Olympic And Paralympic Health Programme

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					Olympics and Paralympics Planning

                  22 September 2009

Prepared by:
Dr Christopher Charlesworth, Public Health SpR.
22nd September 2009

London is hosting the Olympics and Paralympics Games in 2012. The games will
bring a large number of visitors to London and all these visitors need to be confident
that they will have access to healthcare should they need it; and that London is ready
to respond should any concurrent emergency or potential disaster arise.


NHS London has published its Olympic and Paralympic Health Programme, which
contains guidance for local boroughs, on the likely impact of the games on healthcare
services and how to plan to meet these needs. Game time covers the period
between 15th July and 12th Sept 2012. Population estimates suggest between 0.9
million and 2.8 million visitors will stay overnight to visit the Olympic Games, of whom
35% will be from outside the UK.

UK residents will be entitled to NHS healthcare as now, whilst overseas visitors
(unless from an EU country or one with similar reciprocal arrangements) will only
receive emergency care. Healthcare needs of the Olympic Family will be met by
designated NHS Providers and an on-site Polyclinic. Previous Games suggest low
demands and therefore no special facilities are planned, however assumptions
should be made locally on how demand will affect their services. There will be no
relaxation on targets.

Information from previous Games does not give a clear indication of the likely change
in numbers of A+E presentations. Common symptoms resulting in ambulance
incidents during the Sydney Games were lower limb injuries; abdominal pain /
nausea & vomiting; chest pain & arrhythmias; collapse and syncope; upper limb
injuries; head, facial, and eye injuries. Attendances at sexual health clinics were in
keeping with normal activity. Presentations of adverse events due to illicit drug use
were significantly higher during the Games. Most presentations were due to injury
occurring outside the home such as broken glass. Historically, disease outbreaks
during the Olympics and other mass gatherings are rare.


To ensure that healthcare services in Bromley can cope with increased pressures
associated with London hosting the Olympics and Paralympics in 2012.


   1. Consider whether or not increased pressures will be placed upon local
      healthcare services during the games.
   2. Scope the work that needs to be done to ensure healthcare services remain
      robust with adequate capacity to meet healthcare needs of the host
      population and visitors should they need it.
   3. Ensure that locally agreed incident and escalation plans are in place and fit
      for purpose.


Incorporate NHS London’s Olympic and Paralympic Health Programme guidance into
local planning and discuss this at the Public Health Business Planning Meeting. Act
upon feedback from the Public Health Executive Committee and finalise this early
version Planning Report.


Please refer to the table on the next page for considerations and actions.
              CONSIDERATIONS:                                                                        ACTIONS:                                                       P = Priority U = Urgent

Population:   Bromley’s population could increase during the Games due to spectators requiring       BPCT to liaise with LBB and request information on the number of hotels booked           U
              overnight stay and commute to London venues.                                           during the Olympic Games.

                                                                                                     BPCT should consider whether additional pressures from extra visitors in the area        P
                                                                                                     can be met without compromising local services of the host population.

Location:     There are multiple Olympic venues in and out of London with local activity in          BPCT should maintain dialog with LBB regarding any cultural or other planned             P
              Greenwich, which will have between 17,000 - 66,000 spectators per day.                 events in or around Bromley leading up to or during the Olympic Games. Consider
                                                                                                     their impact on local services.
              Spectators visiting London venues but staying over night in Bromley may require
              access to local healthcare services. Especially those with delayed or sub-acute        Ensure adequate systems are in place to manage any hospital transfers from QEH to        P
              presentations which force them to seek help once leaving central London venues.        the PRUH.

              The impact of hospital transfers in and out of Bromley should be considered,
              especially during times of high demand or during an adverse event. This should be
              worked into locally agreed incident and escalation plans.

Accessing     Visitors may not know how or where to access local healthcare services within          Data surveillance measures should be in place throughout the Games for EMDOC,            P
Services:     Bromley. This could impact negatively on LAS and A+E attendances.                      LAS, Urgent Care and A+E services.

Staffing:     NHS staff are allowed paid annual leave to volunteer at the Olympic Games, which       BPCT and BHT should prioritise the impact of the Games on staffing and plan how          P
              may adversely impact on staffing levels. Bank staff are likely to be at a premium.     to best manage it.
              Minimising absenteeism and managing staff numbers should be considered a
              priority.                                                                              BPCT and BHT Human Resources Departments should do a staff survey to                     U
                                                                                                     determine the likelihood that staff will opt to volunteer at the Games.

Adverse       BPCT should plan against the following generic assumptions, drawing on existing        National and locally agreed plans are already in place for many of these scenarios.      P
Events:       arrangements and organisations.                                                        BPCT and LBB should consider whether any local exercises are required in the run
               Infectious / communicable disease.                                                   up to the Games to test responses to these scenarios.
               Mass casualties.
               Chemical, biological, radiological, or nuclear incidents.
               Heat wave.
               NHS resilience / business continuity.
               Food borne illness.

Business      BPCT must maintain business continuity despite reductions in staff levels, increases   A representative of BPCT should attend the NHS London workshop in October                U
Continuity    in population size, high demand or adverse events.                                     2009 to scope work around exploring public health initiatives such as effective
                                                                                                     surveillance, health promotion and disease prevention for reducing demand on local
                                                                                                     hospital and community services. Guidance will be available after the workshop.
In reality much of the work BPCT is expected to do will have already been done i.e.
incident planning, escalation procedures etc. We can also expect more information to
become available over the coming months by way of workshops and published
guidance i.e.

          Olympic Resilience Planning Assumptions are being developed as part of
           the Home Office Olympic Resilience Project.
          Cross-Government Risk Assessments have or are in the process of being
           done: i.e. National Risk Assessment (NRA), Olympic Strategic Security
           Assessment (OSSRA), Olympic Risk Assessment (ORA).
          Key stakeholders will be invited to a meeting in September 2009
           regarding local plans for the incidents and scenarios mentioned above.
          A workshop is planned during October 2009 to focus on health promotion
           and disease prevention initiatives for reducing demand on local hospital
           and community services.

Future Actions:

This report should be distributed to the following groups:

          BPCT Executive & Directors
          Safer Bromley Partnerships
          Emergency Planning Group
          South London Healthcare Trust
          Mental Health, Learning Disabilities, and Physical Disability & Sensory
           Impairment Partnership Groups

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