NHS England Core Standards for Emergency preparedness, resilience and response v3.0 The attached EPRR Core Standards spreadsheet has 6 tabs:

Transcription

1 NHS England Core Standards for Emergency preparedness, resilience and response v3.0 The attached EPRR Core Standards spreadsheet has 6 tabs: EPRR Core Standards tab - with core standards nos 1-37 (green tab) Pandemic Influenza :- with deep dive questions to support the pandemic influenza 'deep dive' for EPRR Assurance (blue) tab) HAZMAT/ CBRN core standards tab: with core standards nos Please note this is designed as a stand alone tab (purple tab) HAZMAT/ CBRN equipment checklist: designed to support acute and ambulance service in core standard 43 (lilac tab) MTFA Core Standard: designed to gain assurance against the MTFA service specification for ambulance service only (orange tab) HART Core Standards: designed to gain assurance against the HART service specification for ambulance service only (yellow tab). This document is V3.0. The following changes have been made : Inclusion of Pandemic Influenza questions to support the pandemic influenza 'deep dive' for EPRR Assurance Inclusion of the HART service specification for ambulance service and the reference to this in the EPRR Core Standards Inclusion of the MTFA service specification for ambulance service and the reference to this in the EPRR Core Standards Updated the requirements for primary care to more accurately reflect where they sit in the health economy update the requirement for acute service to have Chemical Exposure Assessment Kits (ChEAKs) (via PHE) to reflect that not all acute service have been issued these by PHE and to clarify the expectations for acute service in relation to supporting PHE in the collection of samples

2 Acute healthcare Self assessment RAG Core standard STFHT evidence Red = Not compliant with core standard and not in the EPRR work plan within the next Deep Dive Organisation have updated their pandemic influenza arrangements to reflect changes to the NHS and partner organisations, as well as lessons identified from the 2009/10 pandemic including through local debriefing DD1 updated planning arrangements reflect changes and learning version control indicates changes made and timeliness Complete change of approach. Plan is informed by Department of Health UK Influenza Pandemic Preparedness Strategy (2011), NHS England Operating Framework for Managing the Response to Pandemic Influenza (2013) and PHE North East Centre Pandemic Infuenza Operational Plan (2013). Version 1.0 written in March and version 2.0 signed off by BoD in August. Amber = Not compliant but evidence of progress and in the EPRR work plan for the next 12 DD2 DD3 DD4 Organisations have developed and reviewed their plans with LHRP and LRF partners Organisations have undertaken a pandemic influenza exercise or have one planned in the next six months Organisations have taken their plans to Boards / Governing bodies for sign off indication of the process used to develop updated arrangements, including identification of organisations involved in contributing or commenting on drafts agendas/ miniutes illustarting where the updated arrangements have been discussed documentation related to exercise since the 2013 publication, including lessons identified OR invitation letters/ documentation related to exercise scheduled to take place in next six months, including an indication of how lessons identified will be addressed Pandemic Flu was discussed with NTHFT, CDDFT, TEWV and NHS England in a meeting prior to the LHRP sub group on 10 March. Pandemic Flu 2015, v 1.0, was sent to DDT LHRP Sub Group for comment. To set up and deliver an exercise based on the PHE off the shelf exercise - EXERCISE Corvus. Scheduled to take place on 6 November, in David Kenward Lecture Theatre, JCUH. Invitations have been sent out. Feedback from all 4 sessions to be collated into a report to go to EPC in January. Board/ Governing Body agenda or meeting papers indicating Circulated to ID consultants for comment in March. updated pandemic influenza arrangements have been Circulated to members of EPC prior to April meeting. discussed and/ or signed off Acting Head of Nursing presented to Operational Management Board - 18 Aug Acting Head of Nursing presented at BoD - 25 Aug ( ) Deliver Corvus and present learning to EPC in Jan EPR Manager

3 Acute healthcare Hazardous materials (HAZMAT) and chemical, biological, radiolgocial and nuclear (CBRN) response core standards (NB this is designed as a stand alone sheet) Q Core standard Clarifying information JCUH FHN Comm hosp STHFT evidence Self assessme nt RAG Red = Not compliant with core standard and not in the EPRR work plan Preparedness 38 There is an organisation specific HAZMAT/ CBRN plan (or dedicated annex) Arrangements include: command and control interfaces tried and tested process for activating the staff and equipment (inc. Step Plus) pre-determined decontamination locations and access to facilities management and decontamination processes for contaminated patients and fatalities in line with the latest guidance communications planning for public and other agencies interoperability with other relevant agencies access to national reserves / Pods plan to maintain a cordon / access control emergency / contingency arrangements for staff contamination plans for the management of hazardous waste stand-down procedures, including debriefing and the process of recovery and returning to (new) normal processes contact details of key personnel and relevant partner agencies Being able to provide documentary evidence of a regular process for monitoring, reviewing and updating and approving arrangements Version control Appendices to Major Incident Plan: Appendix 6 Incidents involving Chemical contamination, Appendix 7 Incidents Involving Biological Agents, Appendix 8 Incidents Involving Radioactive contamination Major Incident Plan is revised at least annually, unless organisational strucuture changes, guidance changes, or procedures need to be updated following an actual incident or exercise Work closely with NEAS when they notify A&E of numbers and conditions of casualties Communications via Twitter, and to LRF partners Appendix 9 in the MIP details the national stocks for which ambulance control room is first point of contact and those for which it is NHS England EPRR Duty Officer 39 Staff are able to access the organisation HAZMAT/ CBRN management plans. Decontamination trained staff can access the plan Site inspection IT system screen dump 40 HAZMAT/ CBRN decontamination risk assessments are in place which are appropriate to the organisation. Documented systems of work List of required competencies Impact assessment of CBRN decontamination on other key facilities Arrangements for the management of hazardous waste Appropriate HAZMAT/ CBRN risk assessments are incorporated into EPRR risk assessments (see core standards 5-7) MIP is on the intranet and printed A&E have action cards to follow Procedures to follow are listed in the Decontamination folder. Only appropriately trained staff undertake decontamination procedures. Buddy / control in operation outside decontamination room. Risk assessments include self presenters being sent outside to the Decontamination room, no formal contact by clinical staff until fully protected with appropriate PPE, assessment of whether wet or dry decontamination is appropriate (caustic chemical or not), whether to initiate partial lockdown. Section of Appendix 6 lists activities, a risk rating and the PPE which should be worn. Sources used to inform A&E of contaminants involved: TOXBASE, PHE (North East, CRCE and NPIS, NEAS and local COMAH site operators. 41 Rotas are planned to ensure that there is adequate and appropriate decontamination capability available 24/7. Resource provision / % staff trained and available Rota / rostering arrangements At JCUH: All band 6s and 7s have now been trained, so there are always suitably trained staff on each rota. Some 6s and 7s have been trained but are going through annual refresher training, Autumn Medics being trained by Lt Col Paul Hunt at his sessions. Other band 5s trained in suiting up (25 of these members of staff). 42 Staff on-duty know who to contact to obtain specialist advice in relation to a HAZMAT/ CBRN incident and this specialist advice is available 24/7. Decontamination Equipment 43 There is an accurate inventory of equipment required for decontaminating patients in place and the organisation holds appropriate equipment to ensure safe decontamination of patients and protection of staff. For example PHE, emergency services. Provision documented in plan / procedures Staff awareness Acute and Ambulance service - see Equipment checklist overleaf on separate tab Community, Mental Health and Specialist service - see Response Box in 'Preparation for Incidents Involving Hazardous Materials - Guidance for Primary and Community Care Facilities' (NHS London, 2011) (found at: Initial Operating Response (IOR) DVD and other material: completed inventory list (see overleaf) or Response Box (see Preparation for Incidents Involving Hazardous Materials - Guidance for Primary and Community Care Facilities (NHS London, 2011)) Appendix 6 in MIP (section 1.8) refers to TOXBASE. Decontamination file includes details for TOXBASE, PHE (North East Centre, CRCE and NPIS). (see Equipment Checklist tab) 44 The organisation has the expected number of PRPS suits (sealed and in date) available for immediate deployment should they be required (NHS England published guidance (May 2014) or subsequent later guidance when applicable) There is a plan and finance in place to revalidate (extend) or replace suits that are reaching the end of shelf life until full capability of the current model is reached in 2017 n/a trail from EPR Manager to Brian Simpson and Maxime Hewitt-Smith in Finance. 24 in date: last refitted Nov 2014, to be refitted 22 & 23 October 45 There are routine checks carried out on the decontamination equipment including: A) Suits B) Tents C) Pump D) RAM GENE (radiation monitor) E) Other decontamination equipment There is a named role responsible for ensuring these checks take place n/a A) Suits have not been used in an incident. They are reboxed by Respirex engineer at the extension service. Last service was 27 Nov B & C) NO. Rely on mass decontamination at scene and the use of our fixed decontamination unit. D) Monthly checks carried out by HCA (review sheet,maintained) E) Decontamination room on daily cleaning / maintenance schedule

4 Acute healthcare Hazardous materials (HAZMAT) and chemical, biological, radiolgocial and nuclear (CBRN) response core standards (NB this is designed as a stand alone sheet) Q Core standard Clarifying information JCUH FHN Comm hosp STHFT evidence Self assessme nt RAG Red = Not compliant with core standard and not in the EPRR work plan 46 There is a preventative programme of maintenance (PPM) in place for the maintenance, repair, calibration and replacement of out of date Decontamination equipment for: A) Suits B) Tents C) Pump D) RAM GENE (radiation monitor) E) Other equipment n/a Suirs as per Respirex extension schedule Ramgene - see later 47 There are effective disposal arrangements in place for PPE no longer required. (NHS England published guidance (May 2014) or subsequent later guidance when applicable) n/a Following New guidance 2 June 2015 Training 48 The current HAZMAT/ CBRN Decontamination training lead is appropriately trained to deliver HAZMAT/ CBRN training 49 Internal training is based upon current good practice and uses material that has been supplied as appropriate. Documented training programme Primary Care HAZMAT/ CBRN guidance Lead identified for training Established system for refresher training so that staff that are HAZMAT/ CBRN decontamination trained receive refresher training within a reasonable time frame (annually). A range of staff roles are trained in decontamination techniques Include HAZMAT/ CBRN command and control training Include ongoing fit testing programme in place for FFP3 masks to provide a 24/7 capacity and capability when caring for patients with a suspected or confirmed infectious respiratory virus Including, where appropriate, Initial Operating Response (IOR) and other material: n/a Sue Murphy (Department Manager), and previously CBRN lead and Rebecca Ashby, current CBRN training lead previously trained by NEAS. Senior Sister Karen Wood, the training lead was trained by NARU in May Show evidence that achievement records are kept of staff trained and refresher training attended Incorporation of HAZMAT/ CBRN issues into exercising programme Rebecca Ashby is the designated lead for CBRN. Training day covers donning and doffing VHF PPE and PRPS suits, wet and dry decontamination and how to deal with patients. The NARU IOR DVD is shown as part of the training day Planned in for Minor Injuries Unit staff to be trained - RA to go to them Minor Injuries have NHS England: Self presenters pdf (April 2015) and access to the North West London resources. Exercise Diamond (Tues 16 June) - did self presenters for anhyrous ammonia in a doctors clinical session that day at same time as exercise at Wilton was taking place. Exercise Three Cathedrals (TEWV scheduled to take place 9 Oct)- scenario and chemical details shared with RA for inclusion in JCUH A&E training progamme Training for Minor Injury staff to be complete by December 2015 A&E CBRN Dec-15 Training Lead 50 The organisation has sufficient number of trained decontamination trainers to fully support it's staff HAZMAT/ CBRN training programme. 51 Staff that are most likely to come into first contact with a patient requiring decontamination understand the requirement to isolate the patient to stop the spread of the contaminant. Including, where appropriate, Initial Operating Response (IOR) and other material: Community, Mental Health and Specialist service - see Response Box in 'Preparation for Incidents Involving Hazardous Materials - Guidance for Primary and Community Care Facilities' (NHS London, 2011) (found at: n/a 3 mentioned above Rebecca Ashby, CBRN lead Karen Wood, Training lead Sue Murphy, Department Manager As evidenced in Ebola preparations, A&E Receptionists know to make patient walk outside to the front of the Decontamination Room. Clinical staff alerted to get PPE from the cupboard or PRPS suits located on the consultant corridor and enter the Decontamination Room on the instruction of their control.

5 HAZMAT CBRN equipment list - for use by Acute and Ambulance service in relation to Core Standard 43. No Equipment Equipment model/ generation/ details etc. Self assessment RAG Red = Not in place and not in the EPRR work plan to be in place within the next 12 Amber = Not in place and in the EPRR work plan to be in place within the next 12 Green = In place. EITHER: Inflatable mobile structure E1 Inflatable frame E1.1 Liner E1.2 Air inflator pump E1.3 Repair kit E1.2 Tethering equipment OR: Rigid/ cantilever structure E2 Tent shell N/a n/a OR: Built structure E3 Decontamination unit or room es AND: E4 Lights (or way of illuminating decontamination area if dark) es E5 Shower heads es E6 Hose connectors and shower heads Taps on outside of decontamination room E7 Flooring appropriate to tent in use (with decontamination basin if needed) n/a E8 Waste water pump and pipe n/a E9 Waste water bladder n/a PPE for chemical, and biological incidents E10 E11 E12 The organisation (acute and ambulance only) has the expected number of PRPS suits (sealed and in date) available for immediate deployment should they be required. (NHS England published guidance (May 2014) or subsequent later guidance when applicable). Providers to ensure that they hold enough training suits in order to facilitate their local training programme Ancillary A facility to provide privacy and dignity to patients E13 Buckets, sponges, cloths and blue roll es E14 Decontamination liquid (COSHH compliant) es 24 sealed and in date (refitted Nov 2014; next refit is booked for 22 & 23 Oct 2015) yes, 3 E15 Entry control board (including clock) es: placed in corridor Screens to be used outside in ambulance bay for dry decontamination, then Decontamination Room for wet decontamination. E16 A means to prevent contamination of the water supply Can be collected but not in a bund E17 Poly boom (if required by local Fire and Rescue Service) n/a E18 Minimum of 20 x Disrobe packs or suitable equivalent (combination of sizes) es - next room round (relatives room) E19 Minimum of 20 x re-robe packs or suitable alternative (combination of sizes - to match disrobe packs) es - next room round (relatives room) E20 Waste bins 60 litre burn bins and yellow bags Disposable gloves es E21 Scissors - for removing patient clothes but of sufficient calibre to execute an emergency PRPS suit disrobe toughcuts E22 FFP3 masks es E23 Cordon tape es E24 Loud Hailer es E25 Signage Hang on red tape and door E26 Tabbards identifying members of the decontamination team es (Major Incident cupboard) E27 Chemical Exposure Assessment Kits (ChEAKs) (via PHE): should an acute service provider be required to support PHE in the collection of samples for assisting in the public health risk assessment and response phase of an incident, PHE will contact the acute service provider to agree appropriate arrangements. A Standard Operating Procedure will be issued at the time to explain what is expected from the acute service provider staff. Acute service need to be in a position to provide this support. (Reference to letter from PHE: NHS England Gateway reference 02719, 16 Dec 2014) We do not have ChEAK Kits. However the trust has supported and will continue to support PHE in the collection of samples for assisting in the public health risk assessment and response phase of an incident. Radiation E28 RAM GENE monitors (x 2 per Emergency Department and/or HART yes x2 team) E29 Hooded paper suits yes -in emergency cupboard E30 Goggles yes E31 FFP3 Masks - for HART personnel only n/a : HART personnel only E32 Overshoes & Gloves yes