Report to: Trust Board Agenda item: 13. Date of Meeting: 8 June 2011 Title of Report: Status: Board Sponsor: Author: Appendices Emergency Planning Annual Report To note James Rimmer, Director of Operations Alex Massey, Operations Support Manager Avril Webb, Emergency None 1. Purpose of Report (Including link to objectives) To assure the Board that the Trust is compliant with legislation and guidance in relation to emergency preparedness 2. Summary of Key Issues for Discussion Risk Assessment Emergency Plans Live Events, Exercises and Training during 2010/11 3. Recommendations (Note, Approve, Discuss etc) The Trust Board is asked to note the report 4. Care Quality Commission Regulations (which apply) Regulation 9 (Regulated activities) Outcomes 4 Regulation 24 (Regulated activities) Outcome 6 5. Legal / Regulatory Implications / NHS Constitution (NHSLA / ALE etc) Civil Contingences Act 2004 and its associated guidelines 6. Risk (Threats or opportunities link to risk on register etc) Reference: Emergency Planning Risk Register 7. Resources Implications (Financial / staffing) None 8. Equality and Diversity Emergency Planning is delivered in line with the Trust s Equality and Diversity Policy 9. Communication None 10. References to previous reports Board Assurance Report September 2009 11. Freedom of Information Agenda Item: 13. Page 1 of 6
Public Agenda Item: 13. Page 2 of 6
Emergency Planning Annual Report to the Board 1. Background The Trust is required to meet a number of statutory duties in relation to Emergency Planning as detailed in the documents noted below. This report sets out how the Trust meets these responsibilities and the processes for ensuring continued compliance. The Civil Contingencies Act Emergency Planning Guidance 2005 NHS Operating Framework Internal management is coordinated by the Emergency Planning Group, which meets monthly. Operational meetings are chaired by the Operational Support Manager and Strategic meetings (held quarterly) are chaired by the Director of Operations. The Emergency Planning Group oversees the Emergency Planning work programme, managed by the Emergency, and receives regular updates on the Trust s Major Incident, Business Continuity, Pandemic Influenza Contingency and Incident Specific Plans. Locally, the Trust is a member of the Avon Local Resilience Forum (LRF), which is chaired by the Police; the Health Representative on the LRF is Bristol Primary Care Trust (PCT) who represent Primary Care, Acute Trusts and Mental Health. Bristol PCT s Lead Director for Emergency Planning chairs the Avon Health Emergency Resilience Group (AHERG), which meets quarterly and receives reports from the LRF. The Trust is represented on AHERG by the Director of Operations or his delegated deputy. Work streams from AHERG are discussed at the Trust s Strategic Emergency Planning Group. The Trust also has a representative on Wiltshire s LRF Health Resilience Group. Communications from the Department of Health (DH), Strategic Health Authority (SHA) and the LRF is via lead PCTs who in turn communicate with Trusts. The Trust s emergency planning staff regularly meet with colleagues from all emergency services and local authorities to ensure that planning for emergencies is coordinated, planned and integrated. 2. Risk Assessment Risk Assessment is a key tool in ensuring that the Trust manages local risks and plans appropriately. The Emergency Planning Group s Risk Assessment sub-group reviews existing and new risks quarterly, reassessing risks and taking all necessary actions. The LRF monitors and manages the Community Risk Register, which includes all local risks. The LRF oversees a coordinated approach to managing risks ensuring that each Trust has appropriate plans and that these are integrated across the Avon and Somerset Area. The Department of Health issues an annual Risk Register and communicates, through SHAs, any specific significant risks that may affect the health sector. The Government s current level of risk from terrorism is severe. 3. Emergency Plans Agenda Item: 13. Page 3 of 6
3.1 Major Incident Plan The Trust s Major Incident Plan complies with the Government legislation and includes the following information: Operational Management structure and call-out procedures Tactical responsibilities Interoperability between local, regional and national category one and category two responders Arrangements for partners to support escalation plans Mutual Aid arrangements Communications strategy, including communicating with stakeholders and the public Staff, visitor and patient welfare procedures Appendices covering specific incidents, i.e. Chemical, Biological, Radiological or Nuclear, Mass Casualty Action Cards Recovery plans The revised Major Incident plan is due to be reviewed in June 2011 by the Strategic Emergency Planning Meeting. 3.2 Business Continuity Plan The Trust s Business Continuity Plan details procedures to enable the hospital to continue to deliver critical services whilst mitigating the effects of a disruption. The plan covers the following: Extreme weather Telecommunications failure Fuel Crisis Utility failures IT business continuity BS NHS 25999 has recently been published by the British Standards Institute. The standard has been specifically written for the health sector and is part of the Emergency Planning ongoing work programme for 2011/12. Business continuity will be reviewed across the Trust with the aim of aligning the Trust s plans with BS NHS 25999. 3.3 Pandemic Influenza Plan In 2009 the World Health Organisation declared a Pandemic for a new strain of H1N1 influenza; swine flu. Although a small increase in flu activity was witnessed during 2009/10 the Trust did not need to stand up its Pandemic Flu Contingency Plan. However, during 2009/10 the Trust developed an Operational Plan which included staff training in the use of Personal Protective Equipment (PPE) (including the use of FFP2 masks) and specific training in critical care skills. The training undertaken during the previous year equipped the Trust and its staff to treat a high level of critically ill patients during December 2010 and January/February 2011. The numbers of patients requiring intervention by ITU increased beyond normal capacity and the Trust moved to stage 1 of its escalation procedures; these worked extremely well. 4. Live Events, Exercises and Training during 2010/11 Agenda Item: 13. Page 4 of 6
4.1 During December 2010 to February 2011 the Trust activated its Operational Flu Management Plan in treating a large number of critically ill patients requiring care and treatment in ITU. This resulted in the cancellation of elective activity to reduce the pressure on ITU which was supported by the SHA. During the peak period daily meetings were held between ITU consultants throughout the region in support of the RUH and two other hospitals experiencing increased ITU activity. There were a small number of patients treated for flu on Marlborough Ward but these were treated without further hospital escalation. At the start of the Flu season the Trust s Pandemic Influenza Management Group met and continued to meet weekly during the escalation of ITU. As a result of the debrief following the increased activity in ITU a small number of amendments were made to the Operational Flu Plan, which included establishing a meeting of the full Pandemic Flu Management Group in early September to plan for the flu season ahead. The meeting will confirm the arrangements for promoting and reminding staff of procedures in dealing with flu as well as promoting the flu vaccine campaign for staff. 4.2 During November 2010 to January 2011 the Trust dealt with several episodes of adverse weather conditions. The plans put in place the previous year were used to great effect to efficiently manage events. 4.3 The Trust did not respond to any major incidents other than flu and severe weather during 2010/11. However, it put plans in place to respond to threatened industrial action by Great Western Ambulance staff and prepared a response to the threat of industrial action by NHS staff resulting from financial cuts. Thankfully neither of these response plans needed to be activated. 4.4 Trust staff have taken part in a number of exercises and training during the year, these have included: Bath City Centre Evacuation exercise (multi-agency) Anti terrorist exercise Surge Capacity Planning workshop (multi-agency) Communications exercise (multi-agency) Table top of major incident plan Flooding exercise (multi-agency) Crisis support training CBRN training (multi-agency) Mass casualty exercise (multi-agency) Hospital evacuation exercise (multi-agency) As a result of the above the Trust met its legal obligations in testing staff and exercising procedures. 4.5 A schedule of training and exercising is in the process of being developed for the coming year, 2011/12 which will include the following areas: Loggist training On-Call Manager training for terrorist alert and command and control Training for staff in setting up Major Incident Control Rooms Switchboard and Reception staff training for handling threatening phone calls Agenda Item: 13. Page 5 of 6
Live exercise linked to hospital evacuation Olympic sitrep and control room exercise Lockdown test for the Emergency Department 5. Other areas of work The Emergency Planning work programme includes: Development of lockdown plans leading to whole site evacuation plans Business Continuity completion of the BC template in all ward areas Working with health partners to further develop mass casualty plans During the year a number of actions were completed, these include: Inclusion of a Resilience Web page on the Intranet which includes staff advice and links to plans and external websites. Resilience is now part of local induction Completion of ITU evacuation plans; these have been tested Memorandum of Understanding with the Fire and Rescue Service around mass decontamination on site (Cricket Club ground) In March 2011, the Trust s plans and procedures for emergency planning and business continuity arrangements were received by NHS Southwest as part of a region-wide assurance process. No major gaps or issues were identified although two actions were noted. These related to evacuation procedures related to a CBRN incident; this is currently being addressed and secondly, actions following review of the Five London Hospital Fires; an action plan is being drafted by the Fire Safety Committee. The site office, which also acts as the Incident Control Centre (Bronze) in an emergency, has recently been refurbished. It is now suitably equipped as a Control Centre for major incidents. 6. Conclusion The Emergency Planning team continues to work closely with Health and multi-agency partners within the Avon and Somerset areas. Locally the team has developed strong working relationships with BANES PCT, BANES local Council and the National Hospital for Rheumatic Diseases. A new working group has been established focusing on local communications during a major incident which is chaired jointly by the Trust s and the PCT s Emergency s. The Board is asked to note the report and confirm its assurance that key staff are linked into local resilience networks; plans are reviewed on an ongoing basis; a programme of training and exercising is maintained; the Strategic Planning Group monitors the Emergency Planning work programme and oversees governance issues. Agenda Item: 13. Page 6 of 6