Telephone: 01245 544600 Fax: 01245 544610 …...Aside from the first meeting of the next round which...

Resilience Development Network

© NPAG 2014 The NPAG is a part of the East of England Ambulance Service NHS Trust 1

Dale Atkins, Group Facilitator Telephone: 01245 544600 Fax: 01245 544610 Email: [email protected] www.npag.org.uk



MISSION STATEMENT - RESILIENCE DEVELOPMENT NETWORK (RDN)

To encapsulate the principles of inter-agency health and social care networking, with the intention of sharing experiences, knowledge and ongoing best practice initiatives and innovations, thereby enhancing the resilience of member organisations.

INTRODUCTION This has been my third year as facilitator of the Resilience Development Network and once again I have found the whole experience to be very rewarding and extremely interesting. As ever, the wide range of knowledge possessed by group members and their constant willingness to share this with colleagues has been most impressive. This year the Resilience Development Network has, by agreement, held its meetings at venues in the London area. Not only have we been able to secure good external speakers but we have, in this round, benefited from some excellent presentations from within the group itself. Aside from the first meeting of the next round which will be held at the Royal Asiatic Society, Euston, London on Wednesday 14 May 2014 the venues and dates for subsequent meetings will be determined by agreement, depending on the geographical spread of the new annual membership. I look forward to another successful round. Dale Atkins NPAG RDN Facilitator

CHAIRS VIEW It has been a pleasure to chair the 3 Resilience Development Network meetings over the last year. The days have proved to be an invaluable opportunity of information exchange, with colleagues across the country enthusiastic about overcoming their own challenges, willing to share good practice and actively support others going through similar resilience challenges. Whilst guest speakers and group members are unlikely to confess to being experts they have been willing to share their approach, pitfalls and gains to the organisation, when introducing new concepts or developing resilience arrangements, to meet legal requirements. This report highlights the diversity of subjects covered including social media, evacuation and providing emergency accommodation for vulnerable patients, as well as latest national developments on CBRN, major trauma networks and responses to recent flooding demands. Business continuity continues to be a major challenge to us all so it was heartening to hear from those who had persevered and achieved national accreditation as a result. All of this could not have been achieved without the support of Group Facilitator, Dale Atkins and the NPAG Team, for facilitating each event and developing the document reference library, available to all members. Miriam Smith Chair - NPAG Resilience Development Network



MEETING VENUES “As a new member this year I have found the warmth of the group and the willingness to share both experiences and good practise invaluable. Making new contacts and talking with people suffering the same or similar challenges is invaluable.”

Emergency Planning Officer. Maidstone & Tunbridge Wells NHS Trust

“This has been my first year involved in the group, I have found it to be an excellent networking forum, it covers a diverse range of topics, it is great to feel that there are other professionals out there who are equally as keen as myself to face and respond to the many resilience challenges we face. It is a good group which ensures your involvement and recognises your contribution, with lots of sharing taking place”

Head of Emergency Planning & Business Continuity. The Royal Wolverhampton NHS Trust

“The Resilience Development Network is new to my Organisation for this round of meetings – I have been made to feel very welcome and the journey to London each time has certainly been fruitful in the networking and information gained. I will certainly be suggesting that we sign up for the next round of meetings!”

Clinical Risk Manager / Emergency Planning Lead. C alderstones Partnership NHS Foundation Trust

DOCUMENTS/PRESENTATIONS/ETC DISTRIBUTED DURING 2013/14 The following documents and presentations are amongst those that have been shared with group members during 2013/14. They also reflect the range of topics that the group has covered. Please note: copies of these are available upon request from the BVG facilitator on e-mail: [email protected] or via the NPAG Members website or by contacting the NPAG office on tel. no: 01245 544600.

� Presentation: Business Continuity and ISO 22301

(Mandy Brokenshow - Emergency Planning Liaison Officer at Basildon & Thurrock University Hospitals NHS Foundation Trust)

� Document: Basildon & Thurrock’s BIA Templates

� Document: Business Continuity 10 Minute Self-Assessment Tool

� Document: Latest RDN Terms of Reference

� Document: Latest RDN Members Contacts List

� Presentation: EPRR in the New NHS Landscape (Phil Read. Head of Emergency Preparedness, Resilience & Response. Essex A T. NHSE)

� Document: NHS Commissioning Board Core Standards for Emergency Preparedness, Resilience and Response (EPRR) – Narrative and Matrix

� Presentation: EPRR and Social Media (Dale Atkins – Facilitator + Nick Booth – RDN Member)

� Document: ‘Smart tips for Category 1 responders using social m edia in emergency management’ - The Defence Science and Technology Laboratory. March 2013



� Presentation: ‘Healthcare Evacuation – Baby to Bariatric’ (Mike Ware – RDN Member)

� Presentation: CBRN – Latest Developments (Gareth Boynton Senior Resilience and Special Operations Manager. EOE Ambulance Service)

� Presentation: What is a trauma network and what happens in a majo r incident? (Hazel Gleed – RDN Member)

� Presentation: Logistic Training (Michaela Morris - RDN Member)

� Document: ISO 22301 ‘Shalls’ (Michaela Morris - RDN Member)

� Document: Cabinet Office 2013 - Expectations and Indicators of Good Practice Set fo r Cat1 and 2 Responders

� Document: Emergency Preparedness Gap analysis - template - 20 14 (Cab Off) (Hazel Gleed – RDN Member)

� Presentation: EPRR Core Standards Assurance Process – Overview of ‘Narrative’ Document (Dale Atkins – Facilitator)

� Discussions led but with no formal presentation: i) Emergency Accommodation Planning ii) BC not EP - The NHSBT route iii) Severe Flooding in the South West

� Document: ‘Floods Destroy – Be Prepared. Flooding: Advice to the public.’ PHE and Environment Agency

� A recommended book: “The Route Map to Business Continuity – Meeting the Requirements of ISO 22301” 2012. John Sharp. ISBN 978 0 580 74341 2

SUMMARY OF MEETINGS, KEY THEMES AND HOT TOPICS FOR 2013/4

This section provides a brief summary of a selection of discussions that have taken place at the 3 meetings held this year. As can be seen from the range of topics covered, members have been provided with a significant level of information, guidance, ideas for improvement and suggested areas for cost savings. Please refer to the actual minutes of each meeting for a greater level of detail. Four meetings were held in this round: 1st Wednesday 17 July 2013 at the Royal Asiatic Society, London 2nd Wednesday 20 November 2013 at the Royal Asiatic Society, London 3rd Wednesday 19 February 2014 at the Royal Asiatic Society, London



Business Continuity and ISO 22301 (Mandy Brokenshow - Emergency Planning Liaison Officer at Basildon & Thurrock University Hospitals NHS Foundation Trust).

The International Standard specifies requirements for setting up and managing an effective Business Continuity Management System (BCMS). All NHS organisations must use the NHS Commissioning Board BCM Framework and the associated core standards to align themselves with ISO 22301 and fulfil all assurance processes.

The key BCM stages

� Top level management commitment � Identified potential impacts and Risks � Reviewed potential mitigation measures � Implemented agreed strategies � Risk Management undertaken � Trust Risk Register � Business Impact Analysis (BIA) conducted � BCM Strategies developed � Business Continuity Plan (BCP) developed � BCP tested and exercised - lessons identified

Top 10 Tips for implementing ISO 22301

� Get commitment and support from senior management. � Engage the whole business with good internal communication � Compare existing business continuity management system with ISO 22301

requirements � Ensure stakeholders and suppliers have a business continuity process � Establish a BC Steering Group to enable ‘buy in’. � Identify requirements, responsibilities and timescales. � Adapt the basic principles of ISO 22301 standard for your organisation � Imbed BCM in the organisations culture with training, workshops and exercises � Share ISO 22301 knowledge with BC Champions � Regularly review your BCM system against the requirements of ISO 22301

Benefits of ISO 22301 Accreditation

� Enables a clearer understanding of the critical functions within the Trust � Protects the Trust � Protects staff/patients/visitors � Compliance � Identifies the capability to survive from disruptive events � Insight into vital resources and dependencies of critical business processes. � Enabled operational improvements � Reduction of financial and reputation damage



EPRR in the New NHS Landscape (Phil Read. Head of Emergency Preparedness Resilience & Response, Essex at NHSE).

Key Changes to the Health Landscape � NHS structural changes including the establishment of NHS England to manage the changed

NHS system and improve patient outcomes. � The creation of Public Health England (PHE) incorporating the responsibilities and function of the

HPA. � The introduction of Local Health Resilience Partnerships (LHRPs) formed by NHS and local

authority partners to strengthen multi-agency emergency planning. � An enhanced role for local authorities with a stronger role in shaping health services, including

responsibility for local health improvement. � A new role for Directors of Public Health based in local authorities. � Established clinician led Clinical Commissioning Groups (CCGs) to commission the majority of

NHS services and support NHS England to discharge its EPRR functions.

NB: The roles and responsibilities of frontline provider organisations such as acute trusts and the ambulance service will not change fundamentally.

NHS England / EPRR Guidance � The Civil Contingencies Act 2004. � The Health and Social Care Act 2012. � NHS England EPRR documents and supporting materials, including:

a. NHS England Business Continuity Management Framework (service resilience) (2013) b. NHS England Emergency Planning Framework c. NHS England Core Standards for Emergency Preparedness, Resilience and Response

� National Occupational Standards (NOS) for Civil Contingencies – Skills for Justice. � BSI PAS 2015 – Framework for Health Services Resilience. � ISO 22301 Societal Security – Business Continuity Management Systems – Requirements.

NHS England Command � NHS England will ‘command’ all health activities (national IRP). � Local incident coordination will be in partnership with CCG commissioners and local providers. � NHS England & PHE will liaise on all public health issues. � In large scale events / cross border leadership may come from region or national teams to ensure

appropriate use of resources. � National policy will be set through the NHS England board / exec team (ie, new Pandemic Flu

Guidance/Plan). National NHS Incident Levels Prior to MI declaration ‘NHS Significant Incident’ Dynamic Risk Assessment Process undertaken Level 1 – managed by a single local organisation/provider Level 2 – requires a number of providers within Essex borders Level 3 – requires regional support / cross Essex borders Level 4 – national incident



EPRR and Social Media (Dale Atkins – Facilitator and Nick Booth – RDN Member) 1. ‘EPRR and Social Media’ Based on “Use of social media by UK Resilience Forums” (Meaton & Stringer. University of Huddersfield

+PHE. 2013 WIT Press) 2 x Broad Components � How WE USE Social Media to support EPRR. � How we manage the situation where the GENERAL PUBLIC USE Social Media - ie in the event

of an incident. How we Use Social Media � Survey of LRFs re use of social media and social media strategies in their EPRR planning � Found the level of application “varied greatly between LRFs” � Whilst 90% said that they used social media in their strategies most was “reactive or passive”

rather than “proactive and systematic” Survey Findings (63 responders - mix of LRFs and partner organisations)

Yes% No % Not Sure %

Incident Response 59 27 14

Monitor 37 19 44

Broadcast 92 8 --

Social Media Training Provided 38 49 13

Average 56 26 18

How the Public uses Social Media � Number of people carrying a phone or device capable of capturing images and connecting to the

internet is growing. � This makes anyone carrying such a device a potential ‘reporter’ with a far reaching internet

audience. � Often the ‘citizen reporter’ will be at the scene long before traditional media (eg Haiti, tsunamis,

Liverpool ‘Duck’ incident, Hudson River plane crash, etc) � ‘Citizen reporting’ can have positive impacts but also negative impacts Positives of Social Media � Photographs taken by the citizen reporters can form evidence in the emergency following – “often

requested by formal disaster response agencies” � These photographs “can help people to make sense of the event” � A given image can itself “become a ‘community’ where people come together to share and

comment on the content � The greater number and wider geographical spread of citizen reporters enables a wider

geographical mapping of events – “known as Crowd mapping”



Negatives of Social Media

� ‘citizen reports’ can be inaccurate and misleading. � Misleading / inaccurate / negative ‘citizen reports’ can be picked up on by the general media

presenting additional challenges for responding agencies. � If social media reporting by the public is to be monitored during the course of an incident this will

require additional dedicated resources. Key Recommended Document:

‘Smart tips for Category 1 responders using social media in emergency management’ The Defence Science and Technology Laboratory, March 2013

2. ‘Social Media – a mixed blessing’ Nick and colleagues had been directly involved in the M5 multiple pile up incident on the 4 November 2011. This was in fact the second major incident of the day in that earlier significant flooding had hit Bridgewater adversely effecting transport routes at the same time as Bridgewater was hosting its annual carnival with c150,000 additional visitors. Additional ambulances and ambulance crews were already on duty for the carnival. � With social media the incident can go global within minutes. � Constant Twitter feeds - member of the trusts communications team was able to provide constant

Twitter feed updates. Sky News complimented the trust on this and didn’t actually feel the need to send a film crew until the following day. Also greatly reduced pressure on the trust switchboard compared to previous major incidents.

� Followed hashtags within Tweets - trust used hash tagging to determine what the trending issues

were so that appropriate responses could be made instantly. It also made good use of retweeting (not wanting to reinvent wheels) with c100,000 retweets having been made during the incident.

� Blocked access to social media -since this incident and in recognition of the positive benefits of

social media the trust has unblocked all access to social media sites (with appropriate monitoring/policing in place) – the trust CEO now actively uses Twitter for both staff and public benefit.

Key Social Media Challenges � Need extra capacity to monitor social media accounts and ensure accurate, timely and rumour

busting information is sent out. � Need to have in place a system to analyse tweets to provide intelligence and insight.

5 Key Components Identified 1. Monitoring – need to agree who is responsible for managing social media in a major incident, who

will be giving out information. Also important to determine the relationship with incident control room.

2. Responding – needs to be quick - communications team needs to be on-call. 3. Resources – needs for additional needs to be recognised. 4. Openness – need to agree how much information and what type is going to be shared via social

media. Frequency of release is also important. 5. Public Enquiry – social media information can be extremely useful for plotting what happened

during an incident and how issues were dealt with.



And finally a quote from Erik Qualman: “We don’t have a choice on whether we DO social media, the question is how well we DO it”. ‘Healthcare Evacuation – Baby to Bariatric’ (Mike Ware – RDN Member)

Fire Safety Order 2005 Evacuation – Duties & Respon sibilities

� Article 21 extract � Adequate safety training must include suitable & sufficient instruction & training on the

appropriate precautions and actions to be taken by the employee in order to safeguard himself and other relevant persons on the Premises.

� Article 15 extract

� The Responsible Person must establish appropriate procedures including safety drills to be followed in the event of serious and imminent danger to relevant persons.

� Nominate sufficient number of competent persons to implement those procedures in so far as they relate to the evacuation of relevant persons from the premises.

� Safe evacuation must no longer depend upon Fire & Rescue Service support. Hospital Major Evacuations – 2008/9

� Royal Marsden Hospital fire (Jan 08) (350 evacuated) � Great Ormond Street Hospital fire (Sept 08) (335 evacuated) � Chase Farm Hospital (Oct 08) (70 evacuated) � Northwick Park Hospital (Feb 09) (250 evacuated) � Mayday Hospital Croydon (July 09) (30 evacuated)

Examples of Evacuation Equipment Available at Taunt on & Somerset NHS Trust

� 11B stretchers (40 stone max / 254kg) � Scoop stretchers (25 stone max / 158kg) � Vacuum Mattresses (25 stone max / 158kg) � Evacuation Pads (40 stone / 254kg) � 24 Max Trolleys (71 stone / 450kg) � Bariatric Wheelchairs (30 stone max / 190kg) � Carry Sheets (25 stone max / 158kg) � Ez-Glide Chairs (35 stone max / 222kg) � Baby Pods – SWAS vehicle/helicopter adaptions resulted � Improvisation with existing equipment (wheeled chairs /commodes etc)

Key Evacuation ‘Challenges’

� Patient condition / status / bariatric. � Staff / visitors / contractors / people with disabilities. � Challenging people including those with Learning Disabilities. � Changing conditions due to a fire event. � Continuing patient care. � Fire Plans / Emergency Shelter Arrangements monitored and tested regularly in a changing

environment. � Working in silos.



Planning to Evacuate

� New Build – Design for Evacuation / Equipment / DEFEND in PLACE. Unsafe to move people. Stay put within fire compartment (a place of relative safety). Inform Fire & Rescue Service straight away.

� Progressive horizontal evacuation � Assess All Areas link Fire & Manual handling leads (consider DDA issues – Refuges) � Personal Emergency Evacuation Plans (PEEPs). Risk assessment and action plan � Strategically locate evacuation equipment

Traffic Light Evacuation Assessments

� Green- Independent - Move 1st � Amber- Chair dependent - Move next � Red - Highly dependent - Move last

CBRN – Latest Developments (Gareth Boynton Senior Resilience and Special Operations Manager. EOE Ambulance Service) As well as having a senior role within the EoE Ambulance Service re CBRN, Gareth was also involved at a national level having had a lead role in the development of HARTs. Gareth is also a NILO (National Interagency Liaison Officer). Some key extracts/messages from the presentation: � Limited consistency across the country in terms of the CBRN equipment held by acute trusts

which could result in only limited CBRN support being made available from ambulance services due to incompatibility.

� The standard/target time for the delivery of CBRN equipment to a given site is 45 minutes, but

this is extremely aspirational in rural areas where often this will be nearer to 2 hours. � Key message is the current move away from wet decontamination, reverting back to the earlier

model of dry decontamination in which excess materials are wiped away with paper towels. The outer layer of clothing removed and individuals being issued with a de-robing suit. Wet decontamination would only be used in the case of caustic substances (eg acid)

� Rolling-out of the Jessop recommendations. This will begin in January 2014 for the ambulance

trusts but is to be fully rolled out to all relevant trusts by September 2014. It is anticipated that trusts will receive details on a DVD.

� Concerns expressed with the implementation of the IORP (Initial Operational Response

Programme) noting that if this wasn’t performed correctly at the scene it could have a knock-on effects for acute trusts. The main advice here was for acute trust members to keep closely linked in with both their LHRP and their local ambulance trust as the programme is rolled out.

� One particular challenge which the ambulance service faces in dealing with CBRN incidents is

that of ‘reach back’ – as in who the respective agencies report back to. For the ambulance service this is to PHE whereas Fire and Rescue Service reach back to a private company. There having been several cases where the information coming back to the frontline is different in each case.

� Similar challenges exist with some A&E consultants – cases reported where analysis at the

scene have indicated that the individual is not contaminated but when they arrive at the hospital the consultant still insists on undertaking decontamination.



What is a trauma network and what happens in a majo r incident? (Hazel Gleed – RDN Member) Hazel described the work that had been going on within the SW London and Surrey Trauma Network. Background Information � Major Trauma is the leading cause of death in people under the age of 45 and is a serious public

health problem. Source: NHS CB/D15, 2013. � Major trauma is the name given to life-threatening physical injuries such as major head injury,

multiple injuries, bleeding from ruptured organs (such as the spleen or liver), spinal injury, amputation of limbs and severe knife or gunshot wounds.

� 70% of all major trauma cases are the result of road traffic collisions. Principles behind the Network (following the Health care for London 2007 Report) � Prompt clarification of true major trauma. � Best possible clinical care from the point of incident. � Rapid movement through each phase of care. � Equality of care no matter where and when the incident. Set Up � 4 Trauma Networks covering London and surrounding areas, supporting 4 Major Trauma Centres

(MTC) and numerous Trauma Units (TU). � Hub & Spoke approach with a Major Trauma Centre at the centre of each network

� Royal London Hospital & NE London & some of Essex � King’s Hospital & SE London & Kent � St George’s Hospital & SW London & Surrey � St Mary’s Hospital & NW London & some of Hertfordshire

How the Trauma Network Operates � Principal conveyance from scene to MTC within 45 minutes travel time. � Primary conveyance to TU outside 45 minutes. � Secondary transfer to MTC after stablisation / assessment - one hour bundle. � Some patients may require transfer elsewhere for other specialist care – children, burns, spinal

care. � Robust arrangements for consultant to consultant discussion which will determine final diagnosis � Increased rehabilitation team at MTC - Once patients are medically fit for discharge they will be

repatriated to their local hospital. � P1s may find themselves in TU either for clinical or capacity reasons. Case Study - A3 Coach Crash :

� The clinical response worked well and patient pathways were effectively implemented. � The introduction of trauma networks that operate across the boundaries of NHS and multi-agency

partners requires those organisations to recognise the impact of a new model of healthcare in their major incident plans.

� By planning for casualty distribution in accordance with trauma network structures, NHS and multi-agency partners will ensure that they continue to provide a coordinated response to incidents that have a major impact on large numbers of people.



A3 Coach Crash Incident Summary � 23:50hrs 10/09/12 – 999 calls that coach on its side on A3. � Major Incident declared at scene. � Over the next 4 hours ~50 patients were triaged, treated, and conveyed to hospitals. � The response strategy used by SECAmb was that the most severely injured casualties would be

conveyed to Major Trauma Centres and those less seriously injured would be taken to Trauma Units, in line with accepted best practice for trauma patients.

NHS South led NHS Debrief found that: � Police Hospital Investigation Teams are required at each hospital receiving casualties, whether

provided directly or by mutual aid. � Police Casualty Bureaus when set-up need to continue to support all receiving hospitals, whether

directly or via mutual aid arrangements. � Where mutual aid is enacted communication flows need to be agreed and robust to ensure that

the support being provided is as good as it can be. � The consideration of medium/long term support for casualties and family/carers from ‘out of area

is required. Loggist Training (Michaela Morris - RDN Member) Michaela’s presentation described the Loggist Training that is provided from within her trust (Isle of Wight NHS Trust) 1. Aims of the Session

� The duties of the organisation under the Civil Contingencies Act. � The types of threats and incidents that may occur. � Roles and Responsibilities of Health during a major incident. � Command and Control during an incident. � Best practice for logging the vital component of a major incident.

2. The Isle of Wight – Local Details

� 2 lower tier COMAH (Control of Major Accident Hazard sites). � Large number of industrial units using and storing chemicals. � Large events during summer i.e. Festival. � One receiving hospital. � Mutual Aid will take at least two hours to arrive.

3. Plus – Incident Quiz

� Can you name 9 Incidents that have occurred / affected the Isle of Wight since 2006? 4. What Are the NHS Responsibilities?

� Specific plans. � Ensure the resilience of our services. � Continue to support those not affected. � Provide mutual aid to others NHS organisations. � Ambulance Service are “Gatekeepers” at the scene.



5. Command and Control

� Gold – Strategic Overview � Silver – Tactical Overview � Bronze - Operational

6. Incident and Decision Logs

� Personal logs � record of all instructions received � actions taken � and other relevant information.

� Decision logs � records the key corporate decisions, � the process for deciding and the considered alternatives.

7. Why is logging and message taking so vital?

� Procedures must aim to provide the right people with the right information at the right time in a form that they can understand, assimilate and act upon. (Emergency Response and Recovery 4.90)

� In order to facilitate operational debriefing and to provide evidence for inquiries (whether

judicial, public, technical, inquest or of some other form), it is essential to keep records. Single agency and inter-agency debriefing processes should aim to capture information while memories are still fresh.

(Emergency Response and Recovery 4.108) 8. What Should You Log?

� Log key events occurring / announcements within the control room. � Log key communication with external agencies. � If staffing allows, assist in the completion of the electronic log.

9. Logging Best Practice

DO � Clear � Intelligible � Accurate

DO NOT � E – Erase large portions of text, and leave the content underneath un readable. � L – Tear the Leaves out of you book � B – Leave Blank spaces � O – Do not Overwrite � W – Write in margins



EPRR Core Standards Assurance Process plus: ISO 22301 ‘Shalls’ & ‘Expectations and Indicators of Good Practice Set for Cat1 and 2 Responders’ Aim for RDN: to share both common strengths and common weaknesses as well as sharing areas of good practice. A Brief Overview of the ‘Narrative’ Document � These are the minimum standards which NHS organisations and providers of NHS funded care

must meet. � The accountable emergency officer in each organisation is responsible for making sure these

standards are met. � All NHS Commissioning Board EPRR framework guidance will include relevant extracts from

these standards. And EPRR control processes will require evidence that the standards are being met.

� May update these standards from time to time as lessons are learnt from testing, practical use and control processes.

General � NHS organizations and providers of NHS funded care must:

� nominate an accountable emergency officer who will be responsible for EPRR � contribute to area planning for EPRR through local health resilience partnerships

(LHRPs) and other relevant groups EPRR � NHS Organisations and providers of NHS funded care must:

� have suitable, up to date plans which set out how they plan for, respond to and recover from major incidents and emergencies as identified in local and community risk registers;

� test these plans through: o a communications exercise every six months; o a desktop exercise once a year; and o a major live or simulated exercise every three years;

� have suitably trained, competent staff and the right facilities available round the clock to effectively manage a major incident or emergency;

� share their resources as required to respond to a major incident or emergency. Service resilience planning � NHS organisations and providers of NHS funded care must have suitable, up to date plans which

set out how they will: � maintain continuous service when faced with disruption from identified local risks; and � resume key services which have been disrupted by, for example, severe weather, IT

failure, an infectious disease, a fuel shortage or industrial action. � This planning should follow the principles of ISO 22301 and PAS 2015.

The following were identified as the key areas of challenge re the Core Standards:

� standards around Business Continuity Management

� standards linked to ‘111’.

� those standards where there was a tenuous link between different organisations

and where the was no clear lead responsibility



Emergency Accommodation Planning (Jon Tynan – RDN Member) Trust has c220 detained patients of low and medium secure rating. A significant proportion of this population comprising young/ 25 year old males. A major risk to the trust is in relation to the provision of alternative accommodation in the event of an incident that rendered the current accommodation unviable, particularly with the Ministry of Justice requiring that alternative accommodation be provided on a like-for-like basis. Therefore a trust accommodation profile covering both the main site and subsidiary sites. This looks at bed no’s. level of security, male v female facilities and enabled a ready and simple analysis/assessment to be made in the event of a significant incident. Alternative areas covered included: therapy rooms, meeting rooms, offices. Short term provision (up to 28 days) is manageable within the plan but becomes more problematic over a longer period. For this reason the plan extends to cover mutual aid arrangements with other local providers. The plan is currently being used by mental health provider colleagues in his Yorkshire/Lancashire network, but the longer term plan would be for this to be adopted across the north of England.

BC not EP - The NHSBT route (Joel Standing - RDN Member)

NHSBT (NHS Blood & Transplant) is an arm’s length body and doesn’t formally or operate within the EPRR framework. It also doesn’t undertake direct patient care, operating more as a logistics organisation. It provides a ‘product supply’ to hospital and has bespoke products for particular customers. For this reason the organisation has gone down the BC rather than EP route. It had also decided to go for BS25999 and to get fully certificated. The catalyst for this was the lead up to the Olympics. The key components of blood supply, which have all been certificated, are:

� Donation � Transport � Manufacture � Testing � Hospital Services

Any sub-contractors are required to have a clearly defined business plan in place in order to secure the supply chain. Since a major flooding incident in 2012, NHSBT has moved away from national, generic plans to those that are site specific - with site level assessments and BIAs being undertaken. Where NHSBT sites are co-terminus with acute trusts the NHSBT plans will reflect the local BP plans of that trust. Severe Flooding in the South West (Miriam Smith and Nick Booth - RDN Members) Miriam and Nick shared their recent and on-going experiences of the flooding in their respective areas – Plymouth and Somerset.



1. Multiagency Working - including Leadership Mixed feedback. In Plymouth there had been very good joined up working from the word go with the police taking a good positive lead, setting very clear agendas both strategically and tactically. In Somerset there had been very little joined up working initially (for first 3 weeks) but eventually good multiagency working kicked in. Gold command had been running for 4 weeks with daily briefings at 0800, 1200 and 1600 hrs. Somerset felt that Fire and Rescue had done a sterling job as had the Met Office and indeed the EA, despite the criticisms. Particular praise was also given to the voluntary sector and in particular ‘Wessex 4x4’ - noting their very efficient on-line booking facility 2. Social Media Reported that all communications had been strictly controlled in-house with the police, for example not allowing their own local offices to put out briefings. Public social media had been noticeably critical of the politicians questioning the motivation behind their visits to the stricken areas. Indeed there was said to be a view amongst the local communities that there had been overkill with the visits by dignitaries. 3. General Media Local media dealing with the local issues in a practical way had been very helpful. However there was a feeling that for the local communities the attention of the national media had been somehow embarrassing – often with them asking why they were receiving so much attention. There was a view at a local level that the national media had only focused on the negative issues and had failed to highlight a lot of the positives, eg the very good community spirit that had been exhibited and the excellent community working that had taken place. 4. Communication General communication between agencies had been good. Transport communication, however, had been particularly challenged in a number of areas and would be an area to look at going forward. 5. Public Health Component There had been a few issues with infections but nothing significant. A lot of testing had taken place with a lot of PH advice being issued in relation to contaminated water. Related document: ‘Floods Destroy – Be Prepared. Flooding: Advice to the public.’ PHE and Environment Agency 6. Category 1 & 2 Responders Still a lack of clarity on role and support from the CCGs and from NHSE Area Teams. 7. Business Continuity v Major Incident It was noted that the whole incident had been treated as a business continuity issue rather than a major incident.



GROUP MEMBERSHIP 2013/14

Name Job Title Trust

Neil Vine

Emergency Planning Manager

Plymouth Teaching Primary Care Trust

Miriam Smith

EPLO

Plymouth Teaching Primary Care Trust

Steven Swift

Head of Cancer Services & Major Incident Planning

Chesterfield Royal Hospital NHS Trust

Nick Booth

Emergency Planning Officer

Taunton & Somerset NHS Trust

Mike Ware

Fire Safety Officer

Taunton & Somerset NHS Trust

Richard Greene

Resilience Manager

Cumbria Partnership NHS Foundation Trust

Sam Grundy

Emergency Planning Officer

Rotherham Doncaster & South Humber NHS Foundation Trust

Jon Tynan

Clinical Risk Manager / Emergency Planning Lead

Calderstones Partnership NHS Foundation Trust

Diane Preston

Head of Emergency Planning & Business Continuity

The Royal Wolverhampton NHS Trust

Hazel Gleed

EPLO

St Georges Healthcare NHS Trust

Natasza Lentner

Head of Resilience

Brighton & Sussex University Hospitals NHS Trust

Claire O'Brien

Head of Emergency Planning & Resilience

Ashford & St Peters Hospitals NHS Trust

Bob Mearns

Resilience Planning

East of England Ambulance Service NHS Trust

Michaela Morris


Isle of Wight NHS Trust

John Weeks


Maidstone & Tunbridge Wells NHS Trust

Julie Elphick

EPO

Maidstone & Tunbridge Wells NHS Trust

Honorary Members: Mandy Brokenshow

Emergency Planning Liaison Officer

Basildon & Thurrock University Hospitals NHS Foundation Trust

Phil Read Head of EPRR NHS England Essex Area Team



TOPICS IDENTIFIED FOR THE 2014/15 ROUND

� PHE Changes and How They Impact on EPRR.

� Fuel Supplies.

� Flooding Debrief.

� Trauma Escalation.

� CBRN.

� Operation Spring Back.

� Trust Triennial Exercises.

NPAG DEVELOPMENTS CPD Certification The NPAG is a member of the CPD Certification Service. The Resilience Development Network has received CPD approval for 2013. CPD Certification is a formal recognition of the contribution that membership of the Resilience Development Network makes to members' continued professional/personal development. At the end of the annual round of meetings, members will receive certificates of attendance for all meetings attended during the year to evidence the contribution made as part of lifelong learning. NPAG NetWork The NPAG NetWork provides the facility for members to ask questions of any individuals, group or groups within the overall NPAG membership. Questions can be sent to the NetWork Facilitator who disseminates them across the NPAG membership. Responses are collated and returned to the originator and others who declare an interest in the question asked. NPAG Library The NPAG Library holds presentations from NPAG best value groups and conferences, together with policy and other documents sent in by members. Access to these items is via the NPAG NetWork Facilitator. NPAG Alerts The NPAG monitors websites and bulletins to identify health related news items and announcements that may be relevant to NPAG members. Alerts are circulated to BVG facilitators for them to pass on to the members of their BVGs, where considered appropriate. NPAG Website The NPAG website includes a private members Area for each of the NPAG BVGs. Through these sites, BVG members can access and download meeting agendas, minutes, presentations and survey forms. The areas are password protected.



NEW TO NPAG MEMBERS REFERRAL SCHEME AND DISCOUNTS NEW: Members Referral Fee – Introduce a friend and get 1 meeting for free. A member referral resulting in another Trust / Organisation registering for full membership of the same group will result in the referring member qualifying for a one meeting discount* The discount applies to the full membership fee only (not applicable to the 2nd member rate).The discount will be applied once, at the start of the current meeting round. Mid round membership referral discounts will be processed at the start of the following year’s membership round. Multiple referrals will result in multiple discounts up to four referrals per meeting round. *Equivalent to £137.50 for the Resilience Development Network. Second Club Membership - A 10% discount will be applied when an existing NPAG member joins an additional Group. This does not apply to the £185 second member rate.

FURTHER INFORMATION & CONTACT DETAILS For further information about the Resilience Development Network please contact Dale Atkins on 01245 544600 or e-mail: [email protected] For further information about the National Performance Advisory Group and its Benchmarking and Best Value activities, please contact the NPAG on: Telephone: 01245 544600 Fax: 01245 544610



The NPAG organises and facilitates a national network of Best Value Groups that enables members to share experience, identify good practice; innovation and information to assist individual managers develop their own service improvement action plans. For further information on NPAG Best Value Groups, please contact the following Best Value Group Facilitators: - Best Value Group NPAG Facilitator Contact Tel. No

Catering Services Terry Williams 01245 544600

Clinical Engineering North Richard Steventon 01282 694657

Clinical Engineering South Richard Steventon 01282 694657

Estates Services Tony Gent 01245 544600

Facilities (North) Tony Gent 01245 544600

Facilities (South) Roger D’Elia 01245 544600

Health Visiting & School Health Services Development Network

John King 01245 544600

National District Nurses Network Sue Hill 01245 544600

NHS Sustainability Lead Network John King 01245 544600

NHS Transport & Logistics Peter Richardson 01245 544600

Nursing & Temporary Staffing Dale Atkins 07801 374217

Occupational Health & Safety John King 01245 544600

Operating Theatres Services Paul Wilson 01245 544600

Patient Transport Services Network Roger D’Elia 01245 544600

Portering Services John Wigmore 01245 544600

Project Management Dale Atkins 07801 374217

Resilience Development Network Dale Atkins 07801 374217

Sterile Services Benchmarking Club Jo Kerrigan 01245 544 600

Telecomms John Wigmore 01245 544600

Waste Management Services Sue Berry 01245 544600

CPD Certification is a formal recognition of the contribution that BVG membership makes to members' continued professional/personal development. Members receive CPD certificates of attendance for all meetings attended during the year to evidence the contribution made as part of lifelong learning. For further information on the NPAG and our future activities, please contact Marie Cherry or Victoria Combes by telephone on 01245 544 600, or by e-mail on [email protected] or [email protected].



Available to all members of NPAG Benchmarking and Best Value Groups, and individual subscribers, the NPAG NetWork provides the facility for members to ask questions of any individuals, group or groups within the overall NPAG membership. The response to questions raised has been excellent. The NPAG NetWork provides a managed forum for colleagues to share information - saving time and money in not re-inventing the wheel! Questions raised in the past month have included the following topics: -

Pathology waste policy Facilities audit tool tools Decontamination of portable medical equipment Ward hairdressers Laundering Heat Labile items Fleet vehicle insurance Use of latex gloves Use of chute system for waste disposal

Thank you all who have responded! For full details of how to use the NPAG NetWork , please contact NPAG on 01245 544600, or e-mail: [email protected].

Forthcoming NPAG Events Please visit www.npag.org.uk for all our current course, workshops, training & BVG meetings. Telephone: 01245 544600 or email [email protected] or [email protected] Spring 2014 - Clinical Professional Development for Occupational Health Nurses (National & onsite)

• Pre Employment Clearance • Spirometry • Management of Physical Hazards • Audiometry • Sickness Absence Management Referrals • Health & Safety

Please contact Victoria Combes for details. Putting the Patient First – Customer Care and Commu nication Skills in the NHS Training Workshop A one day workshop for NHS professionals, reinforcing customer care best practice so that patients receive the best possible experience through our people, always Putting the Patient First:

• Understanding the impact of your own behaviour on others • How to handle challenging situations and people • Effective communication techniques • Understanding and managing patient expectations • Identifying how and why perceptions are formed • Proactive versus reactive behaviour • Demonstrating a positive attitude • Taking ownership

Please contact Paula Ellis to organise your on-site workshop.



REGISTRATION FORM

Resilience Development Network 2014

ORGANISATION ADDRESS

Type of organisation: NHS Social Enterprise Other PHONE NO. FAX NO.

Member 1 for a £415 fee (3 meetings) Additional Member/s £185

NAME POSITION EMAIL SPECIAL REQUIREMENTS (Dietary/Access)

Reservations Invoicing Please send completed booking form to: If the invoice address is different from that (Photocopies acceptable) above please enter address below National Performance Advisory Group 87 Coval Lane Chelmsford Essex, CM1 1TQ Tel: 01245 544600 Fax: 01245 544610 Email: [email protected] www.npag.org.uk

BOOKING CONDITIONS: A VAT invoice will be issued. VAT Registration No. 654 9195 01. VAT applies to any NHS organisation outside England and to any non-NHS organisation.

Payment is due on receipt of invoice. DO NOT send payment in advance of receipt of invoice. When invoice is received, payment should be made to ‘East of England Ambulance Service NHS Trust.’

ALL cancellations must be in writing. Cancellations received up to 2 weeks before the date of the first meeting will receive a full refund less an administration charge of £100. After this date refunds cannot be made. A substitute is acceptable. NPAG cannot be held responsible for any travel expenses or accommodation costs in the event of a cancellation or postponement of a meeting, workshop or an event. A 10% discount will be applied when an existing NPAG member joins an additional Group. This does not apply to the £185 second member rate.

I confirm that I have read and accept the above BOO KING CONDITIONS and would like to register as a member of the Resilience Development Network. Pleas e invoice me for payment. Authorisation Signature ………………………… Your Order Number ………………………………….

Telephone: 01245 544600 Fax: 01245 544610 …...Aside from the first meeting of the next round which...

Documents

Transcript of Telephone: 01245 544600 Fax: 01245 544610 …...Aside from the first meeting of the next round which...