Major Incident Plan. Valid on date of print only Page 1 of 32

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1 Major Incident Plan Status: ratified Originating Date: June 2009 Date Ratified: June 2009 Next review Date: June 2010 Accountable Director: Director of Nursing Governance and Performance Policy Author: Head of Business Continuity Valid on date of print only Page 1 of 32

2 Page 1 Introduction 3 Flowchart for the declaration of an internal major incident 4 Flowchart for the declaration of an external major 5 incident declared by partner agency Decision to Declare a Major Incident 6 Action card one: Major Incident Room activation 7 procedure Action card two: Role of the Major Incident Room 12 Controller/Director on call Action card three: key organisational contact numbers 14 2 Background information Legal obligations NHS Major Incident Command and Control Hour Alerting Capability Major Incident Room Stand Down Dealing with the Media 20 3 Implementation and Compliance 22 4 Distribution 23 5 Reference documents 24 6 Review 25 Appendix one Appendix two Roles and responsibilities of responding agencies 26 Major Incident Room specification 29 Valid on date of print only Page 2 of 32

3 1. introduction If you are reading this because there is a major incident go straight to the flow charts on pages four and five, and use the action cards that follow The emergency services, NHS services, local authority departments and voluntary organisations must have plans to be able to respond to a large scale emergency 24 hours a day, 365 days a year. This Major Incident Plan will ensure that any major incident, internal or external, can be dealt with in an effective manner. Major incidents are rare and can take many forms. The effects of a major incident may be complex and unpredictable. This plan is intended to be flexible to suit a range of circumstances. The plan has information to ensure that 5 Boroughs Partnership NHS Trust s approach to emergency planning is in line with the principles of integrated emergency management. The Chief Executive of the Trust has responsibility for ensuring that the Trust is able to respond to the major incidents identified in this plan. The plan has been prepared in accordance with the Civil Contingencies Act (2004) and the NHS Emergency Planning Guidance (2005) and associated documents. It is prepared and published to indicate the responsibilities and actions of the staff working for the Trust. The plan cannot be completely prescriptive as there are a variety of incidents that could affect the Trust, and a variety of ways that each incident can develop and resolve. Senior and experienced key personnel will be expected to interpret the Major Incident Plan as circumstances dictate. This plan sits alongside the Pandemic Flu Plan (Revised December 2008), and the winter and heatwave plans. It will also link firmly with the Business Continuity plans which will be developed in the summer of These plans are supported by existing Trust policies and procedures, which are designed to ensure sound governance, compliance with legal requirements and safe practice. This plan is under constant review. Any correspondence requesting changes to the plan should be addressed to the Head of Business Continuity, Hollins Park House, Hollins Lane, Winwick, Warrington WA2 8WA Valid on date of print only Page 3 of 32

4 Internal incident Contact from switchboard Flowchart for the declaration of an internal major incident E.g. Hostage Fire Flood Can I manage request with existing resources? See page 6 Yes No Manage Incident Declare Major Incident Review Open Major Incident Room Stand down Follow action card one, page 7 Valid on date of print only Page 4 of 32

5 Flowchart for the declaration of an external major incident declared by partner agency External incident E.g. Plane crash Terrorist incident Large scale chemical spillage Contact from switchboard Request to open Major Incident Room Request to stand by Follow action card one, page 7 Inform switchboard and stand by phone Valid on date of print only Page 5 of 32

6 Decision to declare a major incident Internal declaration The decision to declare a major incident for the Trust will be made by the Chief Executive or the most senior person on site in his absence (normal working hours), or the Director on call (out of hours). This may be a lone decision, or follow consultation with senior colleagues, and first on call manager. The criteria for declaration is based on the NHS definition Any occurrence [which] require[s] special arrangements to be implemented. The question to ask is Can I manage the incident with the existing resources? If the answer is yes, there are no special arrangements to be made, and it therefore follows that the incident is not major. If the answer is no, then it follows that a major incident should be declared, the major incident room opened and the major incident team assembled. This will ensure that both the demands of normal business and the demands of the incident can be met. External declaration The Trust may be asked to open the Major Incident Room in order to support others involved in a local major incident. The nature and extent of support required will be dictated by the local incident command and control team via the lead PCT. Valid on date of print only Page 6 of 32

7 action card one. Major incident room activation procedure Be CLEAR and COMPREHENSIVE when giving instruction A. Preparation phase 1. Pick up your mobile and charger and take it with you. 2. Ensure you have your identity badge. 3. Make a note of who alerted you and the decisions you have made. 4. Record times and contact details. 5. Liaise with first on call, and decide who is a priority for switchboard to get hold of first. Use generic prompt list at the end of this action card. 6. Normal working hours. Contact Education Centre ( ) and instruct them to clear Lecture Room three if it is being used for training. 7. Out of hours. Confirm with switchboard that you are coming in, and instruct them to send porter over to open up and wait for you at the Education Centre Entrance to Hollins Park House. 8. Instruct switchboard to send porter over with Major Incident Room store cupboard keys and room access code. 9. Instruct switchboard to call staff as per agreement in step 5 above. B. Access phase 1. Normal Working Hours go to the Major Incident Room. 2. Out of Hours meet the porter at the Education Centre Entrance at Hollins Park House. 3. Ask porter to erect sign at Main Entrance to Hollins Park House directing all staff to the Education Centre Entrance. The sign is in the Major Incident Room cupboard. 4. Check whether anybody else has arrived. 5. Ensure Major Incident Room and break out rooms are unlocked Valid on date of print only Page 7 of 32

8 6. Ensure porter stays at HPH Education Centre Entrance to admit members of the major incident team as they arrive. C. Call in personnel 1. Contact Chief Executive, all Directors and Assistant Director of Communications. As Major Incident Room controller, determine which directors are required to: Come in Stand by Be contacted for information only 2. Confirm with those not required to attend that they may be called at a later stage of the incident should they be needed. 3. Where possible, the Director of Nursing, Governance and Performance and the Director of Operations should attend. It is recognised that those not on call will need to declare if they are fit and able to attend. If not, they are to suggest someone to act on their behalf. 4. Check with switchboard who they have contacted, who is coming in and estimated time of arrival. 5. Inform porter so he knows who to expect. D. Open up Major Incident Room See appendix two for specification (page 29) and layout (page 32) 1. Open up major incident cupboard and follow deployment instructions. 2. Start a formal record of calls, decisions and actions. This to be known as the log. 3. Clear tables to make working space. 4. External activation. If asked to set up Major Incident Room by a particular PCT, contact them to confirm that the room is operational. For phone numbers see action card three (page 14). 5. Internal activation. Contact Director on call of relevant PCT. For phone numbers see action card three (page 14). Be clear whether this is for information only, or whether you want them to do something. 6. In addition, contact NHS Knowsley as they act as lead PCT as per Merseyside Command and Control plan. For phone numbers see action card three (page 14). Be clear whether this is for information only, or whether you want them to do something. Switchboard have the numbers. Valid on date of print only Page 8 of 32

9 E. Review phase 1. Is there anybody else who should be brought in to help? Use generic prompt list at the end of this action card. 2. Does the incident still merit the major incident team, or can it now be managed within existing resources? If so, move on to the stand down phase. F. Stand down phase 1. Internal. Stand team down, ensure normal operational management know they are responsible for recovery phase, and inform relevant PCT and NHS Knowsley that the incident is over. 2. Finalise log. 3. Inform switchboard that the Major Incident Room team is being stood down. 4. Conduct brief review of the incident (hot debrief) to capture immediate learning points and concerns. 5. Tidy room and note use of resources that will need replacing. 6. Repack Major Incident Room cupboard. 7. Ensure room is tidy and no confidential papers are left behind. 8. Ensure switchboard organise porter to relock the building, and that all is secure. 9. External. When the PCT informs you that the incident is over, stand team down. 10. Follow steps 2-8 above. Valid on date of print only Page 9 of 32

10 Generic prompt list. Who is required to attend will depend on the nature of the major incident. Contact details of Senior Managers are retained by switchboard. All managers have been asked to obtain and retain the contact details of all members of their team. People Admin and clerical support Communications team Director colleagues Assistant Director colleagues Drivers Head of Business Continuity Health and Safety advice Mental Health Act advice People with local, clinical, or geographical knowledge Relief team Runners Security Specialist advice e.g. estates or information technology Places Alternative accommodation for staff and/or patients Helicopter landing site Marked out parking Media briefing points Rendezvous point for staff Security Equipment Camera Clothing/hard hats/safety shoes Food and drink Fuel Mattresses and blankets Minibuses Mobile catering More phones Remote power Vans Media Briefing room Power Rendezvous point Security External support Acute Trust support Ambulance Council rest centres Fire and Rescue Valid on date of print only Page 10 of 32

11 Mental Health Trust support PCT support Police Social Services Utilities advice Valid on date of print only Page 11 of 32

12 action card two. Role of the Major Incident Room Controller/Director on call Role: to set up an appropriate level of response 1 Keep a record of all messages received or given. Use the log sheets as per example log sheet at the end of this action card. Supplies are in the Major Incident Room cupboard. Record each event with: Running number Date/ time Name of caller Contact details 'phone/ fax Outline of message Actions taken 2 Manage the incident Chair a meeting of the major incident management team and support staff Confirm details of the incident and who is dealing with the various issues. Confirm roles of command team members and support staff Confirm message handling and log keeping system Confirm communications arrangements Internally with bronze command Externally with PCT Confirm arrangements for briefing Chief Executive and Trust Management Team (acting as Trust Gold Command) 4 Review progress Monitor actions being taken and development of incident Draw up plans for identification and deployment of relief teams if the incident looks like lasting more than 4 hours In consultation with control team, consider standing down when the continued management of the incident can be met within existing resources 5 Stand down Stand down team when decision is made that the incident is over Close major incident room as per action card one: Major Incident Room activation procedure Valid on date of print only Page 12 of 32

13 Log sheet Sheet of No Date/ time Caller Contact details Outline of message Actions taken Valid on date of print only Page 13 of 32

14 action card three. Key organisational contact numbers Hospital switchboards (all have 24 hour switchboard) Halton Hospital Hollins Park Hospital Leigh Infirmary / Royal Albert Edward Infirmary Warrington Hospital Whiston Hospital SHA/PCT numbers NHS North West (SHA Director on Call) NHS Ashton Leigh and Wigan NHS Halton and St Helens NHS Knowsley NHS Warrington Office hours Out of hours Local Authority numbers (all have 24 hour switchboard) Halton Borough Council Knowsley Council St Helens Council Warrington Borough Council /Out of hours Wigan Council Valid on date of print only Page 14 of 32

15 2. Background information 2.1 Legal obligations The Civil Contingencies Act divides organisations into two categories, in terms of their response to the demands of a major incident. They are known as category one or category two responders. Category one responders are likely to be at the core of the immediate response to most emergencies, and include Acute Trusts and Primary Care Trusts (PCTs). Category two responders are less likely to be involved in an immediate response, but will be heavily involved in preparing for incidents affecting their sectors. The Act requires them to co-operate and share information with other Category one and two responders. Mental Health Trusts are category two responders, and therefore there is a legal requirement to prepare, co-operate and respond to incidents that would have a detrimental effect on the Trust s ability to carry out its core functions. 2.2 NHS major incident The National Health Service (NHS) definition of a major or critical incident is: Any occurrence which presents a serious threat to the health of the community, disruption to the service, or causes (or is likely to cause) such numbers or types of casualties as to require special arrangements to be implemented by Hospitals, Ambulance Services or Health Authorities. This plan covers three categories of major incident: a major incident affecting the local community, such as a major road traffic accident or chemical spillage a major incident which affects the health services in the area, such as a serious fire on a hospital site a major incident which threatens the continuity of key 5 Boroughs Partnership NHS Trust services, such as the need to evacuate one of the Trust s sites Valid on date of print only Page 15 of 32

16 A major incident will require resources over and above the normal day-to-day provision. There may be many casualties, many evacuees, many people affected by the trauma of such an incident. At such times, priorities for the emergency services and others are to save lives, place people in a safe refuge away from danger and to provide them with the basic essentials of warmth, clothing, food and rest. Statutory and voluntary organisations have special plans to deal with major incidents so that joint working can be achieved. Dealing with a major incident in an effective manner requires the co-operation of the emergency services, NHS, Local Authorities and voluntary agencies. Shared knowledge and resources and a joint approach will bring a major incident to a successful conclusion. For this to happen in practice requires an understanding by all services and agencies of their own and each other s roles and responsibilities at such times. See appendix one (page 26) for a full breakdown of specific roles and responsibilities. 2.3 Command and control Gold, Silver and Bronze are levels of command adopted by each of the Emergency Services. Gold is the strategic level of command. The officer designated as having overall command is known as the Gold Commander and the support necessary to undertake this function is known as Gold Control. It does not exercise operational control of the incident but evaluates developments and seeks to maintain a wide overview of policy. Logistics and other functions in support of Silver are a function of this level of command. Silver is the tactical level of command. The Silver Commander is the Incident Officer responsible for the operational management of the incident. The location of Silver Control will always remain a matter of judgement based upon the circumstances of the incident but will normally be near the scene of the incident. Bronze is the operational level of command appointed by Silver to undertake the control of particular aspects of a disaster, and to manage the incident on site. Valid on date of print only Page 16 of 32

17 Command and control: internal incident Gold Control. The Trust Management Team will act as Gold Control, to maintain a strategic view of the incident. Briefing arrangements will be determined as in action card two, point two (page 12) Silver Control. The Major Incident Team in the Major Incident Room will act as Silver Control. They will detail staff to act as bronze controls appropriate to the nature of the incident. The seniority and experience of the Director and first on call managers will be deployed. If the incident involves the Child and Adolescent Mental Health service, the relevant Assistant Director and Head of Service would be higher up the call in list than others, and similarly if the incident affected services in Halton, the relevant Assistant Director and Head of Service would be at the top of the list to maximise local experience and intelligence. However, it is recognised that not all those on the call in list would be available, hence others on the list will be called until sufficient staff have been contacted and can attend. Bronze Control. This will be led by a Head of Service or Assistant Director, and be responsible for on site management of the incident. Command and control: external incident The Trust falls into three Local Resilience Forum areas. A Local Resilience Forum is the vehicle for risk assessment and emergency planning in a defined geographical area, generally based on police force boundaries. It has been agreed with the Strategic Health Authority that the Trust will link in with NHS Liverpool representing the other lead PCTs for monitoring and reporting purposes. Therefore the Merseyside Lead PCT Function Activation Plan for major incidents requiring co-ordination and mutual aid between NHS organisations and key partners (Oct 2008) applies. When this plan is invoked, NHS Knowsley will be acting as silver command for the Trust. Contact numbers are listed on action card three, (page 14). Valid on date of print only Page 17 of 32

18 Strategic Co-ordinating Group SHA NWAS Public Health Health Protection Agency NHS Gold Commander At SCG Liverpool PCT Knowsley PCT Halton and St Helens PCT Sefton PCT Wirral PCT Liverpool PCT Provider Services Knowsley And St Helens Teaching Hospital Southport And Ormskirk Hospital Wirral University Teaching Hospital Royal Hospital Broadgreen Hospital 5 Boroughs Partnership NHS Trust Aintree Hospital Clatterbridge Oncology Heart And Chest Hospital Mersey Care Walton Neurology Cheshire And Wirral Partnership Alder Hey Children s Hospital Women s Hospital If the Merseyside plan is not invoked, because the incident is local to one PCT area, it may be that the Trust is asked to open the Major Incident Room by that PCT. In this case, the command and control link would be with that PCT. NHS Knowsley should also be informed as in action card one, section D.6 (page 8) hour alerting capability The Trust operates an out of hours on call system for both internal and external contacts. There is a tried and tested on call procedure for staff who wish to contact a Senior Manager out of hours. Internal incident Normal working hours (Monday to Friday, 9am to 5 pm) The Trust would be alerted by staff should there be an internal incident. Staff would contact their manager who would report up the line of accountability should the incident merit more senior attention. This is up to and including the Chief Executive (or most senior officer on site in his absence). This process is supported by the fast track incident reporting mechanism and media policy. Valid on date of print only Page 18 of 32

19 Outside normal working hours (Friday 5pm to Monday 9am, including bank holidays and public holidays) On call arrangements apply for contacting first on call manager or Director on call. The on call system is operated by Hollins Park switchboard who can be contacted on External incident Normal working hours (Monday to Friday, 9am to 5 pm) External contact details are held by sister Trusts and PCTs, and they would contact the Chief Executive s Office in the event of a major incident for which they are requesting help. Outside normal working hours (Friday 5pm to Monday 9am, including bank holidays and public holidays) External contact details are held by sister Trusts and PCTs, and they would contact the switchboard and ask for the Director on call in the event of a major incident for which they are requesting help. 2.5 Major incident room The purpose of the major incident room is to provide a dedicated and equipped space from which to manage the incident. See appendix two (page 29) Major Incident Management Team The Chief Executive or nominated deputy will lead the Major Incident Management Team. Their roles are: Executive authority policy making direction and control Co-ordination of resources Establishment of priorities Action cards Action card one. Major incident room activation procedure (page 7) Action card two. Role of the Major incident room Controller/Director on call (page 12) Action card three. Key organisational contact numbers (page 14) Valid on date of print only Page 19 of 32

20 2.6 Stand down Internal The major incident controller will decide when the incident has been managed to a position where continuing management can be supported from within normal day to day resources. S/he will be mindful of recovery issues, which may need to managed by the major incident team until they are sufficiently controlled to be handed back to the day to day operational management team. The Trust major incident controller will then notify the major incident team, and operational managers that the incident is over. The major incident controller will also inform the relevant PCT. External Notice to stand down at the end of the incident will come from NHS Knowsley acting as the lead PCT within the Merseyside Command and Control agreement (2.3, page 16), or whichever local PCT activated the major incident. The Trust Major Incident Controller will then notify the major incident team, and normal operational managers that the incident is over. Debrief The major incident controller will hold an immediate review of the incident (hot debrief) to record immediate issues and lessons. A further review (cold debrief) will be held within a month, to draw up a measured and reflective list of learning points and action notes. The Trust will also be represented at external debriefs if applicable, and invite external partners to the internal debrief. 2.7 Dealing with the media It may at some stage be necessary to ask for announcements to the public to be relayed over local radio or TV. It is important that this is well co-ordinated. All enquiries should be handled in line with Trust Media Policy. The Major Incident Controller needs to determine at an early stage whether a member of the Trust Communications Team needs to be included in the silver control team. In the event of any incident, the press/media are likely to be on the scene or attending at NHS premises seeking information at an early stage. The level of interest will depend on the nature and scale of the incident. Valid on date of print only Page 20 of 32

21 The police will have a Press Liaison Officer, available through their Silver Control, who will be responsible for briefing and co-ordinating/handling press/media enquiries regarding the incident. It is essential that this person liaises with the Trust Communications representative and be given all the relevant information to ensure a co-ordinated response to the media in line with the Trust s Media Policy. Valid on date of print only Page 21 of 32

22 3. Implementation and compliance All staff are bound by the measures and procedures outlined in this major incident plan. Major incident room A familiarisation programme for those who will be needed in the major incident room has been developed. This will be repeated for new starters who may be required in the incident management team. Exercises will be run as per the Business Continuity workstream agreed at The Management Team meeting in January This will include internal tests in the first instance, but also exercises involving partners. The Trust will also take advantage of exercises run by partners within the three Local Resilience Forum areas. This plan and supporting action cards will be reviewed and amended in the light of lessons learned from exercises or incidents. Valid on date of print only Page 22 of 32

23 4. distribution The plan is available on the intranet at and an edited version is on the internet at [URL to be completed when documents are uploaded] Copies sent to Chief Executive Chairman Directors and first on call Assistant Directors Heads of Service Switchboard In addition, a hard copy is included in the Major Incident Room equipment cupboard. The following external partners have also been sent a copy: PCTs NHS Bolton in their capacity as the lead PCT for emergency planning in Greater Manchester NHS Liverpool in their capacity as the lead PCT for emergency planning in Merseyside NHS Western Cheshire in their capacity as the lead PCT for emergency planning in Halton and Cheshire NHS Ashton Leigh and Wigan NHS Halton and St Helens NHS Knowsley NHS Warrington Acute Trusts St Helens and Knowsley Teaching Hosptials NHS Foundation Trust Warrington and Halton Hospitals NHS Foundation Trust Wrightington Wigan and Leigh NHS Foundation Trust Local Authorities Halton Borough Council Knowsley Council St Helens Council Warrington Borough Council Wigan Council Valid on date of print only Page 23 of 32

24 5. reference documents DH (2005) Emergency Preparedness Division: The NHS Emergency Planning Guidance National Audit Office (2002) Facing the Challenge: NHS Emergency Planning in England HM Government: Emergency Preparedness: guidance on Part 1 of the Civil Contingencies Act (2004) its associated Regulations and non-statutory arrangements HM Government Emergency Response and Recovery: Non-statutory guidance to complement Emergency Preparedness UK Government Capabilities Programme UK Resilience Website Department of Health (2004) Beyond a Major Incident Department of Health (2002) Getting Ahead of the Curve Home Office: Strategic National Guidance for the Decontamination of People Exposed to Chemical, Biological, Radiological and Nuclear Substances or Materials The Health Care Standards Unit website The Needs of Faith Communities in Major Emergencies: Some Guidelines Department of Health (2007) Strategic Command Arrangement for the NHS During a Major Incident Valid on date of print only Page 24 of 32

25 6. review The major incident plan will be reviewed annually in May, or earlier in the light of significant learning points from exercises or incidents. It will be tested by an unannounced exercise during the year. Valid on date of print only Page 25 of 32

26 appendix one: roles and responsibilities of responding agencies Control structure Gold, Silver and Bronze are levels of command adopted by each of the Emergency Services. It should be understood that the titles do not convey seniority of service or rank but describe the function carried out at that level. Gold is the strategic level of command. Silver is the tactical level of command. Bronze is the operational level of command. Police The saving of life Co-ordination of the multi-agency response To secure, protect and preserve the scene. Control sightseers and traffic using cordons. The investigation of the incident and obtaining evidence The collation and dissemination of casualty information The identification of the dead on behalf of HM Coroner Short term measures to restore normality Fire and Rescue Service Life-saving through search and rescue Fire fighting and fire prevention Decontamination in partnership with the Ambulance Service Rendering humanitarian services Provide and/or obtain specialist advice and assistance where hazardous materials are involved The provision of specialist equipment, e.g. pumps and lighting Safety management within the inner cordon or rescue zone Valid on date of print only Page 26 of 32

27 H.M. Coastguard Co-ordination of incidents below high water mark Call out of Royal National Lifeboat Institute to effect rescue on coastal and inland waters Call out of Royal Air Force. Search and Rescue helicopters. Local Authorities Setting up emergency control centre Environmental health Signage and barriers Salvage, damage control, environmental control Call out voluntary agencies Co-ordination of psychological support Assist Police with evacuations by providing o transport o rest centres o staff Ambulance Service To save life in conjunction with the other emergency services To provide treatment, stabilisation and care of those injured at the scene To establish effective triage points and systems To provide an incident control and communications point at the scene for all NHS and other Medical resources To nominate and alert the receiving hospitals To alert the on-call Consultant in Communicable Disease Control (CCDC) at the Health Protection Agency To provide transport to the incident for the Medical Incident Officer (MIO), mobile medical/surgical teams and their equipment Decontamination in partnership with the Fire and Rescue Service Acute Trusts Maintain essential Trust Services Receive casualties Prevent, where possible and appropriate, admissions to Accident and Emergency If necessary, decontaminate self-referrals Provide isolation facilities If necessary liaise with Primary Care Trusts to activate the early release procedure Valid on date of print only Page 27 of 32

28 Non Acute Trusts Maintain existing services Offer mutual aid to neighbouring NHS Trusts Offer access to specialist and technical staff as appropriate Provide logistical support where necessary Health Protection Agency Provide initial response for Primary Care Trust via on-call Consultant in Communicable Disease Control (CCDC) If necessary, set up Health Protection Agency major incident room Arrange for CCDC to attend at appropriate emergency centres. If necessary chair Scientific and Technical Advice Cell Primary Care Trusts Maintenance of essential Trust Services Support to Hospital Trusts including activation of the early release procedure Support Health Protection Agency response Direct care and advice to people affected Care in community settings Social and psychological care in conjunction with Social Services Health screening and continuing care Information and advice to the public (self-referrals) Valid on date of print only Page 28 of 32

29 appendix two: Major Incident Room specification Main contact Phone numbers dedicated lines Rooms See plan on page 32 Primary room Lecture Room three in the Education Centre, Hollins Park site. The room is already equipped with: Chairs Computer Digital lock on the door (code with switchboard and listed in major incident room cupboard) Flip chart easels Projector Tables Television Whiteboards Break out room The Information Technology suite next door will be used as a break out room. Briefing room Lecture room one will be used as a briefing room for press, public or staff. The locked cupboard outside Lecture Room 3 contains the equipment listed below, plus instructions on deployment: Major incident room equipment 4 phones Blackberry mobile phone charger Blutack Digital radio Valid on date of print only Page 29 of 32

30 Door signs Fax machine Flip chart pack Main entrance divert sign Maps Master key Packs of flip chart pens Pens Valid on date of print only Page 30 of 32

31 Backup room Agreement has been reached with NHS Halton and St Helens to use their Major Incident Room. In return they will use our primary room if theirs are out of commission. NHS Halton and St Helens were chosen as they have Major Incident Rooms in both St Helens and Runcorn. If the major incident affecting 5 Boroughs Partnership was on the Hollins Park site, and the principal room was out of action, it is likely that NHS Warrington would have activated their room as the incident is in their PCT area. However, NHS Halton and St Helens are less likely to do so in that scenario. Valid on date of print only Page 31 of 32

32 HOLLINS PARK HOUSE GROUND FLOOR PLAN Valid on date of print only Page 32 of 32