TAUNTON & SOMERSET NHS FOUNDATON TRUST Emergency Preparedness, Resilience and Response Annual Report 2015 Report to: Trust Board on 27 January 2016 Purpose of the Report: (Please type in Bold) To provide an update to the Trust Board on the progress of the Emergency Preparedness, Resilience and Response responsibilities and actions Sponsor: Author: Contact Details: Financial/Resource mplications: Risk mplications Link to Assurance Framework or Corporate Risk Register: Legal mplications: Link to CQC Essential Standards Peter Lewis, Deputy Chief Executive Nick Booth, Emergency Planning Officer Ext 4846 No ndicative Timings (Mins) Freedom of nformation Status: Previous Considerations: Action Required: (Please type in Bold) Tick if one of the following apply: Data protection staff or patient detail Commercially sensitive Stakeholder management Early stage of discussion Potentially prejudicial to staff morale or partnership working To note the progress made TSTA/01.16 Page 1 of 7
TAUNTON AND SOMERSET NHS FOUNDATON TRUST MUSGROVE PARK HOSPTAL Board of Directors Public Board Meeting BACKGROUND The Civil Contingencies Act (CCA) 2004 outlines a single framework for civil protection in the United Kingdom. Part 1 of the Act establishes a clear set of roles and responsibilities for those involved in emergency preparedness and response at the local level. The Trust as a Category 1 responder is subject to the following civil protection duties: Assess the risk of emergencies occurring and use this to inform contingency planning Put in place emergency plans Put in place business continuity management arrangements Put in place arrangements to make information available to the public about civil protection matters and maintain arrangements to warn, inform and advise the public in the event of an emergency Share information with other local responders to enhance co-ordination. Co-operate with other local responders to enhance co-ordination and efficiency With the introduction of the updated Health & Social Care Act 2015 this significantly affected emergency preparedness arrangements with functions being distributed to new bodies; Public Health England, NHS England and CCGs. During the last two years there have been many changes to the national resilience framework assurance requirements in delivering an emergency preparedness resilience and response across the NHS. NHS England Core Standards for Emergency Preparedness Resilience and Response (2015) are the minimum standards which NHS organisations and providers of NHS funded care must meet. The Trust is now required to follow the EPRR framework and delivery of the NHS England Core Standards. These are the minimum standards which NHS Organisations and providers of NHS funded care must meet and provide assurance around EPRR to the Commissioning Board. Alignment to the Business Continuity Standard SO 22301, is a requirement under the NHS England Core Standards 2015. NTRODUCTON This Annual report provides an outline of the Trust s emergency preparedness in order to meet the requirements of the Civil Contingencies Act 2004 and the NHS Commissioning Board Emergency Preparedness Framework 2015. The report covers the following activities to ensure the Trust s resilience in the event of a major incident or severe disruption. Review and update of a variety of Emergency Plans Business Continuity Management Specialised Resilience Ad hoc Planning Training and Exercising Response Live Events Partnership working Assurance and Obligations under the CCA 2004 Priorities for 2016/2017 TSTA/01.16 Page 2 of 7
RSK MANAGEMENT The CCA 2004 places a legal duty on responders to undertake risk assessments and publish risks in a Community Risk Register. The purpose of the risk assessments is to reassure the community that the risk of potential hazards have been assessed, and that preparation arrangements are undertaken and response plans exist. Those risks currently identified on the Avon & Somerset Community Risk Register for which the Trust develops mitigation plans for are set out below: Loss of critical services/supplies Civil unrest Storms & Gales/low temperatures Terrorist Attack nfluenza type disease i.e. pandemic Technical failure of regional electricity network Fluvial, surface water & flash flooding/major reservoir collapse Telecommunications infrastructure no notice loss Radiation disease Contamination Major local accident on motorways/rail The Trust has developed mitigation plans for each of these risks. PLANNNG & PREPAREDNESS ACTVTES A variety of plans and activities have taken place throughout 2015 these being: Major ncident & Mass Casualty Plan The Trust has reviewed its Major incident and Mass casualty plan in line with the new EPRR framework to ensure it continues to have the capability of responding to major incidents of any scale in a way that delivers optimum care and assistance to the victims, and minimises the consequential disruption of our services to patients. The Mass casualty plan incorporates a critical care plan which increases capacity and capability over a protracted period of time in response to an incident and details of how to gain specialist advice in relation to the management of a significant number of patients with traumatic blast and ballistic injuries. Business Continuity Management Business Continuity Management is a management process that helps to manage the risks to the smooth running of the organisation or delivery of a service, ensuring that the business can continue in the event of a disruption. During 2015 a number of key actions have been undertaken. All critical areas now have specific business continuity plans. The Trust now has four Business Continuity nstitute accredited practitioners A review and update of the Trust s business continuity framework and policy. The policy reflects the recommendations of the BCM Management Framework for Commissioners and the Trust s alignment to SO 22301 and PAS 2015:2010, across the whole of its portfolio. Chemical, Biological, Radiological and Nuclear (CBRN) Plan nitial Operational Response (OR) Guidance was launched by the Joint Emergency Services nteroperability Programme (JESP). This was based on extensive research from Public Health England and the University of Hertfordshire on the most appropriate approach to non-caustic chemical decontamination. The OR is predominantly aimed at ensuring an immediate first aid type approach that is capable of being delivered by non-specialist staff to self-presenting casualties in any setting TSTA/01.16 Page 3 of 7
without delay. The Trust s Chemical, Biological, Radiological and Nuclear (CBRN)/Hazmat plan and Emergency Department/Multifunction Team training programme for CBRN/Hazmat incidents has been updated to incorporate the OR guidance. To ensure compliance with guidance published by NHS England on 1 April 2015 (Chemical incidents: Planning for the management of self-presenting patients in healthcare settings) a training programme with appropriate and proportionate plans and response has been developed and delivered. Heatwave Planning The Trust s plan was updated in line with the Heatwave Plan for England 2015, issued in May 2015. During the Heatwave period June 15th September 2015, arrangements were in place should the heatwave triggers be reached, however no action was required as heatwave thresholds were not met. Cold Weather Plan The Trusts Cold Weather Plan was reviewed in line with the Cold Weather Plan for England for 2015 with minor changes being required to the Trust plan. Pandemic Flu Planning n June 2013 the World Health Organisation (WHO) published a revised pandemic influenza guidance which now uses a risk based approach and recognises the importance of national, regional and local plans for pandemic influenza that can be activated within the WHO framework. The key changes to note are that the Area Team, CCG and Public Health England will lead on outbreak incidents and Acute Trusts will not be required to set up antiviral collection centres. A Communicable Diseases Plan has been developed to incorporate pandemic flu, Smallpox, Severe Acute Respiratory Syndrome (SARS) or Viral Haemorrhagic Fever. Specialised resilience ad hoc planning Ebola Planning The outbreak of Ebola in parts of West Africa was classed as the current largest outbreak of disease. All NHS organisations were required to ensure they were well prepared in the event of Ebola reaching the UK. The Trust has undertaken several preparedness activities including the development of guidance to support front line staff in responding to this type of incident, undertaking training and testing sessions and general communications to increase awareness to staff. Prevent Prevent is mandated in the national contract for NHS Trusts to actively engage, participate and ensure that frontline staff are trained in awareness and in prevent strategies for patients/relatives/staff that could be susceptible to radicalisation. Prevent is central to the safeguarding agenda and is therefore a priority within safeguarding policies, procedures and training. The Trust is taking this agenda forward, with staff from ED, AMU, Clinical Site Team and Security Team attending a health workshop to raise awareness of Prevent. TRANNG, TESTS & EXERCSNG Training A variety of training sessions have been undertaken. Please see the table below: TSTA/01.16 Page 4 of 7
Type of training/awareness session Loggist Major ncident & CBRN (Chemical, Biological, Radiological & Nuclear incidents) nitial Operational Response (OR) Major ncident control and management Audience/description of training 8 training sessions were completed for administration support staff. Emergency Department Band 5 Nurses and Multifunction Team trained to support the response to a major or CBRN incident. ED staff including receptionists, Clinical Site managers, Matrons 5 training sessions for on- call managers this training gives on call managers the opportunity to familiarise themselves with tactical command; their role and response needed in the event of a major incident and the control room set up. Date July-September 2015 March-October 2015 April-July 2015 February-July 2015. Exercises & Tests Exercise/Tests Description/outcome Date Live exercise This exercise was to 16 April 2015 specifically test the Trust s response in the event of a fire, evacuation and maintaining business continuity. The scenario was supported by the Fire and Rescue Service, Ambulance Service and Local Authority. A significant focus was on the use of specialised evacuation equipment and the need to move evacuated patients to a safe holding area the a definitive place of care. Table top exercise This exercise was to test the 15 May 2015 health community response to an infectious disease outbreak on site during the Glastonbury Festival. Table top exercise This exercise was to test the 05 November 2015 health community response to a pandemic flu outbreak. t focussed on the impacts on the health service at three different stages of the pandemic. Communication Tests Call Cascade The Trust has undertaken 6 January, March, May, June, September, December 2015 TSTA/01.16 Page 5 of 7
communication tests led by NHS England and requiring a confirmed response by an on-call manager. These test have taken place both in and out of hours Debriefing From Live Events and Exercises Following live events and exercises, debriefs are undertaken in order to capture learning points. Lessons identified from live events and exercises are subsequently incorporated into major incident plans and business continuity plans, and also shared with partner organisations. PARTNERSHP WORKNG The Trust participates in the following health and multi-agency groups to ensure a proactive and co-ordinated approach to warning and informing and sharing best practice, encouraging a joint approach to emergency preparedness in terms of planning, responding and recovery. Local Health Resilience Partnership Strategic Group (LHRP) Local Health Resilience Partnership Tactical Group (LHRP) South West CBRN Acute forum Avon & Somerset Emergency Planning Acute forum LRF CBRN working group Somerset PREVENT Board Resilience Direct ASSURANCE & OBLGATONS UNDER THE CCA Two audits and self-assessments internally and externally have been undertaken: EPRR Core Standards September 2015. Completion of self-assessment of EPRR core standards rated as substantially compliant. CBRN Self-assessment September 2015 and visit by Southwestern Ambulance Service November 2015 on behalf of the NHS England (South), in terms of Trust s readiness in the event of an incident of this type occurring. Three minor recommendations were made. Statutory requirements set out that the Trust will undertake:- Live Exercise Every 3 years Table Top Exercise Yearly Communication Test Every 6 months Trust s achievements for 2015 are: Live Exercise Table Top Exercise Communication Test One Two Six The Trust has therefore achieved its statutory requirements for 2015. TSTA/01.16 Page 6 of 7
PRORTES FOR 2016 The Trust Emergency Preparedness Work Plan for 2016 will be focused on a number of key areas:- Delivery of statutory requirements under the CCA 2004 & NHS Standard Contract requirements for Emergency Preparedness and the delivery of the EPRR core standards for 2015 Embedding of the Business Continuity Management Process in line with SO 22301 for all areas across the Trust. Development of a Business Continuity test/exercise programme as part of embedding the BC process. Training & refresher for new and existing on-call managers and directors Further development for staff groups in line with the National Occupational Standards & Core Competencies for emergency response functions. Development of mandatory training for core staff groups in responding to an emergency incident. Completion of a Mass Casualties plan and exercising and testing locally. Localising new guidance i.e. Planning for the Shelter and Evacuation of people in healthcare settings guidance (Dec 2014). Ongoing delivery of exercising and testing locally and at a multi-agency level. To plan for a Live exercise to ensure compliance with our statutory requirements of undertaking a live exercise every three years. Multi-agency working and exercising. Major ncident Response Planning Development of communications, in particular using social media in the event of a major incident or severe disruption incident. TSTA/01.16 Page 7 of 7