Welcome “ Good morning and welcome to the Avon Room at Acuma House – for this morning… The HICC.” Housekeeping Fire safety information: drills, alarms and escape routes etc. Introductions Who I am: Dominic Mellon What I have done: Senior Civil Protection Officer for the Vale of Glamorgan Council Resilience Officer for Solihull MBC Researcher for Scottish Executive Capabilities Mapping Project Graduate – Development & Health in Disaster Management What I do now – role of the PCT EPA (three main aspects): Liaison With PCTs and other health sector organisations With LRF and multi-agency partners Coordination Avon wide PCT emergency preparedness issues Representation PCTs are category one responders – Bristol is lead for EP EPA represents the lead PCT representing the local health community Interaction Do any of the directors need to introduce themselves? Has anyone had any emergency planning training either in their current role or a previous position? Who has had previous experience of handling or managing major incidents? A word on acronyms – like many other arenas, civil protection uses a plethora of acronyms and abbreviation, perhaps only less than the police and the military – I will endeavour to use them as sparingly as possible, but please stop me if I forget!
“ Duties under the Civil Contingencies Act 2004” Basic question: what is the level of familiarity with the Act? “ Implications of the NHS Emergency Planning Guidance” Basic question: what is the level of familiarity with the NHS EP Guidance 2005/Operational Doctrine 1998 “ Basic concepts of resilience” Hopefully everyone will be familiar with the concepts of command and control and the GOLD/SILVER/BRONZE system? Basic question: has anyone heard of the terms ‘Integrated Emergency Management’ or the ‘Disaster Cycle’? “ Emergency preparedness and response arrangements” Directors should already be familiar with the plan and so the response arrangements. May be less familiar with the ‘preparedness arrangements, for which I have prepared a complex and hard to read diagram! “ Roles of the Emergency Coordination Team and Health Management Team” Again, directors should already be familiar with the ECT & HMT as the arrangements are detailed in emergency plans. “ Mechanisms for providing public health advice” Previously known as JHAC (Joint Health Advisory Cell), HAG (Health Advisory Group) and HAT (Health Advisory Team). Current guidance is for the STAC (Science and Technical Advisory Cell) – which is what we will look at today. If there is time we may cover the role of multi-agency GOLD and how this interfaces with the HMT and STAC.
Civil Contingencies Bill Civil Contingencies Act receives royal assent in ‘04 after a lengthy stakeholder consultation with the emergency services, statutory authorities and supporting agencies. Framework First time that UK has had a legislative framework for civil protection and emphasises the integrated emergency management model and a focus on consequence management and the combined response. Defines an emergency as: • an event or situation which threatens serious damage to human welfare; • an event or situation which threatens serious damage to the environment; or • war, or terrorism, which threatens serious damage to security. Health sector still likes to refer to major emergencies as major incidents which were defined in the previous Home Office guidance as: "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." However the two terms are largely interchangeable although the CCA definition of emergency represents the paradigm shift towards multi-agency Civil Protection with a consequence management slant, than Emergency Planning focussing on the responding agency. Categorises Responding Agencies & Places Duties on Responding Agencies (click twice) The act categorises responding agencies based on their role during the emergency response. PCTs, Acute Trusts, Ambulance Service Trusts and the HPA are all Category One responders and subject to the full range of civil protection duties under the Act – see next slide. Monitoring Arrangements The CCA does not specify any special monitoring arrangements to ensure legislative compliance and suggests instead that organisations use their existing frameworks. As you will be aware, this falls under the ‘Standards for Better Health’ programme and emergency preparedness is assessed under Core Standard 24. Enabling Act As an enabling act the CCA has spawned the Civil Contingencies Act 2004 (Contingencies Planning) Regulations 2005, which have in turn generated a host of statutory and non-statutory guidance – all of which can be found on the UK Resilience website hosted by the Cabinet Office Civil Contingencies Secretariat (CCS).
Cooperation: focuses on the multi-agency nature of the framework and encourages responder to work together, rather than preparing for and responding to emergencies in ‘silos’. Information Sharing: requires agencies to share information which may be required for preparedness activities. Risk Assessment: Recognises that effective planning must be based on a sound risk assessment methodology – the guidance suggests the use of the ANZ standard. Emergency Planning: Whilst it is clear that emergency planning is not the be all and end all of resilience, it is clearly an integral part. Business Continuity Management: Not only a license for consultants to print money, but aims to ensure that responders can undertake an effective response without being compromised by the innate disruptive effects of the emergency situation and the response activities. BS 25999-1&2? Warning & Informing the Public : Includes making the public aware of risks in the area which may cause and emergency and their effects; also includes alerting the public to an emergency situation before or as it develops and infoming them of the appropriate action they should take. Recent informal guidance issued by the Cabinet Office… Local Resilience Forum: Explain
Disaster Cycle model Describe the cycle! Widely used in disaster studies. Not to scale – no fixed timelines and phases may overlap. Highlights the activities in integrated emergency management.
Health Emergency Preparedness The first of two complex diagrams you may struggle to see! Diagram demonstrates the relationships between various ‘official’ and ‘unofficial’ working groups within the LRF structure. Explain the diagram!
Health Emergency Response The second of the two complex diagrams. Explain the diagram! Clarify: Where does the HMT/HICC sit in this diagram? Is the model subjective? SWFRS etc. Dirty GOLD/Shiny SILVER?
PCT Emergency Control Team This information will be familiar – lifted directly from the North Somerset Emergency Plan. Person count = 5 Resilience in personel? How can a long term response be sustained?
Local Control Centre (LCC) Established in the board room at Waverley house according to the operational plan. Maintained by the PCT. Facilities? Sky news Email, fax, web etc. Incident management software GIS?
Health Management Team (HMT) Searched high and low but no snappy quote – activities described under the functions of the HICC NB: The executive liaison officers will be nominated by the lead officers from each of the trusts. SHA rep will attend if requested or SHA feels appropriate depending on the scale and the nature of the emergency. Person count = 1 Total = 6
Health Incident Coordination Centre (HICC) Now we get to where we are. Snappy tagline is taken from the HICC appendix to the Avon PCTs Strategic Emergency Plan. Next few slides will go in to more detail about the venue itself, the facilities available and the role of the HICC and the HMT who staff it. Facilities? Sky news! Wireless networks 4 laptops Dedicated phone lines Fax Satellite communications Bed state board Staff welfare facilities Ease of access! Proximity to ambulance control 24 hour access Backup power supply Needs: GIS/IMS
Describe the pictures briefly!
Standard operating procedures for opening the HICC and setting up the room are basic and need developing.
Utilising the HICC What are the primary functions of the HICC? Technological fixes for data sharing problems. Incident management system?
This will form part of the overall training programme which is going to be developed shortly.
The pan avon response (hicc) 270607
The Pan-Avon Response& The Health Incident Coordination Centre
Presentation Aims & Objectives• Consider duties under the Civil Contingencies Act 2004• Consider the implications of the NHS EmergencyPlanning Guidance 2005• Revisit some basic concepts of resilience• Examine preparedness and response arrangements• Compare the roles of the ECT and HMT• Discuss the mechanisms for providing public healthadvice
Civil Contingencies Act 2004• Civil Contingencies Bill received royal assent in 2004• Creates a framework for resilience in the UK• Defines an emergency• Categorises responding agencies• Places duties on responding agencies• Monitoring of implementation remains with existingarrangements• Enabled The Civil Contingencies Act 2004 (ContingencyPlanning) Regulations 2005• Substantial statutory and non-statutory guidance
CCA DutiesSeven duties placed on responding agencies:• Cooperation• Information Sharing• Risk Assessment• Emergency Planning• Business Continuity Management• Warning and Informing The Public• Business Continuity Promotion (Local Authorities)
NHS Emergency PlanningGuidance• Emphasises the ‘all hazards’ approach to emergencypreparedness• Provides a framework by which NHS Trusts canimplement the requirements of the CCA and associatedregulations and guidance• Introduces the elements of Command, Control &Coordination and the framework of the health response• Sets roles and responsibilities for healthcareorganisations
Concepts in Resilience 1:The Disaster CycleResponseAnticipationAssessmentRecoveryPreventionPreparation
Concepts in Resilience 1:Command & ControlGOLDSILVERBRONZE
PCT Emergency Control Team“The Emergency Control Team is a nominated group of PCT personnelconsisting whose role is to set up, manage and run the PCT LocalControl centre (LCC) either as ‘Lead’ or as ‘Support’.”Membership:• Emergency Control Team Leader (On-call Director)• Emergency Coordinator (Head of Corporate Services)• Community Nursing Coordinator (Head / Director of Nursing)• Medical Director (Chair / Vice Chair of Executive Committee)• Media Coordinator (Member of Communications Team)
The Local Control Centre (LCC)“The LCC will serve as the focal point for all liaison,coordination and control matters.”Location: Board Room, Waverley House, Clevedon
Health Management TeamMembership:• Ambulance Trust Executive Liaison Officer• Acute Trust Executive Liaison Officer• Primary Care Trust Executive Liaison Officer• Administrative Support• Strategic Health Authority Liaison Officer
Health Incident CoordinationCentre (HICC)“The Health Incident Co-ordination Centre (HICC) will be thefocus of the co-ordination of a service wide response on apan-Avon basis. Whenever necessary, in response to areal or potential for a significant increase in demand forNHS services a HICC may be established.”Location: Acuma House, Almondsbury
Activating the HICCActivated as a result of:• Declaration of major incident requiring coordinated healthresponse• Notification of a ‘rising-tide’ incidentDecision to activate HICC should be taken by the ECT lead
Utilising the HICC• Centralised collation of bed-state information across Avon• Centralised coordination of patient admissions, transfersand discharges• Determining admissions policies• Central coordination of liaison arrangements• Coordination of mutual aid arrangements• Resource monitoring and allocation
STAC• Need for public health advice for SCG• Previous arrangements for JHAC/HAT/HAG• STAC Guidance issued by Cabinet Office June 2007• Retrospectively active• LRF responsible for developing arranements• Draft to be submitted to the Avon Health Sub-Group• Approval/adoption required by the LRF
Further Progress• Development of Standard Operating Procedures• Development of Health Management Team (HMT) andsupport staff action cards• Additional training for HMT and support staff• Installation of resilient satellite telecommunicationssystem• Identification of fallback facility• Integrate STAC arrangements with HICC• Develop continuity arrangements• Incident Command Systems and GIS
ReferencesReferences for presentation are available upon request.