MAJOR INCIDENT PLAN
Rotherham, Doncaster and South Humber
(RDaSH)
NHS Foundation Trust
Version:
Author:
Name of responsible committee/individual:
9.2
Emergency Planning Officer
Risk Management Sub Group & Accountable
Emergency Officer
20 August 2014
02 September 2014
August 2015
RDaSH NHS Foundation Trust Staff
Date ratified:
Date issued:
Review Date:
Intended Recipients:
Amendments:
It is the duty of all plan holders to inform the emergency planning officer of any information
concerning changes which will consequently impact upon this plan.
Details of all changes should be recorded on a copy of the “Advice of Change” form
Appendix J and forwarded to the emergency planning officer. A note of amendments
should be made on the “record of amendments” form at Appendix K.
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Major Incident Plan August 2014 (Version 9.2)
STOP
If you are dealing with a Major Incident and you
have not yet read this document DO NOT read it
now!
Please turn to page 13 on how to set up an
Incident Control Centre and Pages 28 - 36 for
Alert Cascade & Action cards
Note the Appendices pages 37 - 51 for
additional information and page 5 for
emergency plans and policies to be used in
conjunction with this plan.
CONTENTS
PAGE
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Major Incident Plan August 2014 (Version 9.2)
1.0 Authorisation & Agreement of Plan
5
1.1 Distribution List
5
1.2 Plans & Policies to be read in conjunction with this plan
5
1.3 Aim of Plan
6
1.4 Definition of a major Incident and related terms used
6
1.5 Principles of Dealing with a Major Incident
7
1.6 Plan activation
7/8
1.7 Alerting Procedure
8/9
1.8 EPRR Operating Model
10
2.0 Incident Control Centre
13
2.1 The Role of the Incident Control Centre
13
3.0 Roles and Responsibilities of RDaSH Staff
14
3.1 Key Roles and Responsibilities for the Trust
14
3.2 Emergency Planning Panel
14
3.3 Communications
14
3.4 Situation Reporting Actions
15
4.0 Record Keeping Mechanisms and Responsibilities
16
5.0 Roles and Responsibilities of other Organisations/Agencies
17
5.1 Role of Primary Care - General Practitioners
5.2 Role of Hospitals
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5.3 Role of the Police
18
5.4 Role of the Fire and Rescue Service
18
5.5 Role of Yorkshire Ambulance Service
19
5.6 Role of the Health Protection Agency (HPA) and (PHE)
19
5.7 Environment Agency
20
5.8 Role of the NHS England & Local Area Teams
20
5.9 Role of the Clinical Commissioning Groups (CCG)
20
5.10 Role of the Strategic Coordinating Group (SCG)
21
5.11 Role of the Scientific and Technical Advice Cell (STAC)
21
5.12 Role of the Local Resilience Forum (LRF)
22
6.0 Business Continuity Plans
23
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Major Incident Plan August 2014 (Version 9.2)
6.1 Arrangements for Mutual Aid
23
6.2 Low Secure Services – Amber Lodge
23
6.3 CBRN, Dangerous Goods (DG) and HAZMAT Incidents
23
6.4 Military, Ministerial and VIP Guidance
24
6.5 Financial Arrangements during a Major Incident
24
6.6 Legal Arrangements during a Major Incident
24
7.0 Debriefing Arrangements
25
8.0 Protocol for Supporting Staff following Incidents
25
8.1 Actions taken to support staff psychologically during a Major Incident
25
9.0 Testing and Review of Plan
27
9.1 Review of Plan
28
Appendix A- Normal Hours Cascade System
28
Appendix B – Out of Hours on Call Cascade System
29
Appendix C - Action Card for Accountable Emergency Officer (or Deputy)
30
Appendix D - Action Card for Incident Co-ordinator
32
Appendix E - Action Card for Incident Loggist
33
Appendix F - Action Card for Administrative Support
35
Appendix G – Action Card for Head of Communications
36
Appendix H- Links to Risks and Hazards
37
Appendix I – Additional Logistical Support
37
Appendix J – MIP Advice of Change Form
38
Appendix K – Amendment Procedure and List of Amendments
39
Appendix L – Example Major Incident Call Record
40
Appendix M – RDaSH Useful Contacts
41
Appendix N - CBRN/HAZMAT Incidents
42
Appendix O - Infectious Disease Information
43
Appendix P - Flooding Information
44
Appendix Q - Severe Weather Information
46
Appendix R – Situation Report Template
49
Appendix S – Testing of Incident Control Room
50
Appendix T – Glossary
51
1.
Authorisation & Agreement of Plan
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Major Incident Plan August 2014 (Version 9.2)
Accountable Emergency Officer and Chief Executive hereby approved this
plan:
Chief Executive _____________________________________________
Accountable Emergency Officer________________________________
This Plan was approved by the RDaSH Risk Management Group on:
1.1 DISTRIBUTION LIST
Filled in by those distributing in locality
Copy Issued To & Date:
No
1
2
Accountable Emergency Officer (Director Children’s &
Community Services
Emergency Planning Officer
3
RDaSH Switchboard
4
Copy available via Trust Internet site
5
Copy available via K:\IGP\Emergency Planning\Emergency
Planning Resilience and Response\Major Incident Plan
Copy Available in Emergency Cupboard – Boardroom 2,
Woodfield House, Tickhill Rd, Doncaster
Copy Available in Emergency Safe – Conference Room
Swallownest Court, Rotherham
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1.2 PLANS/POLICIES TO BE READ IN CONJUNCTION WITH THIS PLAN
(Available on the RDaSH Intranet Page)
Major Incident Recovery Plan
RDaSH Heatwave Plan
RDaSH Pandemic Influenza Plan
RDaSH Road Fuel Plan
RDaSH Severe Weather & Winter Plan
Trust Security Plan
Fire Safety Policy and Procedure
Security Policy
Policy and Procedure for Managing a Bomb Threat
Policy and Procedure for a Lockdown of a Trust Site or Premise
Police Liaison Policy
Policy relating to attendance for duty during periods of inclement
weather or disruption to the public transport system
1.3 Aim
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The aim of this Major Incident Plan (MIP) is to ensure the timely and
appropriate response to a major incident. This is in order to protect the health
and wellbeing of the population of those localities where services are
delivered by the Trust. The MIP will ensure that the Trust works effectively
with the emergency services, other partner agencies and voluntary
organisations.
1.4 Definition of a Major Incident and related terms used
For practical purposes, the criterion to be used for the Trust declaring a “major
Incident” is…..‘any requirement for service provision above a level which
can be contained within existing services.’ In responding to the Major
Incident the Trust will aim to:
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Save life.
Protect the health and safety of personnel.
Prevent the escalation of the situation.
Relieve suffering.
Inform the public.
Promote self-help and recovery.
Restore normality as soon as possible.
Identify and take action to implement lessons identified.
Evaluate the response effort.
The term “emergency” is used throughout the Civil Contingencies Act (2004)
to encompass all disruptive challenges that require the use of assets beyond
the scope of normal operations and require a special deployment.
The term “major incident” is used by emergency services personnel to
describe events or situations which would constitute an emergency as defined
in the Act; this is the threshold of event or situation that will initiate a response
under the Major Incident Plan. These terms refer to the same threshold
and are essentially interchangeable.
According to the NHS Emergency Planning Guidance 2013 section 1.4 the
definition of a Major incident is:
‘Any occurrence that presents 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 trusts or other acute or community provider organisations.’
1.5 Principles of dealing with a Major Incident
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The response to a major incident should be based on the following phases:
Phase 1 - The initial response:
Establishing the scope of the incident, gathering relevant information and
disseminating it to those people who need to be involved.
Phase 2 - Containment:
Preventing exacerbation and escalation, the focus moves to caring for those
affected, evacuation, staff briefing, public information etc.
Phase 3 - Resolution and Recovery:
Restoration/returning the situation to normal and understanding lessons
learned. Local services will co-ordinate the response in the long-term
including support for those involved and the reinstatement of the affected
area.
1.6 Plan Activation
See Action Cards at Appendix A to G
The plan will be activated upon receipt of information which indicates that a
Major Incident has occurred that affects the Trust as per the definition in
section 1.4. The Accountable Emergency Officer (Director of Children’s &
Community Services) will activate the Major Incident Plan. In the absence of
the Accountable Emergency Officer any Director may activate the Major
Incident Plan.
Should no Director be available an Assistant Director should if possible
consult with the Emergency Planning Officer and other appropriate senior
staff and decide whether to declare a major incident and activate the Major
Incident Plan.
The stages of a Major Incident (standby, implement and stand down) are
detailed below. The Accountable Emergency Officer or deputy is responsible
for deciding what stage the Trust is at.
This is common terminology for emergencies and should be used when
activating staff so that they understand what actions are required by them at
the various stages (see Appendices C to G for action cards).
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Request to
Request to
Request to
“Standby”
“Implement”
“Stand Down”
1. “Standby” will be used as an early warning of a hazardous situation which
might at a later stage intensify and become a major incident. The
Accountable Emergency Officer or deputy will provide details of the situation
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Major Incident Plan August 2014 (Version 9.2)
to each Director for dissemination to their teams so they can arrange to
confirm on the availability of officers and resources in anticipation of a request
to implement the MIP for the Trust. The Accountable Emergency Officer will
also notify the NHS England Area Teams (South Yorkshire & North Yorkshire
and Humber) and Trust Switchboard.
2. “Implement” will be used to prompt the immediate implementation of the
MIP and operation of the Trust and its resources as detailed in the plan and
other supporting plans. This may mean non-essential services can be
temporarily suspended to ensure critical services are delivered. The
Accountable Emergency Officer or deputy will provide updated details of the
situation to each Director for dissemination to their teams so they can consult
their individual Business Continuity Plans and respond appropriately. The
Accountable Emergency Officer will also notify the NHS England Area Teams
(South Yorkshire & North Yorkshire and Humber) and Trust Switchboard.
3. “Stand Down”
The Accountable Emergency Officer and Emergency Planning Panel will
decide the timing of the Trust’s “stand down” from emergency procedures.
This will not necessarily coincide with the stand down by other agencies or
other NHS bodies. All staff will be given clear instructions when they are
informed that the incident is over and to stand down. The Accountable
Emergency Officer will also notify the NHS England Area Teams (South
Yorkshire & North Yorkshire and Humber) and Trust Switchboard.
Before stand down, the Accountable Emergency Officer will invoke the Trust
Major Incident Recovery Plan.
1.7 Alerting Procedure
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In the event of a “standby” situation being declared by the Accountable
Emergency Officer or deputy she/he will notify the NHS England Area
Teams (South Yorkshire & North Yorkshire and Humber), Trust
Switchboard and the “on call” manager, assistant director, director and
any other appropriate member of staff. This applies in or out of hours.
If the “standby” situation is declared in normal hours they will also notify
other Directors, Head of Communications and Head of Estates and
consider communication of situation to other staff.
•
If the decision to “Implement” is taken the Accountable Emergency
Officer or deputy will notify the NHS England Area Teams (South
Yorkshire & North Yorkshire and Humber), Trust Switchboard and the
“on call” manager, assistant director, director and any other appropriate
member of staff. This applies in or out of hours. If the “Implement”
situation occurs in normal hours they will also notify other Directors,
Head of Communications and Head of Estates and consider
communication of situation to other staff.
•
Accountable Emergency Officer (AEO) or deputy will then refer to the
Action card detailed in Appendix C and follow the actions therein.
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Major Incident Plan August 2014 (Version 9.2)
•
The alerting cascade covers the following eventualities:
o A Major Incident has been declared.
o A Major Incident or other serious occurrence elsewhere causes
an alert to be received, for example, from another NHS Trust or
Local Authority.
o A Major Incident or other serious occurrence elsewhere causes
an alert to be received, for example, from NHS England Area
Teams (South Yorkshire & North Yorkshire and Humber) or
Local Authority.
As part of the Alerting Procedure the Accountable Emergency Officer will
determine the immediate course of action to be taken.
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Major Incident Plan August 2014 (Version 9.2)
1.8 The Health System EPRR (Emergency Preparedness Resilience and Response) Operating Model below shows how NHS Provider
organisations like the Trust fit into the wider operating model alongside CCGs, NHS England Area Teams and PHE.
In the event of a major incident the Trust would liaise with the NHS England Area Teams for the affected area. This is South Yorkshire for
Doncaster and Rotherham, North Yorkshire and Humber for North and North East Lincolnshire and Greater Manchester for Manchester. The
Area Team would represent the Trust at any Multi Agency Gold Command or Strategic Coordinating Group (SCG) which is usually chaired by the
Police unless they are deemed to be unsuitable (e.g. a flu pandemic would mean an SCG may be chaired by NHS England or PHE).
During the response to an incident requests for action or information would usually come from the SCG via the NHS England Area Team to the
Trust. For example requests for situation reports (sitreps) from the Trust may be made by the SCG while the incident is occurring. It is important
that sitreps are returned to the SCG on time as requested as these form the information picture upon which strategic multi-agency gold command
makes its decisions. NHS England will provide a sitrep template or list of questions to be answered similar to that at Annexe R.
Gold Command (Strategic Coordinating Group) is typically made up of representatives from the following agencies:
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Police
Fire & Rescue
Ambulance Service
Local Authorities
NHS England
Public Health England
Environment Agency
Government Liaison Officer
Depending on the nature of the incident there may be representation from utilities companies, Highways Agency, Network Rail and the Military.
An SCG usually mirrors the geographical area of a police force, e.g. South Yorkshire SCG would most likely cover the area covered by South
Yorkshire Police.
Silver Command (Tactical Coordinating Group) may be made up of multi-agency representatives similar to the list above, but can cover a more
local area e.g. Doncaster.
Bronze Command (Operational) refers to localised responses within individual agencies.
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2.0 Incident Control Centre (ICC)
The Incident Control Centre (ICC) is the room from which the response to the major incident is
coordinated.
Two control centres have been identified which will act as a central point for incoming and
outgoing information and decisions when a major incident is in progress:
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Primary – Boardrooms 1&2, Trust Headquarters, Woodfield House, Tickhill Road, Balby,
Doncaster, South Yorkshire, DN4 8QN.
For out of hours access to Woodfield House a Director on Call must collect the keys and
alarm codes from Tickhill Road Hospital Reception/Switchboard. The Woodfield House
Alarm panel is through the second set of doors as you enter the building on the left wall
near reception (a white keypad). If you have any problems with the alarm Switchboard
have 24/7 access to the alarm company.
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Secondary (If the Primary site is unavailable) The Conference room at Swallownest Court,
Aughton Road, Swallownest, Rotherham, South Yorkshire, S26 4TH. (ICC Tel: 0114 287
6685 or 01709 325 494). Contact Swallownest Reception for keys to room. Resources in
cupboard at back of room).
The Emergency Planning Panel will assemble at the nominated centre, at the discretion of the
Accountable Emergency Officer or deputy, to co-ordinate the Trust’s response to a major
incident.
Boardroom 1 is intended to be used as a quiet meeting room. Boardroom 2 is equipped with
several telephone lines and is to be used as the main control centre. The room is equipped as
follows:
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Emergency phone lines.
Internet access via Wi-Fi for laptops.
Television with Freeview access to 24 hour news.
Meeting space.
Copies of Major Incident Plan and other relevant documents including other emergency
plans and log books are stored in the large cupboard in Boardroom 2. Key is available in a
pigeonhole in Woodfield House Reception.
Record keeping materials i.e. logging stationery and basic materials.
All other equipment that is not a necessity to a Major Incident should be kept to a minimum. The
ICC should also be an organised and tidy environment to ensure that important documents can be
found and utilised as and when needed during and after the incident.
2.1 The Role of the ICC
The purposes of the Trust ICC are as follows:
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Implement and co-ordinate the Trust’s response and recovery operations.
Provide a single point of contact.
The meeting room where the Head of Communications or deputy can gather and prepare
information for media briefing and for delivery of the message to the public.
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Major Incident Plan August 2014 (Version 9.2)
3.0. Roles and Responsibilities of Trust Staff
3.1 The key roles and responsibilities for the Trust.
In responding to a Major Incident key responsibilities are to:
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Convene the Emergency Planning Panel.
Ensure the continued safety of patients, carers and staff.
Maintain the smooth continuation of critical services.
Maintain the safety of the Trust’s estate.
Make provision for a 24 hour a day emergency response.
Assess the ongoing situation and identify emerging issues.
Provide resources to support the local effort using mutual aid either locally or regionally if
appropriate.
Liaise directly with the relevant outside agencies e.g. Multi Agency Strategic Coordination
Group (SCG), NHS England or Public Health England.
In the first instance, the Trust Lead Director is the Accountable Emergency Officer or their
nominated representative this could be any officer who is “on call” at the time of the Incident.
3.2 Emergency Planning Panel
This group comprises of representatives from teams likely to be integral to the response to the
incident. Others may be added at the discretion of the Accountable Emergency Officer.
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Emergency Planning Officer.
Head of Estates.
Head of Communications.
Clinical Lead(s).
Assistant Director(s) of affected services.
Detailed actions cards exist for the following:
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Accountable Emergency Officer - Action Card, Appendix C
Incident Co-ordinator - Action Card, Appendix D
Incident Loggist(s)/Administrative support - Action Cards, Appendix E & F
Head of Communications, Appendix G
3.3 Communications
In a Major Incident, clear and coordinated communications with staff, the public and partner
organisations is essential. Trust communications should, where possible, be consistent with those
coming from partners nationally and locally, recognising that in the initial stages information will be
limited and that information and advice is subject to change as the situation evolves.
In the majority of cases, speed is vital. However, accuracy and clarity must not become casualties
of the need for a rapid response.
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Major Incident Plan August 2014 (Version 9.2)
3.4 Situation Reporting Actions:
During a Major Incident it will be necessary for the emergency planning panel to gather information
from individual teams about how they are coping with the incident. The template at Appendix R
may be used for that purpose.
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The Accountable Emergency Officer may instruct Assistant Directors to start completing
sitreps for their services at any point during a major incident in order to gain an overview of
how Trust services are responding.
In the event of a Major Incident being declared the Accountable Emergency Officer will:
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Explain the rationale to staff for collecting sitreps from each directorate and use the
template at Appendix R.
Set out a clear timetable for when completed sitreps are required.
Give clear instructions as to where completed sitreps should be sent e.g.
[email protected]
Allow a reasonable timescale for information to be collected and recorded on the sitrep
template.
Be mindful of demands for information from external organisations such as PHE, Local
Authorities and the NHS England Area Teams and ensure their sitrep deadlines are met.
Ensure completed sitreps are distributed appropriately to Trust staff.
If necessary ensure Assistant Directors identify a person in each team to be responsible for
completing the sitrep for their team.
Ensure Assistant Directors check completed sitreps for errors before they are sent in.
Ensure all completed sitreps are saved on K:\IGP\Emergency Planning\Emergency
Planning Resilience and Response\Emergency Incidents
Following an incident a debrief and ‘lessons learned’ exercise will be held as described in the
Trust Major Incident Recovery Plan using completed Sitreps as a guide to how the response was
undertaken.
Loss of Communications
In the event of a loss of landline communication staff are advised to use mobile phones as an
alternative or email where possible and appropriate. Should all landline, mobile and email
communications be lost the Accountable Emergency Officer or deputy will consider moving to an
alternative ICC or employing runners to liaise with the separate teams on St Catherine’s estate.
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Major Incident Plan August 2014 (Version 9.2)
4. Record keeping mechanisms and responsibilities
During a major incident it is imperative that accurate records are kept of events, decisions and
actions. It is also vital to accurately record the rationale behind those decisions.
The reason for this level of detailed record keeping is that each major incident and the Trust’s
response to it may be subject to a Public Inquiry or audit. Should there be any adverse effects
created as a result of actions or decisions taken by the Trust in response to a major incident, each
of those decisions needs to be justified and this can only happen within the context of detailed and
accurate record keeping. This will be undertaken by:
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Identified Secretary/staff member: undertaking the minutes, logs of telephone calls made
and decisions taken and communications.
Incident loggists.
In the absence of a trained loggist or other suitable staff members Directors must keep an
accurate record of events and actions.
The names and contact numbers of those staff members who have agreed to undertake the role of
either Secretary/Admin or Loggist are recorded in the Action Cards at Appendix E and are
contained in the Director on Call packs.
The Accountable Emergency Officer or deputy will ensure that loggists work in suitable shifts to
ensure staff can access adequate rest periods.
The overall responsibility for record keeping rests with the Accountable Emergency Officer.
Specially trained Loggists identified within the Trust and Secretaries will relinquish their usual
duties in the event of a major incident and work from the ICC. See Appendix E and F for Action
cards outlining responsibilities.
The Accountable Emergency Officer will ensure that all notes, logbooks and any other
documentation produced during the incident are collated, filed and kept securely for a minimum
period of ten years. Any disposal of records should be done in consultation with the Information
Governance Team
For these purposes ‘documents’ or ‘records’ means paper, photographs, audio and video tapes,
and information held on word processor or other computers. It also includes electronic mail,
documents and images.
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5. Roles and Responsibilities of other Organisations/ Agencies
The information outlined below is accurate at the time of writing. Any re-structuring of the
NHS architecture and roles and responsibilities regarding emergency preparedness will be
reflected in this policy as soon as practicable.
5.1 Role of Primary Care - General Practitioners
CCGs in affected areas will ensure, General Practitioners, Dentists and Pharmacy services ensure
a fully integrated response in all phases of the incident.
For General Practitioners this may include:
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The identification of vulnerable individuals.
Providing medical assistance and advice at survivor centres, rest centres, vaccination
centres and treatment areas.
Providing mutual aid to other general practitioner practices to ensure the continued
provision of services to patients from practices directly affected.
For Pharmacy services this may include:
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The provision of advice and of replacement medication (e.g. when setting up rest centres)
Providing mutual aid to other pharmacies to ensure the continued provision of services.
5.2 Role of Hospitals
NHS Emergency Planning Guidance outlines the roles and responsibilities for Acute Trusts during
a major incident. The following may be applied to the Trust.:
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Provide a safe and secure environment for the assessment and treatment of patients.
Provide a safe and secure environment for staff that will ensure the health, safety and
welfare of staff including appropriate arrangements for the professional and personal
indemnification of staff.
Provide a clinical response including provision of general support and specific/specialist
health care to all casualties, victims and responders.
Liaise with the CCGs, (including GPs, out-of hours services, Minor Injuries Units (MIUs)
ambulance service, and other primary care providers), other hospitals, independent sector
providers, and other agencies e.g. NHS England and PHE in order to manage the impact of
the incident.
Ensure that the hospital reviews all its essential functions throughout the incident.
Provide appropriate support to any designated receiving hospital or other neighbouring
service that is substantially affected.
Maintain communications with relatives and friends of existing patients, the local
community, the media and VIPs.
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5.3 Role of the Police
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The protection of life, in conjunction with other emergency services.
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The co-ordination of the emergency services, local authorities and other organisations.
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To secure, protect and preserve the incident scene, and to control sightseers and traffic
through the effective use of cordons.
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The investigation of the incident by obtaining and securing of evidence, in conjunction with
other investigative bodies where applicable.
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The collation and dissemination of casualty information.
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The identification of any deceased, on behalf of HM Coroner.
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The prevention of crime.
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The restoration of normality at the earliest opportunity.
5.4 Role of the Fire and Rescue Service
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Fire Fighting - extinguishing fires and protecting life and property in the event of fires.
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Road Traffic Accidents - rescuing people in the event of road traffic accidents and
protecting people from serious harm in the event of road traffic accidents.
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Emergencies - when necessary deal with emergencies, other than fires and road traffic
accidents.
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Fire Safety - promoting fire safety, including the provision of information and publicity on
steps to be taken to prevent fires and the giving of advice on how to prevent fires and on
the means of escape from buildings in case of fire.
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5.5 Role of the Ambulance Service
The Ambulance Service forms part of the National Health Service response to a major incident. It
is principally geared to the immediate clinical needs of those directly or indirectly associated with
the incident(s) and their subsequent transportation to established treatment centres.
The Ambulance Service is primarily responsible for the alerting, mobilising and coordinating at the
scene all primary NHS resources necessary to deal with any incident, unless the incident is an
internal health service incident.
The Ambulance Service works to ensure that it is capable of responding to major incidents of any
scale in a way that delivers optimum care and assistance to the casualties that minimises the
consequential disruption to healthcare services and that brings about a speedy return to normal
service provision. This is done by ensuring the Ambulance Services work as part of a multi-agency
response across organisational boundaries.
The key strategic responsibilities of the Ambulance Trusts are:
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The saving of life in conjunction with the other emergency services.
To instigate a command and control structure.
To protect the health, safety and welfare of all health service personnel on site.
To co-ordinate the NHS communications on site and to alert the main “receiving” hospitals
for the receipt of the injured.
To carry out a health service assessment for the incident.
To facilitate a patient triage process when required.
To treat casualties.
To transport casualties to hospital.
To provide clinical decontamination of casualties.
To mobilise the UK national reserve stock, as appropriate to Ambulance Service POD
Holding Trusts only.
To maintain adequate emergency cover throughout other parts of the Ambulance Service
area.
To reduce to a minimum, the disruption of the normal work of the Service.
To alert and co-ordinate the work of those Voluntary services that link directly to the
Ambulance service at the incident.
To make provision for the transport of the Medical Emergency Response Incident Team if
this is an agreed function for that Ambulance Service.
5.6 Role Public Health England (PHE)
Public Health England (PHE) provide the following specialist health protection services:
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Centre for Infections (CIF).
Radiation Protection Division (RPD).
Chemical Hazards and Poisons Division (ChaPD).
Regional Microbiological Network (RMN).
Centre for Emergency Preparedness & Response (CEPR) - which has its own Emergency
Response Department.
In the event of a major incident involving a chemical, biological, radiological or nuclear hazard staff
will:
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Major Incident Plan August 2014 (Version 9.2)
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Support in managing the local response.
Participate in any Scientific & Technical Advice Cell (STAC) established by Strategic Coordinating Group.
5.7 Role of the Environment Agency (EA)
The role of the Environmental Agency is to protect and preserve the environment. The
Environment Agency plays a specific role in providing advice with regard to flooding and pollution
incidents.
5.8 Role of NHS England Area Teams
The Key Roles of NHS England Area Teams in responding to a major incident are:
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Make provision for a 24hr a day emergency response.
Lead and Co-ordinate the local NHS response including the national blood service and
NHS 111.
Coordinate with PHE and Local Authorities, including health protection response locally.
Assess the ongoing situation and identify emerging issues.
Provide resources to support the local effort using mutual aid either locally or regionally,
nationally or internationally.
Support screening, epidemiology and long term assessment and management of the
effects of an incident.
Liaise directly with the NHS delivery representative at the Strategic Coordinating Groups
(SCG).
Liaise directly with the Incident Control Centres (ICCs).
Act as a conduit for information and instruction between local NHS providers and SCG.
Act as the coordination point for the Health Media strategy for the NHS.
Act as a Health focal point for liaison with other agencies and organisations.
5.9 Role of the Clinical Commissioning Group CCGs
CCGs have the following responsibilities:
•
•
•
•
Share information and cooperate with other responders.
Provide a 24/7 point of contact should an NHS Provider wish to inform them of a major
incident.
Have arrangements in place to escalate and mobilise the response of commissioned
services to ensure providers can contribute effectively to a wider response.
Support the NHS England Area Team should any emergency require wider NHS resources
to be mobilised. CCGs must have a mechanism in place to support NHS Area Teams to
effectively mobilise and coordinate all applicable providers that support primary care
services should the need arise.
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Major Incident Plan August 2014 (Version 9.2)
5.10 Role of the Strategic Coordination Group (SCG)
Usually led by the Senior Police Commander, the NHS Gold Commander (the chair of the relevant
LHRP) will attend the SCG to represent the NHS. The SCG may mobilise a Health Strategic
Support Cell (HSCC) to support the NHS Gold Commander at the SCG location.
5.11 Role of the Scientific Technical Advisory Committee (STAC)
If the SCG is receiving conflicting advice from the various assembled experts, it may request the
establishment of a Scientific and Technical Advice Cell (STAC). The STAC’s role is to provide a
single point of scientific and technical advice to the SCG. SCG will ask specific questions of the
STAC and if an incident requires a multi-agency response, then a Strategic Co-ordinating
Group (SCG) made up of the Chief Officers of key organisations is established. Usually, Police will
convene and chair the SCG at the appropriate nominated location. The role of the SCG is to agree
joint aims and objectives to manage the incident and coordinate the overall strategic response of
all organisations involved in the management of the major incident.
The roles of STAC are:
•
•
•
•
•
•
•
•
•
•
To provide a common source of science and technical advice to the Strategic Coordinating
Group.
To monitor and bring together the responding science and technical community to deliver
advice to inform the SCG’s high-level objectives and immediate priorities.
To agree any divergence from agreed arrangements by providing science and technical
input.
To pool available information and arrive, as far as possible, at a common view on the
scientific and technical merits of different courses of action.
To provide a common brief to the technical lead from each agency; represented in the
committee on the extent of the evidence base available, and how the situation might
develop, what this means, and the likely effect of various mitigation strategies.
To identify other agencies / individuals with specialist advice who should be invited to join
the committee in order to inform the response.
To liaise with national specialist advisors from agencies represented in the committee and,
where warranted, the wider scientific and technical community to ensure the best possible
advice is provided.
To liaise between agencies represented in the committee and their national advisors to
ensure consistent advice is presented locally and nationally.
To ensure a practical division of effort among the scientific response to avoid duplication
and overcome any immediate problems arising.
To maintain a written record of decisions made and the reasons for those decisions
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5.12 Role of the Local Resilience Forum (LRF)
This multi-agency group is chaired by the Chief Constable and is designed to "establish and
maintain effective multi-agency arrangements to respond to major emergencies, to minimise the
impact of those emergencies on the public, property and environment, and to satisfy fully the
requirements of the Civil Contingencies Act 2004 (revised 2012)".
This multi-agency partnership is made up of representatives from local public services, including
the blue-light emergency services, local authorities, the NHS, the Environment Agency and other
partners. These agencies are known as Category 1 Responders, as defined by the Civil
Contingencies Act. The LRF is also supported by organisations, known as Category 2
responders, such as the Highways Agency and the public utility companies who have a
responsibility to co-operate with Category 1 organisations and to share relevant information with
the LRF.
The group will work in conjunction with wider partners such as the Military and the Voluntary
Sector who provide a valuable contribution to LRF work in emergency preparedness.
The NHS England Area Team represents the Trust at LRF meetings.
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Major Incident Plan August 2014 (Version 9.2)
6. Business Continuity Plans (BCP)
In responding to a major incident, consideration will be given to the priorities as laid out in the
Trust’s individual team BCPs, particularly if the incident response is prolonged.
BCPs provide details of the services provided by each team. They set out which services are
critical and how long they may be withdrawn before they must be reinstated. These plans can be
used to prioritise services and to assist with redeployment of staff resources as required.
All teams should have electronic and hard copies of their business continuity plans and copies are
also held by the Emergency Planning Officer.
6.1 Arrangements for Mutual Aid and Capacity Management
The resources of other organisations may need to be accessed if needs exceed the local capacity
within the organisation.
Mutual Aid ensures an integrated emergency management approach involving any local Health
Care Organisation to affect an efficient response. This will minimise the impact on the health
community. It is expected that commissioned provider services who receive requests for Mutual
Aid will make every effort to co-operate and work flexibly to support the overall health response
and divert resources to those areas in most need.
6.2
Low Secure Services – Amber Lodge
As a provider of low secure services in the Doncaster locality, (Amber Lodge) the Trust has
agreed principles with the Yorkshire and Humber Specialist Commissioning Group (secure
services commissioning team) the purpose of which is to set out the procedures to be used should
any of the low secure facilities within the region experience an event of sufficient severity that they
are unable to safely provide the required level of care due to threat or actual loss of all or part of
their facility. The Amber Lodge Low Secure Emergency Evacuation Plan aligns with the Yorkshire
and Humber Low Secure Services Emergency Evacuation Plan. Plans for evacuation of Amber
Lodge and Jubilee Close are held by the Trust Forensic Service Team.
Electronic and Hard copies of the Amber Lodge Evacuation Plan are held by Forensic Services
and the Emergency Planning Officer. This plan sets out the procedures for accessing appropriate
alternative accommodation for patients and transportation.
6.3 Chemical, Biological, Radiological and Nuclear (CBRN), Dangerous Goods (DG) and
HAZMAT Incidents
Chemical, Biological, Radiological and Nuclear incidents are referred to as CBRN incidents. Nonweaponised materials are traditionally referred to as Dangerous Goods (DG) or Hazardous
Materials (HAZMAT) and can include contaminated food, livestock and crops
The NHS response to such incidents at scene is largely led by the Ambulance Services NHS
Trusts, who have specific procedures in place for decontamination and the administration of any
antidotes that may be required. The Trust does not receive casualties but is in the process of
developing a policy for dealing with self presenters in the event of an incident of the type described
above.
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Major Incident Plan August 2014 (Version 9.2)
6.4 Military, Ministerial and VIP Guidance
Requests for military assistance should be made as a “last resort”. No request for military
assistance should be made without first consulting NHS England who will liaise with other
emergency responders at the SCG. All requests for military assistance are considered by the
regional military liaison officer and services rendered may be chargeable.
If guidance is sought on a particular issue from a governmental or ministerial level this must also
be made via NHS England who will liaise with the Government Liaison Officer at the SCG.
Should the Trust receive a request from a VIP to visit during or after a Major Incident this request
should be cross checked with the SCG via NHS England or Resilience and Emergencies Division.
Should the Trust receive notice that a VIP or High Risk patient accompanied by a Police Firearms
Officer is to be admitted to our care this should be considered by the Emergency Planning Panel.
The EPO has information to assist with this consideration.
6.5 Financial Arrangements during a Major Incident
If the major incident calls for the Trust to make extra expenditure, the Finance Team will prioritise
work accordingly and make resources available as necessary. If required an appropriate member
of the Finance Team will join the Emergency Planning Panel.
Should unique cost centres or budget codes be required for predicted or unexpected spending
during or after a Major Incident the Emergency Planning Panel will take advice of the Finance
Team representative. Decisions over spending will be agreed by the panel and communicated to
appropriate Assistant Directors and/or Managers.
Should guidance on Insurance matters be sought during or after a Major Incident the Finance
Team will take the lead in providing guidance as necessary and appropriate.
6.6 Legal Arrangements during a Major Incident
Should the Trust require legal advice during a major incident the contacts below are
recommended. Legal advice should not be sought without the approval of the Accountable
Emergency Officer or Chief Executive.
1st Contact
Peter Merchant
Partner
Tel: +44 (0) 113 251 4806
Mobile: + 44 (0) 783 430 8497
[email protected]
7 Park Square East Leeds LS1 2LW.
T +44 (0) 113 251 4700
F +44 (0) 113 251 4900
2nd Contact
Diane Hallatt
Partner
Tel: +44 (0) 113 251 4826
Mobile: + 44 (0) 792 189 0831
[email protected]
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Major Incident Plan August 2014 (Version 9.2)
7. Debriefing arrangements
At the conclusion of the major incident, the Accountable Emergency Officer will make
arrangements for staff to be debriefed and may request other health organisations that have
worked alongside Trust in response to take part.
This process will take place within 3 months of the incident “stand down”.
The debrief may take the form of a pro-forma or a debrief meeting as appropriate to the incident.
At the conclusion of the incident, the Accountable Emergency Officer will prepare a report on the
major incident, to include issues identified by the debriefing process, together with an action plan
to address the issues raised. The report and action plan will then be submitted to the Trust’s
Board of Directors, NHS England Area Teams and other agencies as appropriate, subject to the
agreement of the Trust Board.
The report should be submitted to the Board of Directors within 6 months of the incident
“stand down”.
8. Protocol for Supporting Staff Following Adverse Events/Incidents
The protocol for Supporting Staff Following Adverse Events/Incidents addresses the actions
the Trust will take in the event of staff requiring support following adverse events or incidents.
Examples of adverse incidents would be
•
•
•
Following the death of a patient.
Witnessing, or being the victim of a violent incident or
Major Incident.
This protocol utilises Department of Health guidelines (DH, 2005) for post traumatic stress disorder
(PTSD).
8.1 Actions taken to support staff psychologically during and after a Major Incident:
•
•
•
•
•
•
Providing advice on sustaining collective and personal resilience.
Assisting in identifying staff and service users who may be at greater risk.
Providing managers with advice about monitoring the exposure of staff and service users to
traumatic situations.
Training managers to recognise distress.
Providing a skilled team that can provide intervention services for staff.
Actions taken to promote transition back to ordinary circumstances and to promote recovery
of services and their staff advising and monitoring staff who are returning to work after their
exposure to debilitating distress and dysfunction.
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Major Incident Plan August 2014 (Version 9.2)
9. Training, Testing and Review of the Plan
This plan is to be exercised and/or reviewed at least annually and always after use to identify and
rectify any discrepancies. Exercise scenarios will be based on risks identified in the Community
Risk Register and Local Risk Assessment Guidance. A written debrief of the exercise, by the
Emergency Planning Officer will be presented to Trust Risk Management Sub Group.
All on call Directors will undergo training to ensure their knowledge is based on National
Occupation standards for Civil Contingencies and published competencies. “Strategic Leadership
in a Crisis” training will be recommended for all on call directors.
Lessons learned will be implemented and reflected within policy and planning.
Testing of ICC (Control Room) facilities such as Wi-Fi and phone lines will take place on a yearly
basis by the Emergency Planning Officer. A separate document recording the testing of these
facilities is included at Appendix S.
Any funding required assisting with the training and exercising of the MIP will be sought via Risk
Management Group, Performance and Assurance Group with the agreement of the Accountable
Emergency Officer.
The Emergency Planning Officer is responsible for the exercising of the Major Incident
Plan.
Record details of exercise here:
Exercise Name & Type of Scenario
Date
Location
9.1 Review of the Plan
A formal annual review of the MIP will be undertaken by the Emergency Planning Officer to ensure
that arrangements are still valid, that training remains appropriate, and that there is full
commitment to the Plan. The MIP will be approved by the Trust Risk Management Group.
Additional reviews will be undertaken following:
•
•
•
•
Significant service changes.
Identification of lessons learned from related exercises.
Activation of the Plan in a major incident or crisis.
Annual Review.
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Major Incident Plan August 2014 (Version 9.2)
APPENDIX A
Trust Normal Hours Cascade System:
Manager becomes aware of
potential emergency situation
and requires advice from
Assistant Director
Assistant Director (AD)
informed of potential
emergency. If unable to
resolve seeks advice from
Director.
Outside Agency such as NHS
England or Local Authority
may contact AEO or EPO
directly to inform them of a
Major Incident.
Director informed by AD of
potential emergency. If unable
to resolve will contact AEO,
EPO and other Directors and
staff as appropriate.
AEO or deputy using
information given will decide
whether to move to Standby or
Implement. And inform all
relevant staff and partners.
Implement
Standby
AEO or deputy will keep in
regular contact with those
dealing with incident in order
to keep up to date in case
need to move to Implement
MIP informing all appropriate
staff.
See Action Card
Appendix C
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Major Incident Plan August 2014 (Version 9.2)
APPENDIX B
RDaSH Out of Hours on Call Cascade System:
Manager On Call becomes
aware of potential emergency
situation and requires advice
from on call Assistant Director
Assistant Director informed of
potential emergency. If
unable to resolve seeks advice
from Director on Call
Outside Agency such as NHS
England or Local Authority
may contact RDASH directly
to inform them of a Major
Incident. This may be via
switchboard to on call staff.
Director on call informed by
AD of potential emergency. If
unable to resolve will contact
AEO, EPO and other Directors
as appropriate
AEO or deputy using
information given will decide
whether to move to Standby or
Implement and inform all
appropriate staff and partners
Standby
Implement
AEO or deputy will keep in
regular contact with those
dealing with incident in order
to keep up to date in case
need to move to Implement
MIP informing all appropriate
staff.
See Action Card
Appendix C
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Major Incident Plan August 2014 (Version 9.2)
APPENDIX C
Action Card
Accountable Emergency Officer
(Director of Children’s & Community
Services) or deputy.
“Implement”
Accountable to
Chief Executive
The Accountable Emergency Officer will declare and take charge of coordinating the response to the major
incident. In their absence another Director will assume the role or appoint someone to perform this role.
In the event of declaring a Major Incident you will:
Number
1
Action
Time
Completed
If in normal office hours inform:
• Directors.
• Head of Communications.
• Head of Estates.
• NHS England Area Teams.
• Trust Switchboard.
• Emergency Planning Officer.
• Head of Health, Safety & Security.
• Local Authority Emergency Planning Team in area affected.
That a Major Incident has been declared.
2
3
If Out of Hours, liaise with the Director, Assistant Director and Manager on
Call and inform the NHS England Area Teams and Trust Switchboard that a
Major Incident has been declared. You should also inform Estates on Call,
Head of Communications, Emergency Planning Officer and other appropriate
staff. Ensure you pass on a phone number on which you can be contacted
until the Incident Control Centre is opened.
Appoint an Incident Coordinator and both liaise with the Head of
Communications to ensure all communications with staff and patients are
agreed.
Establish the Incident Control Centre
Primary Site - Board Rooms 1&2, Woodfield House, DN4 8QN. (Boardroom
2 Emergency Cupboard Keys in pigeon hole at Woodfield House Reception).
Boardroom 1 – Quiet Room for meetings and discussion. Boardroom 2 for
incident coordination.
For out of hours access to Woodfield House a Director on Call must collect
the keys and alarm codes from Tickhill Road Hospital Reception/Switchboard.
The Woodfield House Alarm panel is through the second set of doors as you
enter the building on the wall near reception. If you have any problems with
the alarm Switchboard have 24/7 access to the alarm company.
Backup Site – Conference Room, Swallownest Court, S26 4TH (Emergency
Safe Keys in cabinet behind reception – wards hold key for cabinet).
4
5
Ensure that the appropriate staff members are delegated to deal with the
Major Incident.
Ensure the Emergency Planning Panel is convened. The Emergency
Planning Panel may include all or some of the following as appropriate:
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Major Incident Plan August 2014 (Version 9.2)
•
•
•
•
6
7.
8.
Accountable Emergency Officer.
Incident Coordinator.
Director Mental Health Services.
Assistant Directors or deputies of Directorates affected by the Major
Incident.
• Emergency Planning Officer.
• Representatives from Support Services where relevant and can add
value e.g. Communications, Security, Estates, Records Management,
etc.
• Incident Loggists, Minute Takers and Admin Staff.
Liaise with the relevant NHS England Areas Teams to ensure that requests
for situation reports are understood.
Ensure all relevant and current Service Business Continuity Plans are
available to the Emergency Response Panel should they be required. These
are stored on K:\IGP\Emergency Planning\Emergency Planning Resilience
and Response\Business Continuity\Business Continuity Plans March 2014.
Liaise with the Incident Coordinator, Loggists and Admin/Secretaries as
required to ensure that the Major Incident is recorded accurately and in a
timely fashion. Ensure you have a pre-brief meeting with the Loggist before
each meeting and allocate time to agree and sign each log after each
meeting and at each Loggist shift change.
Loggists are not minute takers. You will need a separate minute taker for
each meeting.
In a “Stand by” situation………
•
•
•
•
•
•
Obtain fullest details available from caller. Be clear whether you are calling the situation a
“Stand by” or not. Consider calling the local authority or ambulance service for more
information if you require it.
Consider before committing resources at this stage (situation may not escalate).
Locate relevant Emergency/Major Incident Plan, which should be kept nearby at all times this
include the lead up to the event, during the event and throughout Stand Down procedures. (All
plans are available on Trust Website, contacts list is available in Director on Call Pack)
Begin personal log for use in ongoing emergency, final report or at any inquiry. Make certain that it
is complete, and accurate.
Alert Key Staff (Relevant Directors, Emergency Planning Officer, Head of Communications, and
Potential Incident Loggists and Admin support).
Stay in touch with staff on scene with regular communications to see how situation develops.
In an “Implement” situation………
•
Follow instructions on the Action Card
In a “Stand Down” situation………
•
•
•
•
•
•
•
Authorise phased resumption of services provided, if it is convenient to do so.
Convene an immediate debrief with the Emergency Planning Panel and other relevant personnel to
review the Trust’s response.
Request, collect and collate Directorate reports and prepare final report for submission to the Board
or an enquiry.
Arrange for review / revision of the Trust’s emergency planning arrangements in consultation with
Emergency Planning Panel.
Provide Directors with copies of all reports.
Thank all staff and other agencies involved in the incident.
Thank all staff involved in the continuation and or re-instatement of critical NHS services and those
involved in maintaining normal services in the absence of colleagues involved in incident response.
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Major Incident Plan August 2014 (Version 9.2)
APPENDIX D
Action Card
Incident Coordinator
This role may be assigned to a Head of Business
Support Unit or Assistant Director.
“Implement”
Accountable to
Accountable Emergency Officer or deputy
In the event of declaring a Major Incident you will:
Number Action
Time
Completed
1
Regularly liaise with the Accountable Emergency Officer or Deputy.
2
Assist with the establishment of the Incident Control Centre.
3
Ensure there are two trained Loggists available to log decision making and
sufficient Admin/Secretarial Support to record minutes of meetings, telephone
calls, correspondence and undertake administrative duties as required.
4
Assist the Accountable Emergency Officer in convening the Emergency
Planning Panel.
5
Coordinate any necessary measures to ensure the safety of staff and service
users.
6
Ensure the effective communication of actions taken and progress in dealing
with the Major Incident to Senior Management Team, Trust Board, staff and
service users in the form of a regular, timetabled situation reports (sitrep).
7
Ensure the effective communication of actions taken and progress in dealing
with the Major Incident to the Accountable Emergency Officer and Head of
Communications to ensure communication with NHS Commissioning Board
Local Area Teams in the form of a regular, timetabled sitrep.
8
Liaise with the appropriate staff to facilitate a debrief of the Major Incident
once given the instruction to stand down.
9
Attend the Major Incident debrief.
Incident Co-ordinator
In a “Stand By” situation………
• Ensure you are aware what “Standby” means by consulting pages 7 & 8 of the Major Incident Plan.
• Commence personal log for use in ongoing emergency, final report, or at any inquiry. Ensure that it
is complete and accurate.
• Obtain fullest details available from all callers.
• Alert Key Support Staff such as those who may form the Emergency Planning Panel:
 Determine who is available;
 Inform them of situation;
 Arrange further contacts;
 Advise them of what actions you require them to do;
 Remind them to keep a record of information received and decisions made.
In an “Implement” situation………
•
Follow instructions on the Action Card.
In a “Stand Down” situation………
•
•
•
•
•
Arrange phased resumption of services.
Ensure a rapid return to normal service provision.
Obtain copies of department incident records and reports.
Attend debrief with Accountable Emergency Officer to review RDaSH’s response to the incident.
Convene meeting with Incident Coordinator(s) and Key Staff and request copies of incident records
and reports.
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Major Incident Plan August 2014 (Version 9.2)
APPENDIX E
Action Card
Incident Loggist
This role must be assigned to a qualified Incident
Loggist. Details are included below:
“Implement”
Accountable to
Incident Coordinator
In the event of declaring a Major Incident you will:
Number Action
1
2
3
Time
Completed
Report to the Incident Control Centres (Primary: Board Room 1, at Woodfield
House, Secondary: Conference Room, Swallownest Court).
Liaise with the Incident Coordinator and ensure you know who you are
logging for and have a pre-brief with whoever you are logging for before you
begin. The pre-brief should help you identify what you are meant to log.
Ensure accurate and timely records are kept. You will most likely be logging
during Emergency Planning Panel Meetings and decisions taken in response
to the Major Incident.
Log Books are stored in the large cupboard in Boardroom 2, Woodfield
House (keys on reception) and in the Emergency Planning Cupboard at
the back of the Conference Room, Swallownest Court (keys on
reception).
4
5
Ensure that these records are field safely and confidentially and can be made
available for audit if necessary.
Liaise with the Incident Coordinator to facilitate a debrief of the situation with
relevant staff once the command to stand down has been given.
Alison Garrett
Sandra Pinder Gibb
Helen Moran
Carol Leonards
Alison Edwards
Sam Grundy
PA to Director of
Mental Health
Services & Director
of Children’s &
Community Services
Head of Planning
Mental Health Act
Manager
Senior Secretary to
Louisa Endersby Forensic/LD
Services
Project Assistant
Emergency Planning
Office
01302 796904
[email protected]
01302 796142
07771 387673
01302 796766
[email protected]
01302 796436
[email protected]
01302 794009
01302 796532
07500 12781
[email protected]
[email protected]
[email protected]
Incident Loggist(s)
The role of the Loggist (as outlined in the Civil Contingencies Act 2004) is to keep an accurate record of
decisions made. The Log can be used at a later date in the case of public enquiry and relied upon in court.
The Loggist is not the minute taker at a meeting they are only to record the assigned officers decisions.
The Loggists ideally should only be logging for 1hr and then they should have a break for 15mins (Best
Practice).
The Loggist(s) is only needed in an Implement situation
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Major Incident Plan August 2014 (Version 9.2)
In a “Implement” situation………
•
•
•
•
•
•
•
•
•
•
•
•
•
Begin the Log at start of incident, ensure your name (in full) is put at the beginning of the log
together with date and time (using 24-hour clock).
Ensure all pages within log book are numbered.
Date and time every entry in the log (using 24-hour clock).
Do not use shorthand/abbreviations unless universally recognised e.g. NHS.
Do not make rough notes to “tidy up” later – notes should be contemporaneous.
Record all factual information received and decisions made (ask for clarification of decisions made if
unsure).
Remember to record all officers who enter and leave the room with times they entered and left.
Complete all records legibly and accurately in black ink.
If there are any gaps in the log, cross through the space and initial it. Writing on all pages should
start at the top and end at the bottom (to prevent entries being added/amended). If you make a
mistake, cross through the error with a single line and carry on to the end of the line/page. No gaps
should be left in the Incident Log. Remember to Z off any additional space and initial it.
Receive and record faxes, e-mail or other information which can be referred to and mark as exhibits
to the Incident Log before storing securely. Ensure audit trail is available for evidence (e.g. fax
received, actioned by, responded to)
If passing Incident Log to another person, rule 2 lines in black and put in the entry who you are
handing over to with the date time and your signature and that the new Loggist enters his/her details
accordingly which must inc received from the date time and signature.
- NB make sure the entry numbers follow on.
You are not a minute taker. You should only be taking notes of the decision maker’s
decisions actions and rationale.
Someone else will be assigned to take the minutes in a meeting.
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Major Incident Plan August 2014 (Version 9.2)
APPENDIX F
Action Card
Incident Secretary/Admin Support
“Implement”
Accountable to
Incident Coordinator
In the event of declaring a Major Incident you will:
Number Action
1
Time
Completed
In the event of a Major Incident you should report to one of the Incident
Control Centres:
Primary: Board Room 1, at Woodfield House (Emergency Cupboard Keys in
pigeon hole at Woodfield House Reception – cupboard is in Boardroom 2).
Secondary: Conference Room, Swallownest Court (keys within key cabinet
behind reception – Goldcrest Ward holds key for the key cabinet)
(Ensure you take a mobile phone so you are able to stay in touch with the
Incident Control Centre if your journey is disrupted.)
2
Liaise with the Incident Coordinator.
Your role may include the following:
•
•
•
Minute Taking.
Taking telephone messages.
Providing other general administrative support to the Emergency Planning Panel.
You should not complete the Incident Decision Log unless you have had formal loggist
training.
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Major Incident Plan August 2014 (Version 9.2)
APPENDIX G
Action Card
Head of Communications
“Implement”
Accountable to
Accountable Emergency Officer
In the event of declaring a Major Incident you will:
Number Action
Time
Completed
1
In informed of a Major Incident you should liaise with the Accountable
Emergency Officer (Director of Children’s and Community Services) or
Deputy and if necessary report to one of the Incident Control Centres:
Primary: Board Rooms 1 & 2, at Woodfield House (Emergency Cupboard
Keys in pigeon hole at Woodfield House Reception – cupboard is in
Boardroom 2).
Secondary: Conference Room, Swallownest Court (keys within key cabinet
behind reception – Goldcrest Ward holds key for the key cabinet)
2
3
4
5
6
7
8
9
•
Liaise with Accountable Emergency Officer, Incident Coordinator and
Emergency Planning Officer.
Establish link with NHS England Local Area Team Communications Lead and
Communication Cell at the Strategic Coordination Group (SCG) if one is
established.
Join the Emergency Planning Panel to assist with incident response.
Ensure the Trust website and Intranet front pages contains appropriate Major
Incident information about the status of services (closed/open etc.) and any
other useful information for staff, service users and the public including the
main phone number for each worksite.
Ensure that communications with outside agencies are synchronized with
internal communications and work with the Accountable Emergency Officer or
deputy to ensure that a timetable or “battle rhythm” is set out whereby internal
teams know when they must submit information to the Emergency Planning
Panel.
Ensure that Communications Team staff get access to the generic
[email protected] email account and liaise with the
Emergency Planning Officer to ensure appropriate monitoring of this mailbox.
Co-ordinate media liaison in conjunction with the Accountable Emergency
Officer and Emergency Planning Panel.
Ensure that all staff know that all media enquiries should initially be directed
to the communications team. During a major incident, no member of staff
should enter into any discussion with the media/journalist without prior
contact with the communications team.
In the event of a “standby” situation you will be informed by the Accountable Emergency Officer or
deputy who will agree suitable all staff messages as appropriate (some emergency plans have
example messages for certain types of incident) and the appropriate medium of communication e.g.
email/intranet/twitter/facebook. Remember that all public communications should be approved
at strategic level before being publicised.
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Major Incident Plan August 2014 (Version 9.2)
APPENDIX H
Links to Risks and Hazards
This plan is written in order to help mitigate the effects of hazards and threats identified in the
South Yorkshire Community Risk Register 2013, the Humber Community Risk Register 2011 and
the Greater Manchester Community Risk Register 2013. Copies of these documents are
available from the Emergency Planning Officer.
Individual plans such as the Heatwave Plan, Severe Weather and Winter Plan and Road Fuel Plan
address individual risks with the Major Incident Plan providing an overarching approach to
response and recovery.
A systematic Risk Assessment has been made of this plan and is available upon request.
APPENDIX I
Additional Logistical Support
In the event that the Trust needs to call upon additional resources the Accountable Emergency
Officer will consult with the NHS England Area Teams in order to identify the most suitable
approach. The Trust is listed as a priority customer of utility services.
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Major Incident Plan August 2014 (Version 9.2)
APPENDIX J
Major Incident Plan Advice of Change Form
1. If you have no amendments to make, please tick the following box and
return the form to the address below:
NIL RETURN
2. If you have amendments to make, please provide details below (add
extra sheets if necessary):
Section
Page Number
Amendment
Name: ………………………………………………..………………….………........
Job Title: …………………………………………………………..….......................
Contact Telephone Number: …………………..…………………....………………
Signature: …………………………………………………………..…………….…...
Date: ………………..……………………………………………..…………………..
Please return Advice of Change form (either electronically or in hard form) to:
Sam Grundy, Emergency Planning Officer
Oak Tree Lodge, St Catherine’s, Doncaster, South Yorkshire, DN4 8QN
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APPENDIX K
Amendment Procedure
•
It is ESSENTIAL that information in this plan is kept up to date
•
It will be the responsibility of the Trust Directors, Managers, and Human Resources to
immediately inform the Emergency Planning Officer of any personnel details which have
changed and which may have a subsequent impact upon the procedures outlined in this
Major Incident Plan.
•
It is the responsibility of ALL plan holders to immediately inform the Emergency Planning
Officer of any other details which have changed and which may have a subsequent impact
upon the procedures outlined in this Major Incident Plan.
•
Details of all changes should be recorded on an “Advice of Change” form by the Plan
Holder (copy overleaf) and forwarded to the Emergency Planning Officer who will action the
amendment and re-issue the amended plan or section subject to approval of the RDaSH
Risk Management Group.
•
Plan holders are responsible for ensuring that their personal copy of the Major Incident Plan
is kept up to date.
•
In addition to the above amendments which can be issued at any point during the year, the
Major Incident Plan will be subject to a comprehensive review once a year by Emergency
Planning Officer.
Record of Amendments
Amendment
Number
Date:
Page Number
Amended
Amended by:
1
27/11/2013
24
Sam Grundy
2
27/11/2013
27
Sam Grundy
3
11/08/2014
Annual Update
Sam Grundy
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Major Incident Plan August 2014 (Version 9.2)
APPENDIX L
Example Major Incident message call record
Staff may make copies of this document to use during a Major Incident or Standby.
On receiving a Major Incident “Stand by” or “Implement” message, the following information should
be carefully recorded in the spaces provided:
Time call received ...........................................................................................................................
Name of caller….. ............................................................................................................................
Telephone number...........................................................................................................................
Brief details of call ………………………………………………..........................................................
............………………………………………………………………………...............................................
…………….……………………….........................................................................................................
….……………………………………………………………………………………….………………………
………………………………………………………………….………………………………………………
………………………………………….………………………………………………………………………
………………….………………………………………………………………………………………….……
…………………………………………………………………………………….……………………………
ActionTaken……………………………….…………………………………………………………………
……………………….………………………………………………………………………………………….
…………………………………………………………………………………….........................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
As an Aide Memoire remember the “Methane” report
You should receive as much information as is available at the time on the following issues:
M
E
T
H
A
N
E
Major Incident declared?
Exact location?
Type of incident – brief details of patients, services, teams and buildings involved.
Hazards, present and potential?
Access and egress?
Numbers and types of casualties?
Emergency Services present or required?
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Major Incident Plan August 2014 (Version 9.2)
APPENDIX M
Contacts
Individual contacts both inside and outside the trust may be accessed via switchboard on
01302 796000.
Each Director on Call also has a “Useful Contact Numbers” Document in their On Call
Pack. This document can also be obtained from the Emergency Planning Officer.
The Emergency Planning Officer also holds a database of contact phone numbers and
email addresses of outside agencies.
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Major Incident Plan August 2014 (Version 9.2)
APPENDIX N
CBRN / HAZMAT Incidents
A CBRN (chemical, biological, radiological, nuclear) incident is one which involves the deliberate
release of CBRN material, e.g. a terrorist incident. Such a release may be overt or covert in
nature.
A HAZMAT incident is an incident involving a non-deliberate release of hazardous substance, e.g.
an incident at an industrial site or a transport incident. These terms are sometimes used
interchangeably and it is therefore important to clarify at an early stage what type of incident is
suspected as this may have a bearing on the response.
The message advising the Trust of a potential incident may come for a number of sources.
Notification of an overt CBRN incident or a HAZMAT incident is likely to come from the emergency
services and in particular the Ambulance Service. In the event of a covert CBRN incident, it is
possible that the incident will only become apparent following the presentation of a patient at a GP
surgery, Accident & Emergency Department, MIU or similar.
In addition to the details taken for any major incident the following information should also be
gathered whenever possible:
The nature of the agent and whether status is confirmed
• The estimated number of persons exposed (consider circumstances of the release,
prevailing weather conditions, etc)
• Whether there is likely to be further exposure
• What action is currently being taken by health and other agencies, e.g. Ambulance Service,
Fire and Rescue Service, Police, Local Authority, including evacuation, sheltering and
public order provision
• Present and projected impact on local healthcare providers
Clinical decontamination is the responsibility of the Ambulance Service, with the assistance of the
Fire and Rescue Service as necessary. Each Accident & Emergency Department has
decontamination equipment which can be set up to deal with patients self-presenting at these
facilities.
The main responsibilities of the Trust in the event of such an incident will be the same as any
other major incident.
As the situation develops and further information is available there will inevitably be the need to
find further consideration to response and recovery issues.
Further information regarding CBRN and HAZMAT incidents can be found on the Health
Protection Agency website at https://www.gov.uk/government/organisations/public-health-england
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Major Incident Plan August 2014 (Version 9.2)
APPENDIX O
Infectious Diseases Information
Microorganisms like viruses and bacteria are ever present, co-existing with people and sharing our
environment.
Factors such as global travel and trade, the growth of technology, adaptation of microorganisms
producing strains that are move virulent and resistant to treatment, increases in the number of
people with weakened immune systems (e.g. cancer and transplant patients), and changes in
environmental and land use can create change in the delicate balance and some increase in the
risk to human health from infectious diseases. An outbreak may also result from a food borne
illness.
Information relating to the outbreak of an infectious disease is likely to come from either a Primary
Care source or from an Acute Trust or as a result of public health monitoring. However it is
possible that an infectious disease may result from a terrorist incident involving biological agents.
In the event of an infectious disease outbreak the Trust works with Public Health England to
ensure:
•
•
•
•
•
•
•
•
Co-ordination of necessary health, public health, health protection and other scientific
advice to input into the strategic management of the incident
Co-ordination of the response of the health community
Provision of clear and consistent public health messages and advice
Assessment of the effects of the outbreak on vulnerable individuals
Establishment, in conjunction with the Local Authority, of facilities for the mass distribution
of counter-measures (e.g. vaccines and antibiotics)
Administration of medications, prophylactics, vaccines and counter measures
Consideration is given to the need for medium and long term monitoring
Responsibility for responding to outbreaks of infection occurring in the community lies with
the Consultants in Communicable Disease Control who are based at the Health Protection
Unit. Day to day advice and support to a wide range of community settings where infection
control is important and is provided by the Infection Prevention and Control Team). The
Infection Prevention and Control Team also support the Health Protection Unit Team in
responding to an outbreak.
Suspected outbreaks should be notified to the Infection Prevention and Control Team or
Consultants in Communicable Disease Control at the earliest opportunity.
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Major Incident Plan August 2014 (Version 9.2)
APPENDIX P
Flooding Information
Experience has shown that areas covered by the services of the Trust are vulnerable to flooding
from river or flash flooding. The Environment Agency issues warnings to areas where flooding is
expected, although this only covers fluvial flooding i.e. flooding from rivers and not pluvial, surface
water flooding.
The Emergency Planning Officer may access the Environment Agency’s Targeted Flood Warning
Service to see if any Trust estate is under threat of flooding. Generic flood warning advice can be
found at http://apps.environment-agency.gov.uk/flood/31618.aspx
Should a flood warning be received the Emergency Planning Officer or Head of BSU will notify
Estates and the Assistant Director and Team Manager of the service affected. Guidance will be
issued to follow procedures as set out in the team’s Business Continuity Plan and individual
evacuation procedures if required. For more details see the Severe Weather and Winter Plan.
The Environment Agency works with partner agencies to establish local, district level flood
response plans.
The nature, extent and expected duration of any flooding event will indicate whether or not it is
appropriate for the Trust to activate its Major Incident Plan or whether an appropriate response
can be put in place by escalating some activities in a localised area.
In the event of flooding, actual or anticipated, there will be a need for the Trust to consider:
•
•
•
•
•
•
•
•
Assessing the impact of the incident on the provision of health services
The identification of any Trust/health premises which may be affected, the extent to which
they may be affected and any action which could be take to alleviate the impact of the
incident
The identification of vulnerable persons within the affected area
The provision of advice to evacuees, survivors and relatives, including the replacement of
medication, at a survivor centre, reception centre or similar
The provision of public health advice to both staff and the public
The ability of the Trust and other health providers to continue to provide normal services
The ability of staff to get to normal work locations and/or to their patients
Any staff welfare issues
Following a flooding event there will be a need to consider issues such as:
•
•
•
•
•
•
Providing support, advice and leadership to the local community on health aspects of the
incident
Assessing the medium and long term impact on the health of the community and priorities
for restoration of normality
Working with the Local Authority and community to support recovery
The continued provision of public health advice
Considering the need for long term monitoring
Any staff welfare issues
See overleaf for flood warning codes and flood guidance statements
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Major Incident Plan August 2014 (Version 9.2)
ENVIRONMENT AGENCY FLOOD WARNING CODES
For further information see the Environment Agency website www.environment-agency.gov.uk
FLOOD ALERT
Flooding is possible. Be prepared.
Issued two hours to two days in advance of
flooding.



Be prepared to act on your flood plan.
Prepare a flood kit of essential items.
Monitor local water levels and the flood
forecast on our website.
FLOOD WARNING
FLOOD
Flooding isWARNING
expected. Immediate action required.
Flooding is expected. Immediate action required.
Issued half an hour to one day in advance of flooding.
Issued half an hour to one day in advance of flooding.






Move family, pets and valuables to a safe
Move
place. family, pets and valuables to a safe
place.
Turn off gas, electricity and water supplies if
Turn
offdo
gas,
safe to
so.electricity and water supplies if
safe
to
do
so.
Put flood protection
equipment in place.
Put flood protection equipment in place.
SEVERE FLOOD WARNING
Severe flooding. Danger to life.
When flooding poses a significant threat to life.
•
•
•
•
Stay in a safe place with a means of escape.
Be ready should you need to evacuate from
your home.
Co-operate with the emergency services.
Call 999 if you are in immediate danger.
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Major Incident Plan August 2014 (Version 9.2)
APPENDIX Q
Severe Weather Information
In the first instance consult the Trust Severe Weather and Winter Plan available on the
Trust website.
The term “severe weather” can be applied to a number of different weather extremes which may
present different challenges for the Trust. These include:
•
•
•
•
•
•
Severe gales
Heavy rain
Heavy snow and icy roads
Thunderstorms and lightning
Dense fog
Heatwave
Severe Weather Warnings
Where possible, the Met Office provides advance warning of severe weather through their
National Severe Weather Warning Service. The Met Office issues two levels of severe weather
warnings:
Early warnings of severe or extreme weather
These are issued when the Met Office has 60% or greater confidence that severe weather is
expected in the next few days.
Flash warnings of severe or extreme weather
These are issued when the Met Office has 80% or greater confidence that severe weather is
expected in the next few hours.
In addition, the Met Office publishes advisories on its website (www.metoffice.gov.uk) daily at
11.00am when it has some confidence of severe or extreme weather, although specific early
warnings/flash warnings would be issued when confidence levels reach 60% or greater.
Heatwave Alerts
A Heat-Health Watch system operates in England between 1st June and 15th September
annually. During this period, the Met Office may forecast a Heatwave, based on predetermined
criteria, and issue appropriate warnings.
The Trust has a specific plan in place to manage the response to a Heatwave. For a Heatwave to
be declared in the Trusts locality there must be a Met Office forecast of a temperature of 29
degrees during the day and 15 degrees at night for two consecutive days in Yorkshire and
Humber.
The nature, extent and expected duration of any severe weather event will indicate whether or not
it is appropriate for the Trust to activate its Major Incident Plan or whether an appropriate response
can be put in place by escalating/adjusting some activities in local areas. In most instances, it is
anticipated that the implementation of Business Continuity Plans may be sufficient.
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Major Incident Plan August 2014 (Version 9.2)
In the event of severe weather (actual or anticipated) the Trust will wish to consider the following
actions, in addition to any responsibilities resulting from the declaration of a major incident:
•
•
•
•
•
The need to communicate with health providers in order to establish the impact of the
severe weather event.
The ability of the Trust and other health providers to continue to provide normal services.
The ability of staff to get to normal work locations and/or to their patients.
The identification of any Trust premises which may be affected, the extent to which they
may be affected and any action which could be taken to alleviate the impact of the incident.
Any staff welfare issues.
Advice and updates in relation to severe weather can be found on the Met Office website at
www.metoffice.gov.uk
In the event of specific advice being required, contact can be made with the Met Office Public
Weather Service (PWS) Adviser – see emergency planning officer for information. The Met Office
also offer an emergency support service which can provide easy to access, up to date weather
information and guidance to emergency responders during environmental emergencies. Access is
via the local PWS Adviser.
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Major Incident Plan August 2014 (Version 9.2)
APPENDIX R
Situation Report (Sitrep) Template:
RDASH Ops Situation Report – SITREP No 1
Form to be completed by Team Managers
Asst Directors to receive completed forms by <insert time & date>.
Note: Please complete all fields. If there is nothing to report, or the information request is not applicable, please insert NIL or N/A.
Date:
Team/Business Division:
Time:
Name & Role (completed by):
Telephone number:
Email address:
Type of Incident (Name)
Have you experienced any serious
operational difficulties.
Impact on services and patients:
Have you invoked Business
Continuity Plans?, E.g. Identifying
vulnerable patients,. providing extra
care.
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Major Incident Plan August 2014 (Version 9.2)
Impact on other service providers
Mitigating actions taken
Additional comments,
Role
•
Staff Unable to attend work–
Please list job roles and numbers:
•
•
•
•
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Major Incident Plan August 2014 (Version 9.2)
Number unable to attend
APPENDIX S
TESTING OF INCIDENT CONTROL ROOMS
Incident Control Rooms will be tested on an annual basis. The Table below will record
dates of tests:
Woodfield House Boardrooms 1&2
Swallownest Court Boardroom 2
Date Checked &
Initial
Access to key
Up to date
Emergency Plans
Wi-Fi
Telephone Line(s) &
Handsets
Log Books
Stationery
Date Checked &
Initial
Access to key
Up to date
Emergency Plans
Wi-Fi
Telephone Line(s) &
Handsets
Log Books
Stationery
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Major Incident Plan August 2014 (Version 9.2)
APPENDIX T
GLOSSARY OF TERMS
AEO
Accountable Emergency Officer (Director of Children’s & Community
Services)
BCP
Business Continuity Plan
CBRN
Chemical Biological Radiological & Nuclear
CCDC
Consultant Communicable Disease Control
CCG
Clinical Commissioning Group
CI
Critical Infrastructure
CNI
Critical National Infrastructure
COBR
Cabinet Office Briefing Rooms
COMAH
Control of Major Accident Hazards (Regulations)
CRIP
Commonly Recognised Information Picture (A Sitrep by another name)
CRR
Community Risk Register
DIPC
Director Infection Prevention & Control
DOH
Department of Health
EA
Environment Agency
EMAS
East Midlands Ambulance Service
EPO
Emergency Planning Officer
EPRR
Emergency Preparedness Resilience and Response
GLO
Government Liaison Officer
HAZMAT
Hazardous Materials
HPA
Health Protection Agency
ICC
Incident Control Centre
ICT
Infection Control Team
ICU
Intensive Care Unit
LGD
Lead Government Department (E.g. Home Office for Terrorist Incident)
LHRP
Local Health Resilience Partnership
LRAG
Local Risk Assessment Guidance
LRF
Local Resilience Forum
MIP
Major Incident Plan
NRE
National Resilience Extranet (Web based info sharing system)
OOH
Out of Hours
PHE
Public Health England
PPE
Personal Protection Equipment
SAGE
Scientific Advisory Group for Emergencies
SCC
Strategic Coordination Centre (Set up for Gold in terrorist event)
SCG
Strategic Coordinating Group
SITREP
Situation Report
STAC
Scientific and Technical Advice Cell
SYF&R
South Yorkshire Fire & Rescue
TCG
Tactical Coordinating Group
YAS
Yorkshire Ambulance Service
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