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									Report to:                 Board                                     Category of paper
                                                                  (please tick relevant box)
Title of report:           Planning for Major Incidents           Decision and
Date of meeting:           19 July 2007                           Position statement

Lead Director:             Dr Graham Wardman                      Information

Paper author:              Sharon Scott
Email address:   
Phone number:              01422 281471

Fit with PCT objectives:

Domain:                    C24 Healthcare Commission

Key points to note /       To advise the Board of the current position of the PCT in relation
Summary :                  to planning for major incidents.

                           To note the increase required in managerial capacity as part of

                           To note the continued planning for Pandemic Influenza and Civil

Financial impact           N/A
including VFM:

Risk assessment:        The PCT has undertaken a risk assessment to identify the major
                        hazards/threats pertaining to Calderdale
Patient focus:          The Communication Lead is part of the Emergency Planning
                        Control Group and communications engagement is included
                        within the emergency plan
Impact on equality:     N/A

Impact on health        N/A

Impact on safety:       Plans are in place to cover a range of specific incidents (flood,
                        heatwave, pandemic influenza etc.)
Legal issues:           N/A
Impact on workforce:    Business Continuity plans are in place and regular training and
                        exercise sessions are carried out with staff.
Compliance with         Report brought annually to the Board
Sub group / Committee   N/A
recommendations &
key stakeholders:

FOI status:             Public

Dissemination           A copy of the updated Emergency Plan is kept in all bases,
                        shared with partners and publicised on the PCT website and

EMBARGOED UNTIL DATE AND                                           AGENDA ITEM No 18


                                         19 JULY 2007

                           PLANNING FOR MAJOR INCIDENTS

1.0    Purpose of Report

       1.1     To inform the Board of the arrangements for planning for major incidents
               within the PCT.

       1.2     To inform the Board of the PCT’s state of preparedness for potential
               major incidents.

       1.3    To advise the Board of key emergency planning functions that the PCT
              needs to deliver.

       1.4    To provide the Board with reassurance on Emergency Preparedness
              following the Fitness For Purpose diagnostic work and work completed in line
               with the Healthcare Commission Core Standards.

2.0    Background

       2.1     Emergency Planning is about being prepared for events or incidents that
               stretch our ability to cope beyond our normal day-to-day activity. Preparing
               for an emergency as much as possible can reduce its impact and speed
               recovery. Emergency Planning should aim, where possible, to prevent
               emergencies occurring, and when they do occur, to reduce, control or
               mitigate the effects of the emergency.

       2.2     Emergency Planning is at the heart of the Civil Protection responsibilities for
               Category 1 Responders.1 The Civil Contingencies Act 2004 requires Category
               1 responders to maintain plans for preventing emergencies, reducing,
               controlling or mitigating the effects of emergencies; and taking other action in
               the event of emergencies. The regulations require plans to contain a
               procedure for determining whether an emergency has occurred, provision for
               training key staff and provision for exercising the plan to ensure it is effective.
               Procedures are also in to place to ensure that the plan is reviewed
               periodically and kept up to date.

       2.3     The Emergency Planning team prepares and maintains plans to provide a
               rapid and effective response to any emergency which requires the special

 The Civil Contingencies Act was passed in November 2004, creating a new statutory framework for
civil protection in the UK. Acute NHS Trusts (including Foundation Trusts), Ambulance Trusts and
PCTs are defined as Category 1 Responders under the Act, placing on them a new statutory
responsibility to comply with a number of emergency planning duties.

      mobilisation and / or coordination of PCT resources. The aim of emergency
      planning is to provide appropriate arrangements and procedures, that enable
      the PCT to manage any emergency incident should it occur and to enable us
      to continue to provide normal services so far as is possible.

2.4   Emergency Planning work needs co-ordination, both with other NHS partners
      and with a variety of other external agencies, e.g. emergency and voluntary
      organisations, community groups, local authorities, the military and central
      government. The broader context in which emergency planning need to be
      delivered has increased due to events involving the constant threat of terrorist
      attacks within the UK, fuel crisis, extreme weather conditions, flooding,
      communicable disease outbreaks of which Pandemic Influenza continues to
      be both “inevitable” and “imminent

2.5   The need to meet the requirements of the Civil Contingencies Act 2004    is
      consistent with the requirements of Public Health Core Standard C24 of the
      Healthcare Standards Declarations to the Healthcare Commission.
      Calderdale PCT assessed that it is compliant with the above and meet all of
      the key requirements. The PCT is also compliant with bi-annual Emergency
      Preparedness performance monitoring by the YHSHA

2.6   In accordance with the Civil Contingencies Act, Calderdale PCT is a member
      of Calderdale’s major incident, multi-agency planning group (led by the Local
      Authority) which meet on a quarterly basis. This group includes all Category
      1 Responders responsible within or having responsibility for the Calderdale
      Metropolitan area. The Emergency Planning Manager has also established
      close links with the Lead PCT (Leeds), the Local Resilience Forum and the
      Strategic Health Authority.

2.7   The Lead Director of the Emergency Planning function within the PCT is the
      Director of Public Health, on behalf of the Chief Executive. An Emergency
      Planning Manager takes the lead role for Emergency Planning/Business
      Continuity within the organisation. The PCT has an Emergency Plan which is
      continuously reassessed and updated biannually to identify areas of work that
      require further development. Separate plans have been developed in line
      with current guidance on Business Continuity, Pandemic Influenza,
      Heatwave, Flooding and Communications. The PCT has an in-hours and out-
      of-hours on call rota for a director for issues which includes major incidents.
      There is also a cascade system to call in other staff as required. Copies of
      plans as well as specific advice to the public on dealing with emergencies are
      available on the intranet and intranet.

2.8   Fitness For Purpose for Emergency Planning highlighted the need for
      sufficient resources, both staff and financial to be identified, particularly in
      light of the planning requirements for Pandemic Influenza. A new staffing
      structure has now been approved as part of the PCT internal restructuring.
      The changes will allow an increase to the Emergency Planning Manager
      capacity by a further 0.5wte together with additional administration support.
      In the event of an EP issue financial resources would be made available from
      within the PCTs contingency, if normal budgets were insufficient.

2.9   The 2007 National Framework for responding to an influenza pandemic is due
      to be published by the DoH in October 2007. Although local planning will

       continue, it has been recommended that the PCT focus on the following

      Strengthen partnerships and involve stakeholders both private and voluntary
       sector. The PCT have run table top exercises on Pandemic Influenza and
       engaged the local independent contractors at a PENPALS workshop.
       Practices have also been encouraged to write their own Business Continuity
       Plans. Emergency Planning/Pandemic Influenza “Roadshows” have been
       delivered to PCT HQ staff and the Roadshows are now being rolled out to the
       Provider Directorate. Specific training on Pandemic Flu was developed and
       provided in two workshops for Nursing/Residential Homes, Care Staff and
       Local Authority Social Services staff. Provision of these workshops were a
       triumph for Calderdale PCT as a recent Health Protection Agency survey on
       nursing and residential homes highlighted Calderdale’s work for contingency
       planning for nursing homes. Other training has included a presentation on flu
       contingency planning to Community Pharmacists and following on from a
       PENPALS workshop last year a follow up workshop on flu contingency
       planning for GP practices will be carried out later this year.

       Over the past year the Emergency Planning Manager and Specialist Trainee
       in Public Health have worked closely with the Local Authority in developing
       their Pandemic Influenza Preparedness Plan. This has involved regular
       attendance at their Pandemic Committee meetings. The PCT has supported
       the Local Authority with planning with Funeral Directors and helping Social
       Services to include voluntary organisation in their plans. The PCT has also
       presented at a number of workshops on Pandemic Influenza that the Local
       Authority have organized on contingency planning for local small businesses,
       in December 2006 and January 2007.

      To map and identify the skills of the workforce for workforce planning
       guidance. The Emergency Planning team are already collating data from all
       staff to include within the resilience database which is currently under
       construction. Assistance with the development of the resilience database
       has been provided by a local PCT.
      Staff absenteeism and clinical attack rates are asked to be considered and
       how this impact could be managed, especially for staff with young children.
       This work is being considered by the Calderdale Pandemic Influenza
       Planning Committee and the PCTs Business Continuity Plan has also
       recently being re-drafted and updated to include individual directorates
       response to a business continuity issue.
      GPs should continue to develop their plans for dealing with people with
       complications of pandemic influenza. Training sessions on Pandemic
       Influenza will continue to be rolled out to independent contractors and
       presentations have been given to Practice Managers to encourage and
       advise them how to write their own Business Continuity Plans.
      Planning for delivery arrangements for antivirals should continue and work
       should include collaboration with the voluntary sector. These arrangements
       have been considered by the Committee and further work is ongoing.

2.10   A number of aspects of the Emergency Plan have been put into operation this
       year. It has been necessary to operate the staff cascade list on 3 separate
       occasions following loss of utilities and communications. The cascade
       system was used effectively on each occasion enabling swift interaction with

               the Local Authority and the identification of a significant number of vulnerable
               individuals who were contacted by the Community Nursing Service.

      2.11     In light of recent events in Yorkshire, the Board might like to be reassured that
               the PCT has a flood plan. Although it has not been necessary to use it during
               the recent floods the PCT will be exploring lessons learnt through the region
               to improve our own flood planning for Calderdale.

      2.12     The Emergency Planning Manager together with the Emergency Planning
               Support Officer have commenced Emergency Planning Liaision Officer
               Training at the Emergency Planning College at Easingwould. Staff have also
               attended Loggist training courses facilitated by the Health Protection Agency.
               the Emergency Planning Manager has taken part in a number of both live
               and table-top multi-agency exercises involving the Local Authority,
               Environment Agency and Local Acute Trust.

3.0      Next Steps

         3.1          Implement the Resilience Database.

         3.2          Increase both Managerial and Administration capacity for Emergency
                      Planning in accordance with PCT internal restructuring.

         3.3          Continue planning for Pandemic Influenza in line with the expected
                      2007 National Framework on Pandemic Influenza Preparedness.

         3.4          To continue to work within the requirements of the Civil Contingencies
                      Act 2005 and the NHS Emergency Planning Guidance 2005.

4.0      Recommendations

         The Board is asked to:

         4.1          Receive this report on the current position of the PCT in relation to
                      planning for major incidents.

Sharon Scott
Emergency Planning Manager
July 2007


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