning and Service Improvement Report sponsored by: Judith Paget: Director of Planning and Operations 7

8 ANNEX 1 CATEGORY 1 AND 2 RESPONDERS DEFINED BY THE CIVIL CONTINGENCIES ACT Responders Under the Civil Contingencies Act 2004 Category 1 Category 2 Ambulance Service Airport Operators British Transport Police Electricity Distributors Environment Agency Gas Distributors Fire and Rescue Service Health and Safety Executive Health Protection Agency Highways Agency Local Authority Ports Local Health Board Railway Operators Maritime and Coastguard Agency Telephone Service Providers National Public Health Service Water and Sewerage Undertakers NHS Trust Police Port Health Authority 8