TRUST NAME: Southern Health & Social Care Trust Emergency Preparedness & Response Annual Report to PHA/HSCB (DATES THE REPORT RELATES TO) From: 1/4/14 To: 31/3/15 Report Completed by: Position in Trust: Teresa Cunningham Emergency Planner 1
1. Introduction This section should include a general summary of Trust Emergency Preparedness & Response management structures and processes within the organisation and across sites with roles and responsibilities of key officers. 1.1 Within the SHSCT, the Medical Director has responsibility for Emergency Planning and is responsible for reporting to the Trust s Senior Management Team and Trust Board on emergency planning issues. The Medical Director is supported by a Senior Manager - the Emergency Planning and Business Continuity Manager. Staff from all directorates engage in emergency planning and business continuity management. The Trust has a multi-disciplinary Emergency Planning and Business Continuity Committee comprised of senior managers, clinicians, Public Health Agency representation, Northern Ireland Fire and Rescue Service, Northern Ireland Ambulance Service, Police Service Northern Ireland and Council representation. It is chaired by the Medical Director or the Emergency Planner and meets on a quarterly basis with the aim of ensuring strategic leadership. The Trust s Emergency Planning Manager also participates in the following regional and local fora: Regional Emergency Planning Forum, frequency quarterly promotion of emergency planning, sharing of good practice, development of policies and guidance. Regional Business Continuity Meetings hosted by DHSSPS sporadic meetings now. Southern Civil Emergency Preparedness Group ((SCEPG)formerly Southern Responders Group) Meeting hosted jointly by Council and PSNI, multi-agency forum (PSNI,NIAS, NIFRS, SHSCT, PHA, Local Councils, MCA, NIHE, Red Cross) meets at least quarterly to raise awareness of individual agency roles in Emergency Planning, development and exercising of multi-agency plans/protocols, share learning, debrief following incidents/exercises. Southern Group Emergency Planning Sub-group, meets usually on a quarterly basis Hosted by Emergency Planning Co-ordinator from the Southern Group of councils - to update on pertinent emergency planning issues, share learning and to progress actions (eg exercises). Cross Border Emergency Planning Group recently reconvened with representation from blue light services, councils and Health Agencies from both sides of the border. Meets usually on a quarterly basis and currently aiming to develop protocols for cross border working and facilities and resource mapping. Attendance as requested at local Council meetings to discuss emergency planning issues. Attendance at other relevant planning groups convened eg development of Mass Casualty Guidance (DHSSPS led). 2
There are 3 Emergency Support Centre Teams within the Trust to assist with the response to community incidents, particularly in relation to the establishment of Emergency Support Centres when members of the public are evacuated from their homes. There is a team in each of the 3 areas, Armagh & Dungannon, Newry & Mourne and Craigavon & Banbridge. Each team has 8 members and one member from each team is on call every day, 24/7, all year round. 1.2 Short Term Planning Groups Evacuation and Sheltering Guidance In 2014-15 an Evacuation and Sheltering planning group was established to develop evacuation and sheltering guidance. Work on this is ongoing. Transport Protocol for Severe Weather A Small planning group was established to develop a Transport Protocol to outline the arrangements in place for staff to access 4x4 assistance during periods of severe weather, to ensure they get out to their clients in the community and to assist getting staff into the hospitals for work. Work is ongoing. Special Incidents Plan - CBRN In 2013-14 a small working group was also established to develop a Special Incidents (CBRN) plan. In 2014 the draft plan was reviewed in light of new guidance (Initial Operational Response) on dry decontamination. The draft plan has been issued for consultation to relevant stakeholders. The plan and the arrangements for dry decontamination have to be completed by August 2015. Ebola Planning Group A multi-disciplinary group with representation from NIAS was established to develop an Ebola Plan to deal with any potential presentations at the acute hospitals. The plan continues to be kept under review in light of international and local guidance. Ebola exercises have been carried out on both acute sites and the specified PPE has been purchased. 2. Notification of Incidents to Trust This section using (table and text) should highlight the number; date and types of incidents notified to the Trust since the previous report and the level of response activated. 3
Table 1 identifies the incidents that were alerted in the time period 1/4/14 to 31/3/15. Table 1 Incidents notified to Trust: Date Incident Level of Response Activated/Outcome 25/6/14 Emergency Support Centre (ESC) Response to explosion The locality ESC Manager was contacted at 05:30hrs on 25 th June 2014 by PSNI to advise there had been an explosion in Keady, near an ATM. The PSNI decided, as a precaution, to evacuate 12 properties in the immediate vicinity. ESC Manager was advised the Council was opening a rest centre at Keady Recreation Centre;. 06:10hrs On call manager arrived at Keady Recreation Centre and spoke with a care taker. Given that the main centre was attached to a school which was due to open in under two hours they agreed it would be more prudent to use the pavilion on the same site for the ESC. He advised PNSI accordingly. At approximately 07:30hrs a constable from the PSNI attended the centre, and advised evacuees were making alternate arrangements. Consequently it was agreed that the Emergency Support Centre would be stood down. 13/11/14 Emergency Support Centre (ESC) Response to flooding 15/11/14 Emergency Support Centre (ESC) Response to potential flooding ESC was activated in response to a flooding incident in Bridge Street and Cleary Crescent in Newry. No evacuees presented at the centre which was established in Newry Sports Centre. A call was received by Emergency Planner and on-call manager for C&B ESC Team from Lewis Porter Craigavon & Banbridge Council advising an ESC may be required for the Ashgrove area in Portadown due to potential flooding. ESC team was put 4
on standby however the rest centre was not required. Lessons Learned ESC Activations The PSNI have not always notified Trust when an ESC is to be set up. This issue continues to be raised and reinforced with PSNI, through Southern Responders Group meetings and by the SHSCT Emergency Planner with PSNI Emergency Planner. Flooding November 2014 Identified the need to establish data sharing agreements between PSNI and other agencies to facilitate prompt sharing of information on vulnerable clients during an emergency situation. It also identified the need to establish mechanisms within the Trust to quickly gather information on vulnerable clients from information systems. Work is on-going within Southern Civil Emergency Preparedness Group re data sharing agreements. A section on lessons learned from any issues identified in relation to the various notifications should be outlined along with actions taken to address any identified areas of concern (see debrief reports). 3. Incidents responded to by Trust This section should outline details of the Trust response to all incidents responded to since the previous report. Lessons learned from debriefs (internal and Multi-agency) should be included along with actions taken to address any identified areas of concern. (Trusts should append reports on the incident if relevant / appropriate) 3.1 Severe Weather Flooding Newry On 13/11/15 the Trust s Emergency Planner was contacted by the Emergency Planning Co-ordinator from the Southern Group of Councils to advise that a Silver Command and Control team was being established to deal with the fallout from the heavy rainfall overnight and predicted for the coming days. A Senior Manager from the Trust liaised closely with the command and control team in relation to the identification of vulnerable people in the Bridge Street and Cleary Crescent areas of Newry which were worst affected by flooding following the heavy rainfall. 5
3.2 Strike Action In March 2015, the Trust implemented its business continuity plans in response to Industrial strike action by SHSCT staff and other public services. Reporting arrangements were put in place to report impact on services to the Health & Social Care Board. 3.3 EVENTS There were no major events in SHSCT area during 2014-15. 4. Emergency Preparedness Training Individual Specialised Training This section should outline details of the individual specialised emergency preparedness & response training attended since the previous report by members of staff including dates qualifications obtained and organisation/agency providing the training. 4.1 HOSPITAL MAJOR INCIDENT MEDICAL MANAGEMENT (HMIMM) AND SUPPORT HMIMMS training was provided to 4 staff in 2014-15. MARCH 201 ED Consultant, DHH Clinical Sister, CAH ED Clinical Sister, CAH ED ED Manager, DHH Nominations continue to be made for future courses. 4.2 DECONTAMINATIONTENTS New decontamination tents were delivered to the 2 acute hospitals in March 2015. Two staff from estates attended the Cupola Tent training sessions and will roll out training to estates and portering/security staff on both sites. 4.3 EMERGENCY DEPARTMENT STAFF TRAINING Three members of staff attended the Powered Respirator Protective Suits (PRPS) Train the Trainer training in October 2014 and are currently drawing up a programme to roll this out to the relevant staff in the Emergency Departments of both acute hospitals. 6
4.4 RQIA ESTATES SEMINAR RESIDENTIAL AND NURSING HOME The Trust s Nurse Consultant for Older People attended this seminar which took place in November and made a presentation on the learning arising from the Trust s response to a fire in a residential nursing home which occurred in 2012. 4.5 EMERGENCY SUPPORT CENTRES The Trust s Emergency Planning Co-ordinator continues to meet individually with all new ESC Managers to talk through roles and responsibilities. New team members are also inducted by their team colleagues and are invited to attend multi-agency awareness sessions facilitated by members of the Southern Civil Emergency Preparedness Group (SCEPG). 4.6 LOGGIST TRAINING Three members of staff attended loggist training funded by the PHA and delivered by Bond Solon. Feedback on the training from staff was good. 4.7 BUSINESS CONTINUITY TRAINING The Trust s Emergency Planner and Business Continuity Manager and an Estates Representative attended Business Continuity training funded by the PHA and delivered by Risk and Resilience. This will assist the Emergency Planner in the development and maintenance of a business continuity management strategy for the Trust. 5 Exercises This section should summarise the individual exercises national and local (both attended and run) by trust staff including dates, area of response tested and the name of the organisation /agency facilitating the exercise. 5.1 Southern Regional College Desktop Exercise The Southern Civil Emergency Preparedness Group (SCEPG) facilitates an annual desktop exercise for students from the Southern Regional College studying the Extended Level 3 Diploma in Uniformed Public Services. Emergency Planning scenarios are presented to the students and they are asked to think about the problems/ issues which would arise and how they think the emergency services would respond. Members of the SCEPG guide them through potential solutions. As well as providing an excellent practical learning opportunity for the students, it provides a further opportunity for multi-agency engagement to learn about the roles and responsibilities of the various agencies in an emergency situation. Such an exercise was carried out in May 2014. 7
5.3 Exercise Stannis March 2015 Three members of staff attended the regional outbreak exercise, Exercise Stannis. The debrief report is awaited and learning arising will be incorporated into the review of Trust plans. 5.4 Exercise Gueckedou In October 2014, five members of staff attended a regional ebola exercise hosted by the PHA. There was considerable learning from the exercise which was incorporated into the Trust s Viral Haemorrhagic Fever Management Plan. 5.5 CAH Live Exercise In September 2014 the Trust carried out a live multi-agency exercise at CAH. The exercise involved a live evacuation of a hospital ward requiring establishment of a hospital control team. When the evacuation was completed, the exercise continued as a desktop exercise with injects to the hospital control team which resulted in the establishment of the Trust s Bronze Command and Control Team. Both teams had multi-agency representation ie NIFRS, PSNI, NIAS. The aim of the exercise was to test the hospital fire evacuation procedures at Craigavon Area Hospital. The objectives of the exercise were to: examine roles and responsibilities of key responders examine inter-agency dependencies discuss activation & communication issues involved in evacuation test business continuity plans discuss the role of the media stimulate team networking identify training needs The exercise objectives were fully met. A hot debrief was carried out immediately after the exercise and a full debrief was carried out in November 2014. The debrief report was shared with participants and other Trust Emergency Planners via the Health Emergency Planning Forum. An action plan has been compiled and the learning arising will be incorporated into existing plans. This exercise provided a further opportunity for multi-agency engagement and collaboration both in the planning and execution of the exercise. Feedback on the exercise from participants was very positive and the need for further multi-agency exercises was highlighted. 020215 FINAL EXERCISE CAHOUT DEBRIEF REPORT.pdf 8
5.6 Local Ebola Exercise The Trust carried out a number of ebola exercises on each of the acute sites (CAH and DHH). 6. Controls Assurance Standards This section should note the Trust score against Controls Assurance Standard and outline the areas of concern along with an action plan as to how the specific areas will be addressed. This section will inform a significant part of the individual Trust; PHA/HSCB annual performance meetings. The Trust s Controls Assurance Score this year was substantive (84). The main areas of concern for the Trust are set out in the attached report: EMERGENCY PLANNING ACTION PLAN 31 MARCH 2015 UPDATED 230415.doc.docx 7. Business Continuity Management progress This section should summarise the work carried out by the trust and highlight the relationship within the trust of business continuity and emergency preparedness. A scoping exercise was carried out in 2012-13 to identify the Division/Service Business Continuity/Contingency plans already in existence throughout the Trust. The Emergency Planner has compiled an inventory of plans and is in the process of putting performance management arrangements in place. Updates are included in the Medical Directors Report which is presented to the Trust s Senior Management Team, Governance Committee and Trust Board. 8. Emergency Preparedness & Response Audit This section should identify any emergency preparedness & response audits carried out by the trust since the last report. There were no audits carried out in the past year other than self assessment for Controls Assurance Standards. 9. Areas of future risk in relation to emergency preparedness & response within the trust. 9
Looking to the next year this section should summarise the areas of risk and include an action plan as to how the risks are to be managed. CONTROLS ASSURANCE STANDARDS Following completion of Controls Assurance Standards, an action plan was developed to identify the actions necessary to improve compliance for the forthcoming year. The action plan will be monitored in 2015-16 to ensure actions are implemented. EXERCISE DEBRIEF A debrief report was compiled following Exercise CAHOUT identifying lessons learned and the actions necessary to improve Trust and multi-agency preparedness for dealing with a fire evacuation. The debrief report was shared with all exercise participants and the action plan will be monitored in the forthcoming year to ensure implementation of actions arising from lessons learned. DECONTAMINATION ACTION PLAN The Trust has a live decontamination action plan which is regularly reviewed and updated in line with the introduction of new guidance (eg Initial Operational Response). The action plan is monitored to ensure completion of actions listed. 10. Action plan for the next 12 months to manage identified risks and areas of concern raised during responses to actual incidents. This section should give a detailed action plan as to how the risks are to be managed and how areas of concern are to be addressed in the following 12 months. Ref: Decontamination Action Plan DECONTAMINATION ACTION PLAN UPDATE AS AT 14 April 2014.docx Ref: Debrief Report Exercise CAHOUT 020215 FINAL EXERCISE CAHOUT DEBRIEF REPORT.pdf Ref: Controls Assurance Standards Action Plan 10 EMERGENCY PLANNING ACTION PLAN 31 MARCH 2015 UPDATED 230415.doc.docx
Appendix to annual report Where relevant or appropriate this should include fuller reports on significant exercises / training; audits or incidents responded to. 11
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