Severe Weather Plan V5.5 March 2018

Similar documents
Clinical Guideline for Post-Operative Nausea and Vomiting 1. Aim/Purpose of this Guideline

Diagnostic Testing Procedures in Urodynamics V3.0

Loading Dose Worksheet for Oral Amiodarone

CLINICAL GUIDELINE FOR REFERRAL TO PAIN SERVICE 1. Aim/Purpose of this Guideline

Diagnostic Test Reporting & Acknowledgement Procedures. - Pathology & Clinical Imaging

CLINICAL GUIDELINE FOR THE MANAGEMENT OF SEPSIS IN ADULT PATIENTS 1. Aim/Purpose of this Guideline

CLINICAL GUIDELINE FOR USE OF BED AND CHAIR SENSOR ALARM MATS FOR PREVENTING FALLS IN ADULT PATIENTS

Policy for the authorising of blood components by the Haematology Clinical Nurse Specialist V1.0

CLINICAL GUIDELINE FOR THE ASSESSMENT AND DOCUMENTATION OF PAIN (ADULTS)

A list of authorised referrers will be retained by the Colposcopy team and the Clinical Imaging Department.

Policy on Governance Arrangements Relating to Medicines V2.0

CLINICAL GUIDELINE FOR THE USE OF INTRAVENOUS SLIDING SCALE REGIMEN FOR ADULTS 1. Aim/Purpose of this Guideline

CLINICAL GUIDELINE FOR CLINICAL IMAGING REFERRAL PROTOCOL FOR NURSE SPECIALISTS IN HEART FUNCTION WITHIN RCHT Summary. Start

WARD CLOSURE POLICY V

1.3 Referrer: in the context of this protocol the term referrer refers to a health care worker who is authorised to refer individuals for X-rays.

The initial care and management of patients admitted to RCHT with a Ventricular Assist Device (VAD). V2.0

Clinical Guideline for Clinical Imaging Referral Protocol for Upper & Lower GI Non medical Endoscopist within RCHT. 1. Aim/Purpose of this Guideline

Newborn Hearing Screening Programme Policy

Safe Bathing Policy V1.3

2.1. Applicable areas: Royal Cornwall Hospitals Trust; Neonatal Unit and Delivery Suite

Diagnostic Testing Procedures in Neurophysiology V1.0

Clinical Guideline for Nurse-Led Indocyanine Green Angiography Summary.

School Vision Screening Policy V2.0

PARACETAMOL PATIENT GROUP DIRECTION CHILD HEALTH 1. Aim/Purpose of this Guideline

CLINICAL GUIDELINE FOR THE ADMISSION OF PATIENTS TO PAEDIATRIC HIGH DEPENDANCY UNIT V4.0

CLINICAL GUIDELINE FOR: Management of low-risk upper GI haemorrhage. Page 1 of 10. Management of low-risk upper GI haemorrhage

ESCALATION PLAN PAEDIATRICS AND NEONATAL UNIT 1. Aim/Purpose of this Guideline

CLINICAL IMAGING REFERRAL PROTOCOL FOR REGISTERED NURSE PRACTITIONERS IN THE EMERGENCY DEPARTMENT, URGENT CARE CENTRE AND AMBULATORY CARE

Tissue Viability Referral Pathway. April 2017

This guideline is for nursing staff within the Pain Services assisting with the administration of botulinum toxin.

2.1. It is essential that promoting and safeguarding the welfare of children and young people is integral to all NHS Trust policies and procedures.

Diagnostic Testing Procedures for Ophthalmic Science

CLINICAL GUIDELINE FOR IPRATROPIUM BROMIDE NEBULISER INHALER PATIENT GROUP DIRECTION CHILD HEALTH 1. Aim/Purpose of this Guideline

IBUPROFEN PATIENT GROUP DIRECTION CHILD HEALTH 1. Aim/Purpose of this Guideline

CLINICAL GUIDELINE FOR THE USE OF RECTUS SHEATH CATHETERS IN CHILDREN. 1. Aim/Purpose of this Guideline

Procedure for the Application of a Cast and its subsequent care V1.3

Safeguarding Children Supervision Policy V4.0. November 2016

Occupational Health Surveillance Policy V2.1

OXYGEN THERAPY AND SATURATION MONITORING OF THE NEONATE - CLINICAL GUIDELINE V3.0

Health and Safety Policy and Guidance for Staff Working During Night Time Hours V2.0

CLINICAL GUIDELINE FOR THE EMERGENCY DEFILL OF AN ADJUSTABLE GASTRIC BAND

Safe Staffing Levels for. Midwifery, Nursing and Support Staff. For Maternity Service - Approved. Document V1.5. June 2017

REPORT TO MERTON CLINICAL COMMISSIONING GROUP GOVERNING BODY

MANAGEMENT OF HEREDITARY SPHEROCYTOSIS IN THE NEONATAL PERIOD CLINICAL GUIDELINE 1. Aim/Purpose of this Guideline

Meeting of Governing Body

Patient Experience Strategy

PRESCRIBING, DISPENSING AND ADMINISTRATION OF CHEMOTHERAPY TO CHILDREN AND YOUNG PEOPLE - CLINICAL GUIDELINE V4.0

Central Alerting System (CAS) Policy

Business Continuity Plan

Inclement Weather Plan. Controlled Document Number: Version Number: 004. Controlled Document Sponsor: Controlled Document Lead: On: October 2017

NHS England (South) Surge Management Framework

The Newcastle upon Tyne Hospitals NHS Foundation Trust. Water Safety Policy

Business Continuity Management Framework

2.0 - EMERGENCY PLANNING POLICY NO: 2.02

Adverse Weather / Staff Attendance During Extreme Weather Conditions. Policy and Procedure

SUMMARY REPORT (11) TRUST BOARD 26 November 2015

UCL MAJOR INCIDENT TEAM MAJOR INCIDENT PLAN. Managing and Recovering from Major Incidents

Kingston CCG Emergency Preparedness, Resilience and Response (EPRR) Policy

Outbreak Control Policy

The Newcastle upon Tyne Hospitals NHS Foundation Trust. Key Control Operational Policy

Date ratified November Review Date November This Policy supersedes the following document which must now be destroyed:

The Newcastle upon Tyne Hospitals NHS Foundation Trust. Implementation Policy for NICE Guidelines

CEREBRAL FUNCTION MONITORING (aeeg). NEONATAL CLINICAL GUIDELINE 1. Aim/Purpose of this Guideline

Lone worker policy. Director of Nursing Therapies Patient Partnership Author and contact number Safety and Security Lead

The Newcastle upon Tyne Hospitals NHS Foundation Trust. Central Alert System (CAS) Policy and Procedure

The Newcastle upon Tyne Hospitals NHS Foundation Trust. Patient Choice Directive Policy & Guidance

The Newcastle upon Tyne Hospitals NHS Foundation Trust. Code of Practice for Wound Care Company Representatives and Staff with whom they interact

SEVERE WEATHER PLAN. Estates Group

41 EC Emergency Planning Toolkit Action Cards

Document Details Title

RCHT Non-Ionising Radiation Safety Policy

The Newcastle upon Tyne Hospitals NHS Foundation Trust. Patients Wills Policy

The Newcastle upon Tyne Hospitals NHS Foundation Trust. Ventilation Policy

Pan Dorset Procedure for the Management of the Closure of a Care Home Supporting people in Dorset to lead healthier lives

The Newcastle upon Tyne Hospitals NHS Foundation Trust. Strong Potassium Solutions Safe Handling and Storage

The Newcastle upon Tyne Hospitals NHS Foundation Trust. Protected Mealtime Policy

The Newcastle upon Tyne Hospitals NHS Foundation Trust. Procedure for Monitoring of Delayed Transfers of Care

Positive and Safe Management of Post incident Support and Debrief. Ron Weddle Deputy Director, Positive and Safe Care

Moving and Handling Policy

The Newcastle upon Tyne Hospitals NHS Foundation Trust. Access to Drugs Policy

Agenda item 8.5. Meeting date: Meeting / committee: Board of Directors. 24 th June Title: Emergency Preparedness Annual Report 2013/14.

The Newcastle Upon Tyne Hospitals NHS Foundation Trust. Use of Patients Own Drugs (PODs)

Helicopter Landing Site (HLS) Policy, Procedure and Guidance (HSP025) V2.0

Health and Safety Policy

Emergency Care Network Capacity Management and Escalation Plan Action Cards December 2009 December 2010

NHS HARINGEY CLINICAL COMMISSIONING GROUP EMERGENCY PREPAREDNESS, RESILIENCE AND RESPONSE (EPRR) POLICY

Version: 2. Date adopted: 17 May publication: Review date: September Expiry date: March 2019

Incident Management Plan

Document Number: 006. Version: 1. Date ratified: Name of originator/author: Heidi Saunders, Senior Portfolio Coordinator

BUSINESS CONTINUITY PLAN

CLINICAL GUIDELINE FOR TRANSFERS AND DISCHARGES IN THE LAST FEW WEEKS OF LIFE 1. Aim/Purpose of this Guideline

PHARMACEUTICAL REPRESENTATIVE POLICY NOVEMBER This policy supersedes all previous policies for Medical Representatives

Other (please specify): Note: This document has been assessed for any equality, diversity or human rights implications

Policy Register No: Status: Public NURSING STAFFING SHORTFALL ESCALATION POLICY. NICE Guidelines July 2014 CQC Fundamental Standards: 17

NON-MEDICAL PRESCRIBING POLICY

NHS Waltham Forest Clinical Commissioning Group. Emergency Preparedness, Resilience and Response (EPRR) Policy

Version: 3.0. Effective from: 29/08/2012

This procedural document supersedes the previous procedural documents for Policy for the Management of Patients/Clients Access to Services

Defining the Boundaries between NHS and Private Healthcare. MECCG Policy Reference: MECCG142

Other (please specify): Note: This policy has been assessed for any equality, diversity or human rights implications

Transcription:

V5.5 March 2018

Table of Contents 1. Introduction 3 2. Purpose of this Plan. 3 3. Scope. 3 4. Ownership and Responsibilities. 3 5. Escalation Levels and Actions 5 6. Staffing Contingency and Guidance. 10 7. Summary of Actions. 14 8. Dissemination and Implementation 17 9. Monitoring Compliance and Effectiveness... 17 10. Updating and Review... 17 11. Equality and Diversity.. 17 Appendix 1. Governance Information.. 19 Appendix 2. Initial Equality Impact Assessment Screening Form... 21-2 -

1. Introduction 1.1 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, the Royal Cornwall Hospitals NHS Trust (RCHT) has developed a plan which incorporates an escalation plan and staffing guidance. 1.2 This plan needs to be read in conjunction with other relevant Trust plans eg the Major Incident Plan, Business Continuity Plans and relevant Local Resilience Forum severe weather plans. 1.3 In addition, in the event of severe cold weather, this plan will work through a system of cold weather alerts linked to the existing winter weather warning system developed by the Met Office which will trigger appropriate actions up to a major incident. (See the Cold Weather Plan for England. Department of Health). 1.4 This version supersedes any previous versions of this document. 2. Purpose of this Plan 2.1 The purpose of the plan is to ensure that the trust has the ability to maintain services during severe weather. 3. Scope 3.1 This plan applies to all RCHT staff. 4. Ownership and Responsibilities 4.1 In each NHS organisation the Chief Executive is responsible for ensuring that there are plans in place for emergency planning and business continuity based on the principles of risk assessment, cooperation with partners, communicating with the public and, where necessary, to share information. 4.2 Role of the Chief Operating Officer The Chief Operating Officer is the nominated executive director and is responsible for ensuring that: A is in place Plans are written and published to ensure business continuity for any emergencies that may impact on Trust activity The plan is maintained, exercised and tested The Trust is compliant with all legislation relevant to emergency planning Trust staff are familiar with the plans for their particular work area and are familiar with other plans that support this one A report is submitted to the EPRR Committee following activation of the plan The Trust s activity with regards to emergency planning meets the requirements of the NHS EPRR Core Standards and Care Quality Commission Standards. - 3 -

If requested, ensure suitable representation at the Tactical Coordination Group to represent RCHT or the wider Cornwall health economy. 4.3 Role of Associate Directors and On Call Managers All areas of the Trust will have differing responsibilities in the event of severe weather conditions. On Call Managers will monitor severe weather alerts that they via email. The Associate Directors need to ensure that the following issues are considered: The unavailability of patient transport for discharge Patients unable to get to the hospital for appointments Visitors stranded at the hospital Site safety issues for patients, staff and visitors Staff unable to get to work and return home Communication difficulties Excess demand for catering Temporary supply shortages Disruption to utilities Traffic management problems The staff groups listed below will have particular responsibilities and their actions are highlighted in the various levels of preparation and escalation. Ward and department managers (All RCHT sites) Head of Patient Flow/Clinical Site Manager Patient Transport Associate Directors Estates and Facilities teams 4.4 Role of the Line Managers Line managers are responsible for ensuring: That plans are in place and that all staff are aware of their responsibilities That there are suitable Business Continuity Plans in place to mitigate the effects of severe weather 4.5 Role of the Emergency Preparedness, Resilience and Response (EPRR) Committee The EPRR Committee is responsible for: Ensuring that the plan is maintained Gaining assurance and evidence from the committee members that the plan is implemented in all divisions 4.6 Role of Individual Staff All staff members are responsible for ensuring: They understand the plan and follow the actions as directed. - 4 -

5. Escalation Levels and Actions 5.1 Preparedness Phase: This phase is activated when there is a warning of possible severe weather conditions within the next 4-5 days. This phase will enable wards and departments to prepare for disruption to staffing levels and provide an opportunity to review stocks and supplies of consumables. It will also allow essential services to ensure that plans are in place to minimise disruption. Level 1 Escalation: This level is activated when there is warning of severe weather conditions expected within the following 24 hours. Level 2 Escalation: This level is activated when severe weather conditions are affecting Cornwall. 5.2 Preparedness Phase Actions: This phase is activated when there is a warning of possible severe weather conditions within the next 4-5 days. Departmental Managers/Sisters/Charge Nurses/Divisional Nurses: Review staffing rotas and identify staff members who may experience difficulties in travelling to and from work. Identify members of staff who live within walking distance of their place of work. Plan for possible temporary shortages of consumables. Head of Patient Flow: Ensure that there will be Clinical Site Manager cover over the next 7 days. Review the Senior On-Call Manager rota to ensure cover for the next 7 days (inconjunction with the Chief Operating Officer). Liaise with the RCHT Transport Lead to ascertain the level of transport that will be available during a period of severe weather. Liaise with CPFT and Cornwall Council Adult Care to plan patient pathway strategies. Associate Directors: Put in place business continuity strategies to ensure that key services have been prioritised in the event of severe weather. - 5 -

Supplies: Ensure all critical supplies of blood products, pharmaceuticals and consumables will be maintained at a safe level for at least 7 days. Emergency Planning Lead: Advise Cornwall Council of the potential need to establish the Tactical Coordinating Group 4x4 cell and ascertain whether assistance can be given in the event of staff not being able to travel to and from work (in the absence of the Emergency Planning Lead this task will need to be delegated to another suitable manager). Estates: Implement relevant part of Estates Winter Plan as appropriate. Haematology Department: Check stocks of blood products to determine whether these will be adequate for the next 7 days. Investigate modes of transport available to deliver stocks during severe weather conditions. Pharmacy Department: Check stocks of pharmaceuticals to determine whether these will be adequate for the next 7 days. Investigate modes of transport available to deliver stocks during severe weather conditions. Kernowflex: Assess the availability of temporary staff during a period of severe weather. Communications Manager: Prepare communication message templates to be used for warning and informing patients, visitors and staff. - 6 -

5.3 Level 1 Escalation Actions This level is activated when there is warning of severe weather conditions expected within the following 24 hours. Departmental Managers/Sisters/Charge Nurses/Divisional Nurses: Adjust staffing rotas to ensure that business continuity is maintained. Agree an on-call rota with members of staff who may be required to cover staff shortfalls at short notice taking into account the need to achieve a safe skill mix. Head of Patient Flow/Clinical Site Manager: Ensure that there is Clinical Site Manager cover 24/7 and adjust rotas accordingly. Review the Senior Manager On-Call rota with a view that staff covering the next 72 hours will be available (inconjunction with the Chief Operating Officer). In conjunction with wards, departments and the discharge teams expedite discharge of patients from hospital in order to free up potential capacity. Consider whether additional facilities will be required if the patient pathway is affected by severe weather. Associate Directors: Convene a meeting to discuss priorities for the delivery of essential services. Activate business continuity plans if it is likely that critical services will be affected. Ensure that essential supplies are adequate for all services within each division. Appoint a SMH/WCH Lead to liaise with the Incident Coordination Centre Team at the Royal Cornwall Hospital. Estates Teams: Liaise with Cornwall Council with regard to the highway management of minor roads. Ensure that site areas to be gritted in icy conditions are mapped. Identify overnight accommodation for staff via Knowledge Spa team (see section 6.4). Emergency Planning Lead: Ensure that staff transport needs have been assessed and a process is in place for managing this in conjunction with other health providers and Cornwall Council (via 4x4 cell of the Tactical - 7 -

Mitie: Coordinating Group). In the absence of the Emergency Planning Lead this task will need to be delegated to another suitable manager. Check and order additional food supplies if appropriate. Check and order other supplies if appropriate. Activate business continuity plans if critical services will be affected. Supplies Department: Obtain extra supplies of consumables if required. Haematology Department: Order extra supplies of blood products if considered necessary. Pharmacy: Order extra supplies of drugs if considered necessary. Kernowflex: Ensure that information on staffing availability is in place. Contact staff to ascertain if they are willing to work additional shifts. Communications Manager: Implement the RCHT Communications Strategy to ensure that staff, patients and visitors are kept informed of the situation. 5.4 Level 2 Escalation Actions This level is activated when severe weather conditions are currently affecting parts of Cornwall. The setting up of an Incident Coordination Centre (ICC) will enable central coordination of the severe weather event and provide communication links. (The major incident control room provides facilities for the management of a major incident as per the RCHT Major Incident Plan). This type of incident could be managed from other venues to cover: Communications Patient flow Staff issues Site issues - 8 -

Role of the Incident Control Team: Establish links as required, with Cornwall Council Emergency Management Team, CPFT, KCCG, SWAST and participate in conference calls as required. Monitor the weather via the Met Office noting any effects that the severe weather may be having on the wider community. Establish a communications strategy which allows for the provision of information to staff, patients and visitors. Send member of staff to Tactical Coordination Centre (New County Hall, Truro) if requested by NHS England to represent either RCHT or the wider Cornwall health economy. Liaise with CPFT and KCCG with regard to patient flow issues. Coordinate any response that may be required to support or accommodate any outpatient or discharged patients transfer. Coordinate any response that may be required to support or accommodate any staff members who are unable to attend work or leave work. Monitor and ensure adequate, safe staffing levels within all clinical and non clinical areas, liaising with ward managers and department heads and redeploy staff to critical areas. Take measures to ensure that the safety of staff, patients and visitors is maintained throughout the incident by providing safe routes in and around the hospital sites. Coordinate the reduction in non-essential services. Identify critical staff that may require assistance with transport to RCHT sites and link with multi agency partners at Tactical Coordination Centre, if opened, to assist. The coordination of transport bookings that will require assistance from the 4x4 tactical cell may be passed to the patient transport team for them to manage. Monitor the situation and manage any response to a developing situation. Departmental Managers/Sisters/Charge Nurses/Divisional Nurses: Implement staffing plans to ensure adequate and safe staffing levels. Liaise with the Incident Control Team with regard to any inadequacies. Undertake vetting of any transport (4x4) or accommodation requests from their staff. Utilise Care Buddies as required. Coordinate staff able to accommodate fellow staff overnight within their homes. Clinical Site Manager: Manage the actual and potential bed state relaying information regularly to the Incident Control Team. - 9 -

Liaise with patient transport to co-ordinate patient discharge as the weather situation allows. Associate Directors: Implement strategies to reduce non-essential services if required should be authorised by the Chief Operating Officer. Monitor activity and give regular updates to the Incident Control Team. Review business continuity contingencies for elective and non elective activity. Estates: Liaise with Cornwall Council with regard to local highway management. Liaise with utility companies if problems are anticipated and report any potential issues to the Incident Control Team. Monitor the external walkways and publish a site map of areas that have been gritted for use by staff and patients. Ascertain the status of the local Park and Ride facilities. Make overnight accommodation available for staff via the Knowledge Spa team (see section 6.4). Ensure trees are surveyed for damage. Supplies Department: Distribute extra supplies to wards and departments as appropriate. Haematology: Activate blood shortage plan if required. Pharmacy: Activate plans to manage medication for patients, staff or visitors if required. Kernowflex: Provide regular situation reports to the Incident Control Team and Safe Care meetings. Communications Manager: Produce bulletins and press releases to inform the wider public of the situation together with information about reduced services. Mitie: Activate plans for emergency food distribution if required. - 10 -

6. Staffing Contingency Guidance Attendance for duty during severe weather conditions: 6.1 Introduction Inclement weather which affects normal working merits special arrangements to ensure that essential services can be maintained in the event of staff having difficulty getting to and from their place of work. For the purpose of this plan, severe weather is that which presents hazardous road conditions or an environment that is potentially unsafe to travel to or from work. This guidance is formulated in the context that staff often work flexibly for the benefit of patient care and/or the organisation. The concept of reciprocal goodwill is therefore the basis of this guidance. 6.2 Fundamental Principles There are regular predictive weather forecasts from the Met Office which provide details of anticipated severe weather events. Where this is the case, line manages should take reasonable steps to make plans. These should include: Reviewing off duty so that rotas are not reliant on those living furthest away or those who will need to attend to domestic responsibilities. Ensuring that there are sufficient staff to cover unplanned absences. Postponing attendance at events outside the working base. The decisions to be made in the event of severe weather will be a balance between: Ensuring patient care and essential services are not compromised. Ensuring that the safety of staff is not compromised. The decision with regard to whether it is safe to travel to and 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 Met Office advice. This guidance therefore requires managers and staff to exercise responsible decision making bearing in mind the needs of patients and the expectations of the Trust in such situations. 6.3 Expectations of Staff Members of staff will report for duty unless they are prevented from doing so by the prevailing weather conditions. Where staff do arrive late, there will not be a need to make up for lost time. - 11 -

It is expected that staff will exercise their judgement on whether it is impossible for them to attend their normal workplace. The Trust recognises, however, that some staff may not wish/be able to demonstrate the above and will need to take annual leave/lieu time/unpaid leave or be asked to make up the lost time once normal working resumes. Where it is a domestic emergency and/or dependant care arrangements break down as a result of the weather conditions, it may be appropriate to take leave under the Trust policy on Special Leave for Domestic, Personal or Family Reasons. Members of staff who are at work when travelling conditions become hazardous will be expected to exercise decision making in relation to finishing early. For example, if it is clear from weather reports that hazardous conditions will have diminished by the end of a shift/working day, it may not be appropriate to leave early. Where staff are stranded on site, or volunteer to remain on site to cover absences, every effort will be made to provide accommodation (see section 6.4) and food. 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. Where travelling conditions are hazardous, Associate Directors will decide when it is appropriate for staff as a whole to leave early and will communicate this to line managers. Once the Associate Director has consented to staff leaving early, those members of staff wishing to leave work early should gain final agreement from their line manager. Where the line manager is not present or involved in managing the emergency, the most senior person for that group/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 agreement has been reached, staff that leave early or arrive late because of the weather will be considered to have worked their full hours. 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 has indicated worsening conditions, being allowed to leave earlier than others. Members of staff will ensure that their arrangements during extended periods of severe weather are communicated to their line manager. - 12 -

Individuals who work for other NHS providers in Cornwall may be requested to work at RCHT if they are unable to access their normal place of work and vice versa. Members of staff who are still able to get to and from work from an affected area by virtue of their mode of transport (e.g. off road/4x4 vehicle) will be asked to assist other staff members in getting to and from work from that area. They will receive suitable remuneration (mileage expenses) for giving assistance. 6.4 Emergency Accommodation Procedure RCH - Normal working hours, Monday-Friday, contact Knowledge Spa Manager (ext 5133) or Planning & Projects Manager (ext 2954) or Head of Estate Development (ext 2393 or mobile: 07342 088706). If they are unavailable on these numbers try the Knowledge Spa Reception (ext 6400). They can arrange for the use of any vacant rooms in Pendeen and Penlee House. RCH Out of hours, Clinical Site Co-ordinators or Senior Manager On Call should contact Kestrel Security (mobile: 07825 826787 or KSpa Emergency Line 01872 260863) and provide names of staff authorised to use any vacant rooms in Pendeen or Penlee House. Once authorisation has been received, staff will need to present to Knowledge Spa main reception with their RCHT ID Badge. They will be asked to complete a registration form and will then be issued with keys for their accommodation. After use keys should be returned promptly to the Knowledge Spa. WCH Keys for any spare staff accommodation above outpatients can be accessed from switchboard 24/7. Any site - If this does not provide enough accommodation then contact Clarity Travel on tel: 0333 010 0023 with your request. They will make enquiries and come back to you with what they have available. They will then require a signed-off request form (available in the RCH Incident Coordination Centre). The completed request form should be scanned and emailed to: nhs@claritytm.co.uk A budget code is required to book accommodation and the Major Incident planning budget code can be used for this purpose: 40260. If hotel accommodation doesn t meet the outstanding need then in extremis staff can sleep in the K Spa Clinical Skills Lab (4 beds) with the permission of the University, utilise Paeds Parents Accommodation (if free) or may need to sleep in clinical areas that will be closed to patients at night (Newlyn/Imaging Recovery Bay Tower Level 1/Theatres/Outpatients/Discharge Lounge). - 13 -

7. Summary of Actions SERVICE PREPAREDNESS PHASE (4-5 days notice of severe weather) LEVEL 1 ESCALATION (24 hours notice of severe weather) LEVEL 2 ESCALATION (Severe weather affecting the region) Ward/ Departmental Managers ALL SITES Review staffing rotas and identify staff members who may experience difficulties travelling to and from their place of work. Identify members of staff who live within walking distance of their place of work. Plan for possible temporary shortages of consumables. Adjust staffing rotas to ensure that business continuity is maintained. 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 safe skill mix. Implement staffing plans to ensure adequate and safe staffing levels. Liaise with the Incident Control Team in relation to any inadequacies. Vet any requests from their staff for 4x4 transport or accommodation. Utilise Care Buddies as required. Coordinate staff able to accommodate fellow staff overnight within their homes. Clinical Site Manager /Head of Patient Flow Ensure Clinical Site Manager cover over the next 7 days. Review the Senior Manager On-Call rota to assess whether those covering the following 7 days will be available (inconjunction with the Chief Operating Officer). Liaise with the Trust transport lead to ascertain the level of transport that will be available during a period of severe weather. Liaise with CPFT and Cornwall Council Adult Care and Support to plan patient pathway strategies. Ensure that there is 24/7 cover for the Clinical Site Manager and adjust rotas accordingly. Review the Senior Manager On-Call rota with a view to ensuring that the staff covering the forthcoming 72 hours will be available (inconjunction with the Chief Operating Officer). In conjunction with wards and departments and the discharge teams, expedite discharge from hospital in order to free up potential capacity. Consider whether additional facilities will be required if the patient pathway is affected by severe weather. Manage the actual and potential bed state and relay this information regularly to the Incident Control Team -14-

SERVICE PREPAREDNESS PHASE (4-5 days notice of severe weather) LEVEL 1 ESCALATION (24 hours notice of severe weather) LEVEL 2 ESCALATION (Severe weather affecting the region) Associate Directors Estates (NB: Estates have a separate Cold Weather Plan detailing their actions) Supplies/ Equipment: Put in place business continuity strategies to ensure that key services have been prioritised in the event of severe weather. Ensure that all critical supplies of blood, pharmaceuticals and consumables will be maintained at a safe level for at least 7 days Check and locate essential supplies of grit salt and sandbags if relevant. Check that all utilities provided on site are not at risk of breakdown in the event of severe weather (cold, flooding ) Review Q Park staffing rotas (in conjunction with Travel Planning). Ensure CFPU have checked their business continuity arrangements for delivery to the RCHT sites. Identify consumables that would be in greater demand. Assess the potential of obtaining extra supplies. Convene a meeting to discuss the delivery of essential services. Activate business continuity plans if it is likely that critical services will be affected. Ensure that essential supplies are adequate for all services within the division. Designate a WCH/SMH Lead to liaise with the Incident Coordination Centre if Level 2 reached. Liaise with Cornwall Council with regard to highway management of minor roads Ensure site areas to be gritted in icy conditions are mapped. Identify and book overnight accommodation for staff (see section 6.4). Order extra supplies of consumables if required. Implement strategy to reduce nonessential services if necessary. Monitor activity and keep the Incident Coordination Centre informed. Review business continuity contingencies for elective and non elective activity. If travelling conditions are hazardous then decide if it is appropriate for staff to leave early. Liaise with Cornwall Council with regard to local highway management. Liaise with utility companies if problems are anticipated and report any potential issues to the incident coordination centre team. Monitor the external walkways and publish a site map of areas that have been gritted for use by staff and patients. Survey trees. Ascertain the status of the local park and ride facilities. Make overnight accommodation available for staff (see section 6.4). Distribute extra supplies to wards and departments as appropriate. - 15 -

SERVICE PREPAREDNESS PHASE (4-5 days notice of severe weather) Haematology: Check stocks of blood products and determine whether these will be adequate to cover the Trust s needs for the following 7 days. Investigate modes of transport available to deliver stocks of blood during severe weather conditions. Pharmacy: Check pharmacy stocks to determine whether these will be adequate for the next 7 days. Investigate modes of transport available to deliver stocks of drugs during severe weather conditions. Kernowflex: Assess the availability of temporary staff during a period of severe weather. Communications Manager: Prepare communication message templates to be used for warning and informing staff, patients and visitors. Mitie Check supplies of food and assess if sufficient to meet an increased demand. LEVEL 1 ESCALATION (24 hours notice of severe weather) Order extra supplies of blood products if considered necessary. Order extra supplies of drugs if considered necessary. Ensure that information on staffing availability is in place. Contact staff to ascertain if they are willing to work additional shifts. Implement the Trust s Communications Strategy. Check and order additional food supplies if appropriate. Check and order other supplies if appropriate. Activate business continuity plans if critical services will be affected. LEVEL 2 ESCALATION (Severe weather affecting the region) Activate blood shortage plan if required. Activate plans to manage medication for patients, staff or visitors if required. Provide regular situation reports to the incident coordination centre team with regards to staffing issues. Produce bulletins to inform the wider public of the situation, together with information about reduced services etc. Activate plans for emergency food distribution if required. - 16 -

8. Dissemination and Implementation 8.1 The plan will be disseminated via the Emergency Preparedness, Resilience and Response (EPRR) Committee and once approved will be published in the documents library. 9. Monitoring Compliance and Effectiveness Element to be monitored Lead Tool Frequency Reporting arrangements Acting on recommendations and Lead(s) Change in practice and lessons to be shared The whole plan requires monitoring following an incident or following an exercise. Emergency Planning Lead The plan will be monitored by observing during an incident or exercise. Following a live incident there will be a debrief session involving key staff from the incident this is to establish what went well and what did not go so well, this enables the plan to be revised. The plan is reviewed every 3 years and earlier if utilised. The EPRR Committee meets quarterly. The Emergency Planning Lead then completes a quarterly report for the Quality Assurance Committee. An annual report is submitted to the Trust Board. The department or lead will undertake subsequent recommendations and action planning for any or all deficiencies and recommendations within reasonable timeframes. This will be led by the Emergency Planning Lead. Clear action plans will be required. Actions will be identified and completed in a specified timeframe. The action plan will be monitored by the EPRR Committee. System/practice changes will be identified through debriefing of stakeholders, both internal and external, following a live incident or exercising. Staff will be trained in significant changes through table top exercises and training. 10. Updating and Review 10.1 This plan will be reviewed every 3 years unless the plan is activated or there is new guidance from the Department of Health/NHS England. 11. Equality and Diversity 11.1 This document complies with the Royal Cornwall Hospitals NHS Trust service Equality and Diversity statement which can be found in the Equality, Diversity & Human Rights Policy or the Equality and Diversity website. 11.2 Equality Impact Assessment An Initial Equality Impact Assessment Screening Form is at Appendix 2.

Appendix 1. Governance Information Document Title V5.5 Date Issued/Approved: 27 March 2018 Date Valid From: 27 March 2018 Date Valid To: 26 March 2021 Directorate / Department responsible (author/owner): Matthew Overton, Emergency Planning Lead Contact details: 01872 256356 Brief summary of contents Describes actions based on three levels of escalation to be activated in a severe weather event. Includes a staffing contingency plan. Suggested Keywords: Target Audience Executive Director responsible for Policy: Severe weather, flooding, business continuity, ice, snow, flooding, major incident RCHT PCT CFT Chief Operating Officer Date revised: 27 March 2018 This document replaces (exact title of previous version): Approval route (names of committees)/consultation: V5.4 Emergency Preparedness, Resilience and Response Committee Divisional Manager confirming approval processes Name and Post Title of additional signatories Signature of Executive Director giving approval Publication Location (refer to Policy on Policies Approvals and Ratification): Document Library Folder/Sub Folder Susan Bracefield, Deputy Chief Operating Officer Not Required {Original Copy Signed} Internet & Intranet Intranet Only Chief Operating Office/Emergency Planning - 18 -

Links to key external standards Related Documents: Training Need Identified? Emergency Preparedness: Guidance on Part 1 of the Civil Contingencies Act (2004). HM Government. NHS England - EPRR Core Standards (2017). RCHT Major Incident Plan LRF Multi Agency Flood Plan Business Continuity Strategic Plan and Local Plans Cold Weather Plan for England. 2016. Department of Health. None Version Control Table Date Version No Summary of Changes Changes Made by (Name and Job Title) Aug 2010 V3.0 Revised Sue Corcoran, Resilience and Fire Safety Lead 25 Jan 12 V3.1 Governance information amended to align with format of Document Manager Upload Form Andrew Rogers, Corporate Records Manager Oct 2012 V4.0 Revised to take into account the Department of Health: Cold Weather Plan for England (2011). Nov 2015 V5.0 Revised with emergency accommodation protocol and 4x4 cell information. Beverley Hales, Clinical Site Manager and Emergency Planning Lead Matthew Overton, Emergency Planning Lead May 2016 V5.1 Revision to 4x4 cell activation. Matthew Overton, Emergency Planning Lead Jan 2017 V5.2 Contact numbers in para 6.4 updated. Jacqui Hughes, Admin Manager, Emergency Planning June 2017 V5.3 Para 6.4 updated. Jacqui Hughes, Admin Manager, Emergency Planning July 2017 V5.4 Corrected contact number and made minor amendments to 7. Summary of Actions. March 2018 V5.5 Amended following activation of the plan for snow in March 2018. Matthew Overton, Emergency Planning Lead Matthew Overton, Emergency Planning Lead All or part of this document can be released under the Freedom of Information Act 2000 This document is to be retained for 10 years from the date of expiry. This document is only valid on the day of printing Controlled Document This document has been created following the Royal Cornwall Hospitals NHS Trust Policy on Document Production. It should not be altered in any way without the express permission of the author or their Line Manager. - 19 -

Appendix 2.Initial Equality Impact Assessment Screening Form Name of service, strategy, policy or project (hereafter referred to as policy) to be assessed: Directorate and service area: Is this a new or existing Procedure? Emergency Planning Existing Name of individual completing Telephone: assessment: Matthew Overton 07818 581950 1. Policy Aim To ensure that the Trust is prepared for a severe weather event which may affect business continuity 2. Policy Objectives To provide an escalation plan To provide guidance for staff 3. Policy intended To provide all essential services in the event of a severe Outcomes* weather incident 4. How will you measure Activation or testing of the plan the outcome? 5. Who is intended to Staff, patients, visitors benefit from the Policy? 6a. Is consultation required with the workforce, equality groups, local interest groups etc. around this policy? b. If yes, have these groups been consulted? c. Please list any groups who have been consulted about this procedure. Yes staff side representative on EPRR Committee 7. The Impact Please complete the following table. Are there concerns that the policy could have differential impact on: Equality Strands: Yes No Rationale for Assessment / Existing Evidence Age Sex (male, female, transgender / gender reassignment) Race / Ethnic communities /groups Disability - Learning disability, physical disability, sensory impairment and mental health problems - 20 -

Religion / other beliefs Marriage and civil partnership Pregnancy and maternity Sexual Orientation, Bisexual, Gay, heterosexual, Lesbian You will need to continue to a full Equality Impact Assessment if the following have been highlighted: You have ticked Yes in any column above and No consultation or evidence of there being consultation- this excludes any policies which have been identified as not requiring consultation. or Major service redesign or development 8. Please indicate if a full equality analysis is recommended. Yes No 9. If you are not recommending a Full Impact assessment please explain why. No indication for full assessment. Signature of policy developer / lead manager / director Matthew Overton Names and signatures of members carrying out the Screening Assessment 1. 2. Date of completion and submission 27 March 2018 Keep one copy and send a copy to the Human Rights, Equality and Inclusion Lead, c/o Royal Cornwall Hospitals NHS Trust, Human Resources Department, Knowledge Spa, Truro, Cornwall, TR1 3HD A summary of the results will be published on the Trust s web site. Signed Date - 21 -