NOT PROTECTIVELY MARKED Pandemic Influenza Plan 2015/2016 Policy number: N/A Version 1.5 Approved by Name of author/originator Owner (director) Executive Management Team Mark Twomey, Deputy Director of Governance and Compliance Jonathan Inglesfield, Medical Director Date of approval 24 November 2015 Date of last review December 2014 Next due for review November 2016 Who can invoke the plan When Who notified? The Chair At any time On Call Manager & Chief Executive The Chief Executive At any time On Call Manager & Chair The On-Call Manager Following an incident EMT 2015/16 GWCCG Pandemic Influenza Plan 1
STOP IF A MAJOR INCIDENT HAS BEEN DECLARED AND YOU ARE READING THIS PLAN FOR THE FIRST TIME, DO NOT CONTINUE MAKE SURE YOU HAVE YOUR ON CALL PACK TO HAND ASSESS SITUATION, BACKGROUND AND ACTION GO DIRECTLY TO THE ACTION CARD SECTION OF THE EMERGENCY PLAN SEEK OUT YOUR ACTION CARD AND FOLLOW IT IF YOU DO NOT HAVE AN ACTION CARD THEN AWAIT FURTHER INSTRUCTIONS FROM YOUR MANAGER DO NOT CALL THE SWITCHBOARDS OF THE CCG OR ACUTE HOSPITAL TRUST FOLLOW ANY EVACUATION PROCEDURES AS DIRECTED ENSURE THAT YOUR MANAGER AND WORK COLLEAGUES HAVE A CONTACT NUMBER FOR YOU AND THAT YOU ARE ABLE TO CONTACT THEM DO NOT GO TO THE INCIDENT CONTROL CENTRE UNLESS YOU HAVE BEEN INFORMED TO DO SO BY ON CALL MANAGER KEEP YOUR ID CARD ON YOU AT ALL TIMES 2015/16 GWCCG Pandemic Influenza Plan 2
Version control sheet Version Date Author Status Comment 1.0 December 2014 Samantha Chalmers Draft Outline plan only 1.1 February 2015 Mark Twomey Draft Updated following meeting with NHS England EPRR Lead 1.2 March 2015 Mark Twomey / Danny Bailey 1.3 March 2015 Mark Twomey / Danny Bailey Draft Final Following comments and feedback from Clinical Commissioning and Director of Contracts Following approval at EMT 1.4 November 2015 1.5 December 2015 Mark Twomey Draft Following staff changes and EP Exercise in October 2015 Mark Twomey Final Approved at Governing Body November 2015 2015/16 GWCCG Pandemic Influenza Plan 3
Equality statement NHS Guildford and Waverley aims to design and implement services, policies and measures that meet the diverse needs of our service, population and workforce, ensuring that none are placed at a disadvantage over others. We take into account the Human Rights Act 1998 and promote equal opportunities for all. This document has been assessed to ensure that no employee receives less favourable treatment on the protected characteristics of their age, disability, sex (gender), gender reassignment, sexual orientation, marriage and civil partnership, race, religion or belief, pregnancy and maternity. Members of staff, volunteers or members of the public may request assistance with this policy if they have particular needs. If the member of staff has language difficulties and difficulty in understanding this policy, the use of an interpreter will be considered. We embrace the four staff pledges in the NHS Constitution. This policy is consistent with these pledges. The Equality Impact Assessment has been completed and attached however this will need to be reviewed at point of outbreak to ensure any situational dynamics are addressed. 2015/16 GWCCG Pandemic Influenza Plan 4
Contents STOP... 2 Contents... 5 1 Introduction... 6 2 Scope... 6 3 Roles and responsibilities... 7 3.1 Pandemic influenza lead... 7 3.2 CCG on call managers... 7 3.3 CCG duties and responsibilities (preparation for a pandemic)... 7 3.4 Review of the plan... 8 4 Triggers, activation and escalation... 9 4.1 Triggers...Error! Bookmark not defined. 4.2 Activation... 9 4.3 Recording decisions... 9 4.4 Capacity and resilience management (escalation)... 9 4.5 CCG business continuity arrangements for staff absence (including flu)... 9 4.6 Commissioned arrangements... 10 5 After the event (post pandemic responsibilities)... 11 6 Appendix A Decision log... 14 7 Appendix B Action Card 6...Error! Bookmark not defined. 2015/16 GWCCG Pandemic Influenza Plan 5
1 Introduction The top rated risk in 2015/16 for the country is pandemic flu. The most significant risk for the organisation is the dependence on a small pool of staff and the specialist skills and knowledge required to undertake the day to day business of the organisation. This plan is to be used to assist in the continuity and recovery of NHS Guildford and Waverley Clinical Commissioning Group (CCG) and the provider services that are commissioned by the CCG in the event of an outbreak of pandemic influenza (pan flu). This plan is not intended to replicate or replace national strategy 1 and guidance 2 and should be read in conjunction with these documents. The plan details response functions and arrangements It complements existing arrangements for escalation and winter planning and also compliments the Business Continuity Plans It must be read in conjunction with the Surrey Local Resilience Forum (SLRF) and providers plans The impact of a pandemic on health and social care services will vary according to the nature of the virus and its effects on the population. This plan should be used in conjunction the business continuity plan and the surge and Capacity plan. 2 Scope The primary audience of this document is Emergency Preparedness, Resilience and Response (EPRR) leads, including the On-Call Managers; however the wider multiagency and health resilience partnership will find it useful to understand the role of CCGs in pandemic preparedness and response. The plan documents the roles and responsibilities of the CCG in the preparation and mobilisation of the Surrey health economy resources specific to Guildford and Waverley to respond to a flu pandemic that has significant impact on routine services and/or require additional resources to implement effective control measures The plan also builds on the Surrey Local Health Resilience Partnership organisations individual pandemic influenza response plans The Guildford and Waverly CCG Surge and Capacity plan and business continuity plans provide a process for dealing with day to day management of seasonal flu or other winter pressures. 1 Department of Health (2011) UK Influenza Pandemic Preparedness Strategy 2 Department of Health (2011) Health and Social Care influenza Pandemic Preparedness and Response 2015/16 GWCCG Pandemic Influenza Plan 6
3 Roles and responsibilities 3.1 Pandemic influenza lead The pan flu lead is responsible for ensuring that the CCG has complied with the NHS England guidance and with national strategy for the management pandemic influenza. The pan flu lead for the CCG is the Medical Director. 3.2 CCG on call managers The Chief Executive has delegated the authority to respond to an influenza pandemic to the on call managers. They have the authority to activate the CCG s emergency and business continuity plans and to liaise with the Local Health Resilience Partners and other category 1 and category 2 responders on behalf of the CCG. 3.3 CCG duties and responsibilities (preparation for a pandemic) The primary responsibilities of the CCG are to ensure that the CCG continues to function if there is a pandemic, to ensure that the services that the CCG commissions continue to function if there is a pandemic and to provide support to NHS England. The duties of the CCG before, during and after an influenza pandemic are set out in the NHS England guidance (NHSE) gateway 00857. The specific duties of the CCG to prepare for a pandemic are: Specific duty Identify a Pandemic Influenza Executive Lead (likely to be the AEO) to lead internal organisational pandemic planning activities in light of national and international developments, advice and guidance Undertake internal business continuity planning in the context of pandemic influenza Communicate plans with employees, contractors, and affiliated organisations Participate in relevant planning groups to discuss, plan, exercise and share best practice Ensure early engagement of communications professionals to devise, deliver and maintain internal, external and stakeholder/ cross-partnership communications before, during and after a pandemic Work with their commissioned service providers, in planning for surge in relation to elective work and Current provision Jonathan Inglesfield, Medical Director Business Continuity policy and template plan inclusive of Pan flu Redacted BC policy available on website and copies sent to LRF Regular attendance at LHRP and operational group Communicationss strategy used in capacity and resilience plan resilience plan to set out 2015/16 GWCCG Pandemic Influenza Plan 7
the possible financial implications if there is ongoing disruption to normal service levels over the period of a pandemic and its recovery phase Participate in appropriate assurance processes regarding their arrangements and be assured that their commissioned services have adequate provisions in place for managing a pandemic detail (see section 3.4) Business Continuity Plans are a requirement of all NHS Funded organisations. NHSE assurance exercise 2015/16 3.4 Contractual arrangements 3.4.1 All NHS Funded organisations are required to have and maintain organisational business continuity plans as part of the NHS Standard Contract. 3.4.2 The assurance around business continuity arrangements and all other areas of the EPRR assurance requirements are reviewed at least annually through the Surrey Local Health Resilience Partnership to ensure a co-ordinated approach across the system 3.5 Review of the plan 3.5.1 The plan will be reviewed annually and also following any exercises undertaken or any significant organisational changes. 3.5.2 Amendments to the plan will be approved by the Executive Management Team. 3.5.3 This plan will be audited for effectiveness at least once per year. 2015/16 GWCCG Pandemic Influenza Plan 8
4 Activation and escalation 4.1 Activation The plan can be activated by the Chief Officer or the Chair at any time if an influenza pandemic is declared. It may also be activated by the on call manager with or without reference to the pan flu lead. The plan should be activated by the on-call manager as soon as possible after an influenza pandemic has been declared by any partner agency (including but not limited to NHS England, Public Health England, the Directors of Public Health or any designated representative of the Department of Health or Cabinet Office Briefing Rooms). 4.2 Recording decisions All decisions made and actions taken should be recorded using the template in appendix A. 4.3 Capacity and resilience management (escalation) The operational capacity and resilience management plan ( winter or surge and escalation plan) sets out the specific mechanisms by which the CCG and the provider organisations will respond to and escalate to the operational capacity issues that the local health economy may experience as a result of reduced staffing due to pan flu. The relevant organisational capacity and resilience plans should be read in conjunction with this plan. 4.4 CCG business continuity arrangements for staff absence (including flu) NB: Refer to the sickness absence policy and review Action Card 6 in the business continuity plan (attached as appendix B). Staff absence (including flu) Risk: Very High Action Outcome Lead Completion date 1 Identify staff with specialist skills for agency or interim cover 2 Enable all other staff to work from home by providing remote access to secure systems, as All specialist roles required for business continuity are covered by agency or interim staff Reduced risk of staff contracting flu Chief Officer or senior decision maker Line manager or senior decision Within 8 hours of incident Within 24 hours of incident CO sign off Y/N Y N 2015/16 GWCCG Pandemic Influenza Plan 9
appropriate maker 3 Apply remote workers policy Ensure staff are protected and supported Line manager or senior decision maker Within 24 hours of incident N 4 Review every 24 hours for continuity and organisational effectiveness Full operational effectiveness Chief Officer or senior decision maker Within 24 hours of incident Y 5 Alert NHS England and other key stakeholders of organisational status Comply with EPRR requirements for Cat 2 responder Chief Officer or senior decision maker Within 24 hours of incident Y 4.5 Arrangements for managing the pandemic (during an outbreak) The majority of the operational requirements to manage a pandemic influenza outbreak are detailed in the operational capacity and resilience plan and on call arrangements for the CCG. Specific duty Work with NHS England Regional and Area Teams to identify appropriate local providers to support the delivery of a pandemic influenza response, particularly regarding the provision of antiviral collection points through community pharmacies Support the national pandemic response arrangements as laid out in Department of Health and NHS England guidance issued prior to or during a pandemic occurring In line with other guidance, ensure 24/7 on-call arrangements remain robust and maintained, particularly with respect to surge and responding to major incidents Lead the management of pressure surge arrangements with their commissioned services as a result of increased activity as part of the overall response Current provision (see section 4.6) Coordinate communications with NHS England via on-call arrangements and pan flu communications strategy On call rota in place resilience plan 2015/16 GWCCG Pandemic Influenza Plan 10
Support NHS England Regional and Area Teams in the local coordination of the response, e.g. through tried and tested surge capacity arrangements, appropriate mutual aid of staff and facilities, and provision of support to the management of clinical queries As necessary share communications with locally commissioned healthcare providers through established routes Participate in the multi-agency response as appropriate and agreed with NHS England Regional and Area Teams to ensure a comprehensive local response. Maintain close liaison with local NHS England colleagues, particularly when considering changes to delivery levels of NHS commissioned services Enact business continuity arrangements as appropriate to the developing situation to ensure critical activities can be maintained Maintain local data collection processes to support the overall response to the pandemic, including completion and submission of relevant situation reports and participation in coordination teleconferences Throughout the pandemic, undertake and contribute to appropriate, timely and proportionate debriefs to ensure best practice is adopted through the response resilience plan resilience plan resilience plan/ NHSE mobilisation framework Emergency plan/ on call rota Business Continuity policy and template plan inclusive of Pan flu resilience plan/ BC plan resilience plan 4.6 Anti-viral collection points NHS England will look to use the business as usual processes to manage the distribution and collection of anti-virals. More information on the specific logistics will be cascaded to Clinical Commissioning Groups and other parts of the system when the plans are activated to ensure and an appropriate and proportionate response to the dynamics of a pandemic. 5 After the event (post pandemic responsibilities) Specific duty Contribute to local, regional and national health post-pandemic debriefs and consider the implementation of recommendations from any subsequent reports Current provision resilience plan 2015/16 GWCCG Pandemic Influenza Plan 11
Acknowledge staff contributions Assess the impact of the pandemic on the provision of commissioned services and ensure that the ongoing service level is sufficient to meet the demands of the system Ensure the recovery of services to business-asusual as soon as appropriate Review response update plans, contracts and other arrangements to reflect lessons identified, particularly where these have been commissioned locally Collect financial and contractual impact information from commissioned providers Team brief, line managers 1:1, e-brief System Resilience and Commissioning Contract Meetings Business Continuity policy and template plan inclusive of Pan flu Emergency policy planning Business as usual for contract management and business intelligence 2015/16 GWCCG Pandemic Influenza Plan 12
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Appendix A Decision log REMEMBER YOU CAN CO-OPT ADMINISTRATION SUPPORT TO ASSIST YOU IN MANAGING THE INCIDENT EFFECTIVELY Name: Situation: Background: Assessment: Recommendations: On-call receiving sheet Notice received from: NHS England Area Team Other CCG [ ] SECAmb NHS Provider [ ] Public Health England Other C1 Responder [ ] Other [ ] Type of incident: Business continuity Surge Mutual aid Emergency Major Incident o Major o Mass o Catastrophic Other (specify) Incident details Message Time Decision/Action 2015/16 GWCCG Pandemic Influenza Plan 14
Message Time Decision/Action 2015/16 GWCCG Pandemic Influenza Plan 15