2.0 - EMERGENCY PLANNING POLICY NO: 2.02

Transcription

1 SECTION: EMERGENCY PLANNING POLICY NO: 2.02 NATURE AND SCOPE: SUBJECT: POLICY TRUSTWIDE SEVERE WEATHER This policy provides guidance, advice and information needed to maintain the safety of individuals and ensure that the Trust is prepared to respond to any severe weather situation, or the results of severe weather, that has the potential to disrupt the delivery of Trust services DATE OF LATEST RATIFICATION: OCTOBER 2014 RATIFIED BY: EXECUTIVE LEADERSHIP TEAM IMPLEMENTATION DATE: OCTOBER 2014 REVIEW DATE: NOVEMBER 2017 ASSOCIATED TRUST POLICIES AND PROCEDURES: Heatwave Risk Assessment in Health and Safety Trust Major Incident Response Plan/Annexe 1 Winter Resilience Plan ISSUE 6 OCTOBER 2014

2 NOTTINGHAMSHIRE HEALTHCARE NHS TRUST SEVERE WEATHER POLICY CONTENTS 1.0 Introduction 2.0 Aim 3.0 Scope 4.0 Policy Activation 5.0 What is Severe Weather? 6.0 Problems as a Result of Severe Weather 7.0 Closure of Schools due to Severe Weather 8.0 Risk Assessment 9.0 Activation of Command and Control Procedures 10.0 Liaison with Multi Agency Partners 11.0 Preparation/Escalation for Severe Weather Preparedness Phase Level One Escalation Level Two Escalation 11.2 Actions to be taken during the Preparedness Phase On Call Managers Department/Ward Managers Community Staff Head of Facilities (Local Services and Forensic Division) Hotel Services/Catering Head of Emergency Preparedness Resilience & Response/Head of Communications 11.3 Actions to be taken at Level One of the Escalation Plan On Call Managers Department/Ward Managers Community Staff Head of Emergency Preparedness Resilience & Response (EPRR) Hotel Services/Catering 11.4 Actions to be taken at Level Two of the Escalation Plan Department/Ward Managers On Call Managers Community Staff Head of Emergency Preparedness Resilience & Response/Head of Communication Hotel Services/Catering 12.0 The Department of Health Cold Weather Response Plan 13.0 Health & Safety ISSUE 6 OCTOBER

3 14.0 Severe Weather and Flood Warning Services Available 15.0 Debriefs 16.0 Exercising and Training 17.0 Target Audience 18.0 Consultation 19.0 Legislation Compliance 20.0 Equality Impact Assessment 21.0 Champion and Expert Writer 22.0 Monitoring Compliance 23.0 Policy Review Date 24.0 References/Source Documents Appendix 1 Appendix 2 Appendix 3 Appendix 4 Appendix 5 Appendix 6 Cold Weather Plan for England, Department of Health Attendance for Duty during Severe Weather Conditions Frequently Asked Questions Severe Weather Severe Weather and Flood Warning Services Record of Changes Employee Record of Having Read the Policy ISSUE 6 OCTOBER

4 1.0 INTRODUCTION NOTTINGHAMSHIRE HEALTHCARE NHS TRUST SEVERE WEATHER POLICY 1.0 Severe weather conditions are not common but when they do occur they have the potential to disrupt the ability of organisations to deliver their services as planned. 1.2 The key to a successful response to any emergency is an early and accurate assessment of the nature of the incident. With severe weather in mind, Nottinghamshire Healthcare NHS Trust (the Trust) has developed this policy, which incorporates a Preparation/ Escalation Procedure. This policy should be read in conjunction with other relevant plans e.g. the Trust Major Incident Plan 1.3 Whilst planning is unable to offer a solution to every problem created by severe weather, it is practical to highlight the preparations and actions that are required to be undertaken within any warning period that may be available to us. 2.0 AIM 2.1 The aim of this policy is to outline the arrangements that can be put in place both before and during an episode of severe weather to ensure the maintenance of essential Trust services as a minimum. 3.0 SCOPE 3.1 This policy provides guidance, advice and information needed to maintain the safety of individuals and ensure that the Trust is prepared to respond to any severe weather situation, or the results of severe weather, that has the potential to disrupt the delivery of Trust services. 4.0 POLICY ACTIVATION 4.1 This policy will be activated when there is advanced warning of severe weather conditions threatening to disrupt the provision of health care services provided by the Trust. 4.2 This may trigger the activation of Directorate Business Continuity Plans. 5.0 WHAT IS SEVERE WEATHER? 5.1 Severe weather may be in the form of: Heavy snow Sub Zero Temperatures High winds (gale force) Heavy, prolonged rain (flooding) Storms (electrical) Fog Heatwave (dealt with separately in the Trust Heatwave Policy 2.01) or a combination of these. 6.0 PROBLEMS AS A RESULT OF SEVERE WEATHER 6.1 Severe weather is likely to affect the ability to move patients, goods, foods around Trust sites. It may well affect the ability of staff to travel to and from work. Deliveries could also be affected as well as services and structures to some extent. ISSUE 6 OCTOBER

5 6.2 Recent experience has highlighted the following issues: Unavailability of patient transport Unavailability of Trust transport for delivery of urgent drugs from Pharmacy Department Visitors unable to leave Trust premises Patients unable to get to Trust premises Staff unable to get to work Staff unable to leave work Community staff unable to make home visits Communication difficulties 7.0 CLOSURE OF SCHOOLS DUE TO SEVERE WEATHER 7.1 During severe winter weather schools can close for a variety of reasons, such as: Access road to the school is not on a priority or severe weather route and is therefore untreated Insufficient staff are able to reach the school to maintain minimum teacher to pupil ratios Pupils are unable to reach the school School buses stop operating Problems with the school heating supply Access routes within the school site are considered hazardous. 7.2 The decision to close a school rests with the headteacher. 8.0 RISK ASSESSMENT 8.1 The Management of Health & Safety at Work Regulations 1999 impose a legal duty on employers to carry out documented risk assessment for hazards in the workplace that could cause harm to employees/others. 8.2 Severe weather conditions and/or the results of severe weather are classed as non routine situations which require the completion of a Trust Risk Assessment form. 8.3 In addition, a dynamic risk assessment in response to rapidly changing circumstances will be required. See Trust Policy Risk Assessment in Health and Safety Policy and Procedure ACTIVATION OF COMMAND AND CONTROL PROCEDURES 9.1 In the event of severe weather and its associated problems threatening to disrupt the provision of Trust services, the Executive Director On Call will discuss with the Divisional Senior Managers On Call whether there is a need to instigate a Command and Control procedure to manage the Trust response to the issues as they arise within their Divisions. 9.2 Once formed, the Command Teams will assess the current situation and any likely impact the severe weather or flooding could have on the Trust s ability to provide its health care services. 9.3 The GOLD Command Team will: Co-ordinate measures to minimise the effect the severe weather is having Co-ordinate or manage any response required to any developing situation Ensure message are issued as per the Trust Emergency Communications Policy ISSUE 6 OCTOBER

6 Approve general health advice and information to be placed on the Trust intranet and e- mail as appropriate 9.4 The SILVER Command Teams will: Keep essential health services running by activating Business Continuity plans Ensure contingencies are put in place where necessary Ensure sufficient cover is maintained for the delivery of essential services 9.5 Key issues that may arise will be to: Co-ordinate any response that may be required to support or accommodate any staff members who are unable to get home Identify and co-ordinate designated areas to manage staff, patients and visitors who are unable to get home Monitor and ensure adequate, phased staffing levels within all clinical and non clinical areas, liaising with Ward Managers and Departmental Heads, and redeploying staff to critical areas Co-ordinate the reduction in non-essential services, including home visits, in conjunction with the GOLD Command Identification of nursing/support staff who may be deployed to Local Authority Rest Centre if opened Regularly assess the situation and update GOLD Command 10.0 LIAISON WITH MULTI AGENCY PARTNERS 10.1 GOLD Command will receive and cascade information from the Multi Agency Strategic Coordination Group (GOLD Command) or Tactical Co-ordination Group (SILVER Command) if they have been established, to the wider organisation Multi Agency coordination is crucial to ensure an effective emergency response to severe weather situations. Liaison with other agencies involved in the emergency response will be maintained by the NHS England Area Team whose SILVER/GOLD Commander who will represent the Trust at the Strategic Co-ordination Group (GOLD) or Tactical Co-ordination Group (SILVER). This group will be chaired during the response phase by the Police but in the Recovery phase by the Local Authority PREPARATION/ESCALATION FOR SEVERE WEATHER 11.1 In the event of severe weather conditions, the Trust has identified a preparedness phase and two levels of escalation. Each level will need to be activated in accordance with the weather forecasts that are available at different stages. The levels are as follows: Preparedness Phase: This phase is activated when there is a warning of possible severe weather conditions within the following four/five days. This preparedness phase will enable wards and departments across the Trust to review their Business Continuity Plans, prepare for disruption to staffing levels and review their stocks and supplies of consumables. Level One Escalation: This level is activated when there is a warning of severe weather conditions expected within the following 24 hours. Level Two Escalation: This level is activated when severe weather conditions are actually affecting parts of the East Midlands and South Yorkshire. ISSUE 6 OCTOBER

7 11.2 Actions to be taken during the Preparedness Phase On Call Managers Review the Manager On Call rota to assess whether those covering the following seven days will be available Department/Ward Managers Review Business Continuity Plans Review staffing rotas and identify staff members who may experience difficulties in travelling to and from their place of work Identify members of staff who live within walking distance of their place of work, who may need to be rostered, taking into account the need to achieve a satisfactory and safe skill mix Identify consumables that would be in greater demand in the event of a period of severe weather Assess the potential of obtaining extra supplies Encourage staff to have the Seasonal Flu vaccination (if it is the Flu season) Community Staff Review staffing rotas and identify staff members who may experience difficulties in travelling to and from their place of work Review patient/client lists which require community nursing visit or urgent hospital treatment to identify patients who may be in the affected areas Create lists of vulnerable patients who may be in the affected areas Encourage staff to have the Seasonal Flu vaccination (if it is the Flu season) Review Business Continuity Plans Head of Facilities (Local Services and Forensic Division) Ascertain the level of transport that would be available during a period of severe weather for deliveries Ensure appropriate quantities of rock salt/gravel area available for use on Trust internal roads, footpaths, walkway and car parks Ensure mechanisms are in place to spread the rock salt/gravel as necessary Ensure business continuity plans are reviewed in event that Trust transport is stranded or unusable eg for urgent Pharmacy deliveries, food Encourage staff to have the Seasonal Flu vaccination (if it is the Flu season) Hotel Services/Catering Ascertain food stock levels and estimate if levels are sufficient to meet a potential increase in demand Review staff contingency plan Encourage staff to have the Seasonal Flu vaccination (if it is the Flu season) Head of EPRR/Head of Communications Place Weather Warnings on Trust Intranet (under Emergency Planning) Forward Warnings to Executive Leadership Council and Emergency Planning Liaison Officers Prepare Key Messages for staff via Trust Intranet Newsflash and Trust Advertise availability of Seasonal Influenza vaccination clinics on Trust Intranet ISSUE 6 OCTOBER

8 11.3 Actions to be taken at Level One of the Escalation Plan On Call Managers Consider instigating Command & Control structure Check s Review the On Call Managers rota with the view to ensuring that the staff covering the forthcoming 72 hours will be available Department/Ward Managers Adjust staffing rotas to ensure that staff who may experience difficulties in travelling to and from work, during a period of severe weather, are not rostered to work during that period where practical Agree an On Call rota with the members of staff who may be required to cover staff shortfalls at short notice, taking into account the need to achieve a satisfactory and safe skill mix Community Staff Ensure vulnerable patient client lists are available to On Call Managers in the areas affected by the severe weather In the event of the potential for extreme flooding, discuss and propose alternative arrangements for providing care to patients eg transferring high dependency patients from the community to nursing homes where capacity exists Head of EPRR Obtain accurate weather forecasts relaying those to relevant groups of staff and the Executive Director On Call Ensure up to date information is available on the Trust Intranet Hotel Services/Catering Review Business Continuity Pans Place orders for predetermined stocks of food Increase stocks of linen 11.4 Actions to be taken at Level Two of the Escalation Plan Department/Ward Managers Implement Business Continuity Plans Ensure mobile telephones are charged in areas where usage is permitted Instruct all staff to bring with them an extra set of clothing and sleeping bag Implement staffing plans to ensure adequate and safe staffing levels Liaise with the General Manager/Service Team Leaders in relation to any staffing inadequacies On Call Managers Instigate the Command and Control Structure (ref Trust Major Incident Plan) if not already activated Ensure all essential telephone services are maintained within Directorates ISSUE 6 OCTOBER

9 Consider asking staff who live more locally to the areas affected by severe weather to remain at work to keep key buildings and departments open during normal office hours as identified in business continuity plans Community Staff If Local Authority Rest Centres are opened as a result of the severe weather, the Trust may be approached to provide support at these locations On Call Manager will be asked to identify suitable nursing/support staff to be deployed to Rest Centres from the Community Services Division Services to patients with long term conditions eg diabetes, heart disease, respiratory disease and complex care packages, essential palliative care will have to be maintained In the event of the potential for extreme flooding, discuss and propose alternative arrangements for providing care to patients eg transferring high dependency patients from the community to nursing homes where capacity exists Head of EPRR/Head of Communication Produce bulletins to inform the wider public of the situation together with information about reduced services etc on Trust Intranet and Trust website Keep staff updated via regular s Hotel Services/Catering Implement Business Continuity Plans Distribute extra linen supplies to appropriate areas Where possible, extend the opening times of staff restaurants to provide catering services for stranded staff and visitors 12.0 THE DEPARTMENT OF HEALTH COLD WEATHER RESPONSE PLAN 12.1 The Public Health England Cold Weather Plan (CWP) for England 2013 Protecting Health & Reducing Harm from Cold Weather is a framework intended to protect the population from harm from cold weather. It aims to prevent the major avoidable effects of cold weather by alerting people to the negative health effects of cold weather, enabling them to respond appropriately. It recommends a series of steps to reduce the risks to health from cold weather for the NHS, Social Care and other community organisations throughout the year to support vulnerable people who have health, housing or economic circumstances that increase their risk The Cold Weather Plan is in force each winter from 1 st November and will cease 31 st March. The plan works through a system of Cold Weather Alerts which are intrinsically linked to the existing winter weather warning system developed by the Met Office, which will trigger appropriate actions up to a major incident.. The alerts are divided into 5 levels of escalation and will be distributed to the Executive Leadership Council for onward distribution as appropriate Leaflets, prepared by Public Health England, are available on the Trust Intranet for printing and distribution to patients and carers as appropriate The additional duties required to be undertaken by Trust staff are outlined in Appendix 1 of this Policy. ISSUE 6 OCTOBER

10 13.0 HEALTH AND SAFETY 13.1 Members of staff living in areas which have been identified as being at a high risk of flooding should inform their line managers. These staff will potentially have their access routes to and from work affected. It may be advisable to agree flexile working arrangements in advance which should be reflected in the Department s business continuity plan so this can be taken into account should there be a heightened risk announced by the Flood Advisory Service for their area. Maps showing areas at risk of flooding can be found in Appendix In applying this policy, the Trust recognises the need to safely maintain services during adverse weather conditions, whilst properly discharging its duty of care to employees. Employees should not put themselves at unnecessary risk and in this regard should use their own judgement and pay due regard to severe weather warnings Managers must seek to take account of any advice issued by or sought from the police, weather centre, public transport and motoring organisations in relation to prevailing weather SEVERE WEATHER AND FLOOD WARNING SERVICES AVAILABLE 14.1 The Head of EPRR has access to a number of warning, advice and alert services for both severe weather and flood forecasting and warnings. These are circulated to members of the Executive Leadership Council for onward transmission as appropriate. They are also placed on the Trust Intranet in the Emergency Preparedness/Severe Weather, Extreme Rainfall and Flood Alerts section. Details of these agencies and the services they provide can be found in Appendix 4 of this policy Advice leaflets which can be printed out and distributed to staff providing advice are available on the Trust Intranet in the Emergency Preparedness/ Severe Weather, Extreme Rainfall and Flood Alerts section DEBRIEFS 15.1 Formal debriefs will be held following all or part activation of this policy to capture any lessons learned which will be fed back into the planning process. This will include a Trust specific debrief and a multi agency debrief EXERCISE AND TRAINING 16.1 The policy will be tested by individual Directorates alongside other business continuity plans TARGET AUDIENCE 17.1 This policy will apply to all Trust staff CONSULTATION 18.1 The policy has been written after consultation with the Trust Emergency Preparedness, Resilience & Response (EPRR) Assurance Committee and the Executive Leadership Council LEGISLATION COMPLIANCE 19.1 Civil Contingencies Act ISSUE 6 OCTOBER

11 19.2 NHS Commissioning Board Emergency Preparedness Framework Health & Safety at Work etc Act Management of Health and Safety at Work Regulations EQUALITY IMPACT ASSESSMENT Severe Weather This plan has been assessed using the Trust Equality Impact Assessment Screening Tool. The assessment concluded that the procedure has no adverse impact on, or result in the positive discrimination of, any of the diverse groups detailed. These include the protected characteristics of race, gender, gender identity, sexual orientation, disability, age, religion/belief, marriage/civil partnership status, pregnancy/maternity status as well as social inclusion, community cohesion and human rights. Although the plan is applied generically it has a positive impact on key protected (vulnerable) groups e.g. older people, children, people with disabilities and/or mobility issues (including pregnant women) etc. as it aims to ensure that all resilience arrangements actively take into account the diverse needs of those whom they aim to protect Two of the core Trust values are to respect individuals and ensure effective communication. The Trust will ensure that all staff embrace these values when working with service users/carers and help make a difference to their lives. The Trust is committed to treating every individual fairly and will not discriminate against individuals/ groups of people because of their race, gender, gender identity, disability, sexual orientation, age, or religion/belief, marriage/civil partnership status of pregnancy/maternity status CHAMPION AND EXPERT WRITER 21.1 The Champion of this policy is the Executive Director, Nursing, Quality & Patient Experience. The Expert Writer is the Trust Head of Emergency, Preparedness, Resilience & Response MONITORING COMPLIANCE 22.1 The effectiveness of the policy will be assessed at the Trust Quality & Risk Committee on reviewing the consequences for the Trust of a disruption due to severe weather POLICY REVIEW DATE 23.1 This policy will be reviewed: after activation to incorporate any lessons learned on the issue of new national advice or the circulation of new guidance or in November REFERENCES/SOURCE DOCUMENTS Cold Weather Plan for England 2013 Protecting Health & Reducing Harm from Cold Weather, Public Health England The Met Office Website Reduce the Risk of Seasonal Excess Deaths Systematically in Vulnerable Older People to Impact at Population Level, Department of Health ISSUE 6 OCTOBER

12 APPENDIX 1 COLD WEATHER PLAN FOR ENGLAND PROTECTING HEALTH AND REDUCING HARM FROM COLD WEATHER In 2011/12 there were 22,800 more deaths in England between the months of December 2011 to March 2012 than were observed during the non-winter months. Although there are several factors contributing to winter illness and death, in many cases simple preventative action could avoid many deaths, illness and injuries associated with the cold. Many of these measures need to be planned and undertaken in advance of cold weather. The Cold Weather Plan for England Protection Health and Reducing Harm from Cold Weather 2013 aims to prevent avoidable harm to health, by alerting people to the negative effects of cold weather. It also aims to reduce the pressure on the health and social care system during the winter through improved anticipatory actions with vulnerable people. The impact of cold weather on health is predictable and mostly preventable. Direct effects of winter weather include an increase in incidence of: Heart attack Stroke Respiratory disease Influenza Falls and injuries Hypothermia Indirect effects of cold include mental health illness such as depression, and carbon monoxide poisoning from poorly maintained or poorly ventilated boilers, cooking and heating appliances and heating. Groups of greater risk of harm from cold weather include: Older people (over 75 years old) Otherwise frail older people Children under the age of five People with pre-existing chronic medical conditions such as heart disease, stroke or TIA, asthma, chronic obstructive pulmonary disease or diabetes People with mental ill-health that reduces the individual s ability to self-care (including dementia) People with learning difficulties People assess as being at risk of, or having had, recurrent falls People who are housebound or otherwise low mobility People living in deprived circumstances People living in houses with mould People who are fuel poor Elderly people who live alone and do not have additional social services support Homeless or people sleeping rough Other marginalised groups A Cold Weather Alert Service operates from 1 st November and ceases on 31 st March, based on Met Office forecasts and data. The Cold Weather Alert Service comprises five main levels (levels 0-4). The actions required by the Trust at each level to reduce harm from cold weather are described below. ISSUE 6 OCTOBER

13 LEVEL 0 LONG TERM PLANNING YEAR ROUND PLANNING All year-round planning is required to build resilience and reduce the impact of cold weather. This is the level of alert relates to those longer-term actions that reduce the harm to health and cold weather when it occurs. General preparation includes: Engagement of the Trust in local Emergency Planning Resilience and Response (EPRR) planning arrangements across the region Ensuring that those patients/clients most vulnerable to cold weather can be identified for joined up support with partner agencies and agree data-sharing arrangements within information governance principles Ensuring Divisions have identified all those patients/clients vulnerable to cold weather an arrangements are in place to support and protect them appropriately Assessing the longer term implications of climate change; reduction in carbon emissions; and sustainability for longer-term business continuity Considering how best to mobilise Community teams Making sure that staff have identified all those vulnerable to cold weather and that arrangements are in place to support and protect them appropriately Encouraging staff to be vaccinated against flu before winter starts Working with staff on risk reduction awareness, information and education. Encourage staff to be vaccinated against flu before winter starts Ensure that business continuity plans include severe winter weather. Plan for a winter surge in demand for services Considering carers needs and support they can continue to give Working with environmental health officers in Housing Health and Safety Rating System hazard identification Ensuring that staff have been made aware of the Cold Weather Plan and the dangers of cold weather to health and know how to spot signs and symptoms Using clinic attendance and home visits as opportunities to identify vulnerable people and discuss winter preparedness Working with at-risk individuals, their families and carers to ensure that they are aware of the dangers of cold weather and cold housing and how to access support; ensuring that there are clear arrangements for signposting to other services (eg home insulation schemes, benefits entitlements) when identified in clinical situations LEVEL 1 WINTER PREPAREDNESS AND ACTION 1 NOVEMBER 31 MARCH This is the level is in force throughout the winter from 1 November to 31 March and covers the moderate temperatures where the greatest total burden of excess winter death and disease occur. Actions described at this level should be taken throughout the winter to protect and improve health. Preparations should be in place to protect health and ensure service continuity in the event of severe cold and for episodes of heavy snow and/or widespread ice. Ensure that Cold Weather Alerts are going to the right staff and appropriate actions are agreed and able to be implemented, especially to protect vulnerable patients/clients Ensure staff have identified those vulnerable to cold weather and arrangements are in place to support them appropriately Ensure staff are undertaking appropriate home checks when visiting patients/clients eg room temperature, medication and food supplies Ensure rooms in in-patient and residential units are kept warm, particularly bedrooms and living rooms, and that staff take appropriate action to protect patients from cold weather Work with partner agencies to co-ordinate weather plans; ensure data sharing and referral arrangements are in place ISSUE 6 OCTOBER

14 Continue to work with staff on risk reduction awareness, information and education. Encourage staff to be vaccinated against seasonal flu, if not already. Work with local authority teams to identify accident hotspots on pavements or roads, advise on gritting priorities to prevent accidents, and ensure access by utilities and other essential services Ensure staff are aware of the business continuity plan for winter weather; plan for a winter surge in demand Ensure carers are receiving advice and support Trust preparations should be undertaken as follows: Department/Ward Managers Review Business Continuity Plans Review staffing rotas and identify staff members who may experience difficulties in travelling to and from their place of work Identify members of staff who live within walking distance of their place of work, who may need to be rostered, taking into account the need to achieve a satisfactory and safe skill mix Identify consumables that would be in greater demand in the event of a period of severe weather Assess the potential of obtaining extra supplies Encourage staff to have the Seasonal Flu vaccination Identify vulnerable patients such as those with chronic lung disease, eg COPD who can decompensate at relatively small drops in their usual environmental temperature, and those with cachexia (eating disorders, self-neglect, possible hunger striking) in order to consider making special provision in advance on the onset of severe weather such as a small supervised warm ward Community Staff Review Business Continuity Plans Encourage staff to have the Seasonal Flu vaccination Identify vulnerable patients such as those with chronic lung disease, eg COPD who can decompensate at relatively small drops in their usual environmental temperature, and those with cachexia (eating disorders, self-neglect, possible hunger striking) in order to consider making special provision in advance on the onset of severe weather such as a small supervised warm ward Continue to signpost those at risk patients/clients to other services (eg home insulation schemes, benefits entitlements) when identified in clinical situations; use the Keep Warm Keep Well booklet for up-to-date patient information and advice Remind patients/clients of the actions they can take to protect themselves from the effects of severe cold; including warm clothing, warm food and drinks, keeping active as much as they are able within the context of their care plan Check client s room temperature if visiting. Endure that they have at least one room which meets the recommended room temperatures Head of Facilities (Local Services and Forensic Division) Review Business Continuity Plans Ascertain the level of transport that would be available during a period of severe weather for deliveries Ensure appropriate quantities of rock salt/gravel area available for use on Trust internal roads, footpaths, walkway and car parks Ensure mechanisms are in place to spread the rock salt/gravel as necessary ISSUE 6 OCTOBER

15 Ensure business continuity plans are reviewed in event that Trust transport is stranded or unusable eg for urgent Pharmacy deliveries, food Encourage staff to have the Seasonal Flu vaccination Hotel Services/Catering Review Business Continuity Plans Ascertain food stock levels and estimate if levels are sufficient to meet a potential increase in demand Encourage staff to have the Seasonal Flu vaccination Head of EPRR/Head of Communications Place Weather Warnings on Trust Intranet (under Emergency Planning) Disseminate Warnings to Executive Leadership Council and Emergency Planning Liaison Officers Prepare Key Messages for Intranet Newsflash Prepare Key Messages to be issued globally via Trust Attend relevant multi-agency meetings as required and feedback to senior managers Advertise availability of Seasonal Flu Clinics on Trust Intranet, global s etc LEVEL 2 SEVERE WINTER WEATHER IS FORECAST ALERT AND READINESS This is triggered when there is a 60% risk of severe cold weather lasting at least 48 hours which is expected to arrive in the next 2-3 days. Mean Temperature of 2 C and/or widespread snow is predicted. Although there are usually fewer days at these lower temperatures, the risk of negative health impacts increases as the temperature falls. Health and Social Care Services and professionals need to ensure that all those at risk have been identified and can be contacted. They should ensure business continuity plans are implemented, media messages are communicated to the public. Individuals and communities should monitor the weather forecasts and ensure they have adequate stocks of food and medicine and keep an eye on people at risk. Trust actions should be as follows: On Call Managers Consider instigating Command & Control structure Check s Review the On Call Managers rota with the view to ensuring that the staff covering the forthcoming 72 hours will be available Activate Business Continuity arrangements and emergency plans as required. Activate plans to deal with a surge in demand for services if applicable Department/Ward Managers Adjust staffing rotas to ensure that staff who may experience difficulties in travelling to and from work, during a period of severe weather, are not rostered to work during that period where practical Agree an On Call rota with the members of staff who may be required to cover staff shortfalls at short notice, taking into account the need to achieve a satisfactory and safe skill mix ISSUE 6 OCTOBER

16 Ensure patient bedrooms are kept warm. Minimum recommended daytime temperature for rooms occupied during the day is 21 C (70 F); minimum recommended night-time temperature for bedrooms is 18 C (65 F). Consider implementing Business Continuity Plans Hotel Services/Catering Review Business Continuity Pans Place orders for predetermined stocks of food Increase stocks of linen Community Staff Activate business continuity arrangements and emergency plans as required Activate plans to deal with surge in demand for sevices Review patient/client lists which require community nursing visits or urgent hospital treatment to identify patients who may be in the affected areas Ensure vulnerable patient client lists are available to On Call Managers in the areas affected by the severe weather Arrange daily contact/visits for the vulnerable ensuring appropriate home checks are undertaken Ensure that carers are receiving appropriate advice and support Continue to remind patients/clients of the actions they can take to protect themselves from the effects of severe cold Consider how to make best use of available capacity eg by using community beds for at risk patients who do not need an acute bed and enabling access to step down care When making home visits, be aware of the room temperature in the household and be able to advise on recommended room temperatures. Minimum recommended daytime temperature for rooms occupied during the day is 21 C (70 F); minimum recommended night-time temperature for bedrooms is 18 C (65 F) When making home visits, check medications and food supplies Know how to signpost clients onto other services Remind clients of the actions they can take to protect themselves from the effects of cold weather Head of Emergency Preparedness Resilience & Response (EPRR) Obtain accurate weather forecasts relaying those to relevant groups of staff and the Executive Director On Call Ensure up to date information is available on the Trust Intranet Ensure Cold Weather Alerts are ed to Executive Leadership Council for onward distribution Attend multi-agency meetings as required and feedback to Command Teams LEVEL 3 SEVERE WEATHER ACTION This is triggered as soon as the weather described at level 2 actually happens. It indicates that severe winter weather is now happening and an impact on health services is expected. Mean temperature of 2 C or less and/or widespread ice and heavy snow. Health and Social care services and professionals should activate plans to deal with a surge in demand for services and mobilise community/voluntary services. There should be daily contact either in person or via a telephone whilst the weather lasts. There should be on-going media messages. ISSUE 6 OCTOBER

17 Individuals and communities should take actions to minimise the harmful effects of the weather and by checking on people who are known to be at risk. On Call Managers Instigate the Command and Control Structure (ref Major Incident Plan) if not already activated Receive information on issues relation to the weather which are impacting on the delivery of Trust services Agree redeployment of staff to maintain essential services Ensure staff are receiving alerts Ensure locally agreed actions are taking place, especially those to protect vulnerable patients and clients Department/Ward Managers Maintain Business Continuity Ensure mobile telephones are charged in areas where usage is permitted Instruct all staff to bring with them an extra set of clothing and sleeping bag Implement staffing plans to ensure adequate and safe staffing levels Liaise with the General Manager/Service Team Leaders in relation to any staffing inadequacies In-Patient Units Maintain Business Continuity Plans Ensure that rooms, particularly living rooms and bedrooms, are kept warm Minimum recommended daytime temperature for rooms occupied during the day 21ºC (70ºF) Minimum recommended night-time temperature for bedrooms 18ºC (65ºF). No health risk but may feel cold NB This temperature may be too low for some in-patient areas, particularly those where patients with COPD or eating disorders, for example, may be being cared for Ensure that patients and residents wear warm clothing that is appropriate to the temperature and weather conditions, indoors and outdoors Identify particularly high risk individuals Ensure that patients and residents take warm drinks and food regularly Ensure that staffing levels will be sufficient to cover the anticipated period of extreme weather Repeat messages on risk and protective measures to staff Community Staff Maintain Business Continuity Plans Consider daily visits/telephone calls to high risk individuals living on their own who have no regular daily contacts Ensure carers are receiving appropriate advice and support Ensure all community staff are aware of cold weather health risks and are able to advise patients on how to protect against them Implement plans to deal with surge demand Advise carers to contact the patient s GP is there are concerns about an individual s health Other actions as per Level 2 ISSUE 6 OCTOBER

18 Head of EPRR/Head of Communication Liaise with multi-agency partners Produce bulletins to inform the wider public of the situation together with information about reduced services etc on Trust Intranet and Trust website Keep staff updated via regular s and alerts as issued Hotel Services/Catering Maintain Business Continuity Plans Distribute extra linen supplies to appropriate areas Where possible, extend the opening times of staff restaurants to provide catering services for stranded staff and visitors LEVEL 4 MAJOR INCIDENT EMERGENCY RESPONSE This level is reached when cold weather is so severe and/or prolonged that its effects extend outside health and social care, and may include for example power or transport problems, or water shortages, and/or where the integrity of health and social care systems is threatened. At this level, multi-sector response at national and regional levels will be required. The decision to go to Level 4 is made at national level and will be taken in light of a cross-government assessment of the weather conditions, co-ordinated by the Civil Contingencies Secretariat (Cabinet Office). On-going actions for the health sector include: Continuing to maintain Level 3 actions during the emergency unless advised to the contrary Continue to implement Business Continuity arrangements Ensure local healthcare can continue to operate by clearing snow etc Risk appraisals on the wider population as new at risk individuals are identified The Cold Weather Plan for England and associated documents can be accessed at: _final.pdf ISSUE 6 OCTOBER

19 Introduction ATTENDANCE FOR DUTY DURING SEVERE WEATHER CONDITIONS Severe Weather 2.02 APPENDIX 2 Inclement weather, of the severity which effects normal working, is a very rare occurrence. It therefore merits special arrangements that differ to the normal requirements for staff to be at work. For the purpose of this policy, severe weather is that which presents hazardous road conditions or an environment in which it is potentially unsafe to travel to or from work. This policy is formulated in the context that Trust employed staff often work flexibly for the benefit of patient care and/or the organisation. The concept of reciprocal good will is, therefore, the basis of this policy. Fundamental Principals There is a weekly predicted weather forecast circulated to the Trust by the Meteorological Office, which provides details of the likelihood and nature of any anticipated severe weather Incident. Where this is the case, Line Managers should take reasonable steps to make plans in advance. These could include: Reviewing off duty so that rotas are not reliant on those living further away or who will need to attend to domestic responsibilities Ensuring there is sufficient staff to cover unplanned absences Postponing attendance at events outside of the working base The decisions to be made in event of severe weather will be a balance between: Ensuring patient care is not compromised Ensuring the safety of staff at work is not compromised The decision regarding whether it is safe to travel to or from one s normal place of work can only be made at the time, taking into account the particular circumstances which apply and having due regard to the prevailing traffic and weather conditions including any Police and Meteorological Office advice. The policy therefore requires staff and managers to exercise responsible decision making, bearing in mind the needs of the people we serve and the expectations of the Trust in such situations. Expectations of Staff a) All members of staff are expected to make every effort to attend work. This includes using alternative transport or walking if they live within a reasonable distance of their work location. Staff who are unable to attend work at the start of their normal working day should endeavour to come to work later in the day should conditions improve. Where staff do travel to work and arrive late, there will not be the need to make up lost time b) Any member of staff who believes that it would not be possible to reach work due to adverse weather conditions, should contact their line manager or other manager at the earliest opportunity and as close as possible to the beginning of their shift/day s work. c) Where staff are unable to attend work due to adverse weather conditions, the following options should be considered: ISSUE 6 OCTOBER

20 i. Approve working from home, if this is appropriate given the nature of the work. Where this is the case, this must be agreed, together with the nature of the work to be undertaken, by the Line Manager. ii. Request the member of staff attend another site other than their usual base site which is more accessible (although this may not be practical for offender health colleagues due to the necessity for security clearance. However, it may be that they are able to attend for duties at a Trust site where strict security clearance will not be required. iii. Approve the taking of: Annual Leave Previously accumulated time in lieu Flexi-time Allow staff to make the time up on a later occasion Unpaid leave d) Members of staff will work together wherever possible to ensure that patients who are prioritised as needing a service receive appropriate care. It is expected that people will exercise their judgement and, without endangering themselves in any way, will offer to assist in the nearest NHS Centre if this is appropriate e) The Trust recognises, however, that some staff may not wish to demonstrate the above and will need to take annual leave/lieu time/unpaid leave/ or asked to make up the lost time once normal working resumes (See Ciii above) f) Where it is a domestic emergency and/or dependent care arrangements breakdown as a result of the weather conditions it may be appropriate to take leave under the Trust Policy Special Leave and Career Break Approval for such leave should be sought from managers in the normal way. g) Managers of members of staff who are at work when travelling conditions become hazardous will be expected to exercise responsible decision making in relation to enabling staff to leave work early. For example, if it is clear from weather reports that hazardous conditions will have diminished by the end of the shift/working day, it may not be appropriate to leave early, or where this is not the case, staff with the longest journeys should be allowed to leave first. h) Where staff are stranded on site or volunteer to remain on site to cover absences, every effort will be made to provide sleep and/or rest accommodation and food where appropriate. When making such decisions, Managers will take account of patient need. Such staff working beyond their contracted hours will be entitled to the appropriate level of pay in accordance with their terms and conditions of service i) Where travelling conditions are hazardous, the Executive Director On Call will decide when it is appropriate for staff to leave early and communicate this to Line Managers. Once the Executive Director On Call has consented to staff leaving early, those members of staff wishing to leave work early should gain final agreement from their Line Manager. When a Line Manager is not present or involved in the emergency, the most senior person for that Directorate/Department should make the necessary decisions. Any decisions will take account of maintenance of services, in particular the safety of patients, visitors and staff. Once an agreement has been reached, staff who leave early or arrive late because of the weather will be considered to have worked their full hours j) Decisions taken regarding staff leaving early will take into account the personal circumstances of each member of staff. This may result in for example staff living further away or in areas where intelligence is indicated worsening conditions, being allowed to leave earlier than others ISSUE 6 OCTOBER

21 k) Members of staff will ensure that their arrangements during extended periods of severe weather are communicated to their Line Manager Severe Staff Shortages In the event of severe staff shortages, it may be necessary to make a public announcement for any Healthcare Professionals to contact the Trust to see if they have skills that are needed to maintain essential services. Where individuals not employed by the Trust are asked to attend, arrangements will be made to pay them at the rate of the role they undertake whilst working for the Trust. If an individual works for another Trust in the East Midlands and is asked to attend the Trust at a time they would usually be working for their employer, they will only be paid once for the hours they work at the Trust Such arrangements should be entered into with care, and checks undertaken in liaison with their current employer to confirm identity, right to work in the UK, DBS status, qualifications etc appropriate to the role. Further advice can be obtained from Human Resource Teams. A legal opinion must be sought via the Trust Company Secretary regarding vicarious liability for these individuals whilst they are undertaking work for the Trust. This action would only be considered as a last resort. ISSUE 6 OCTOBER

22 APPENDIX 3 FREQUENTLY ASKED QUESTIONS SEVERE WEATHER The questions below have been asked by members of staff during periods of bad weather. Q1 A1 Q2 A2 Q3 A3 Q4 A4 Q5 A5 My car broke down on the way to work and I was not able to make it in, do I need to take annual leave? Please talk to your line manager about how you can make the time up that is convenient to you and will support the service. Alternatively you will need to book a days leave My manager sent me home due to the weather conditions, do I need to take annual leave, take it as unpaid or take flexi time? If your manager sent you home, then you do not need to make the time up or take annual leave, however if you asked to go home, you will need to agree how to make the time up with either flex working, annual leave etc I cannot afford to take unpaid leave and have no holiday left to cover the time off I required because of not being able to make it in to work due to the weather conditions. Please talk to your line manager about how you can make the time up that is convenient to you and will support the service My child has been sent home from school and I don t have anyone else to look after them Please talk to your line manager about how you can make the time up that is convenient to you and will support the service My public transport is not running as normal and I cannot get in to work or will be delayed Please talk to your line manager about how you can make the time up that is convenient to you and will support the service ISSUE 6 OCTOBER