Emergency Planning
At time of writing, the UK is covered with snow. Temperatures are dropping to an average of minus 7 with a maximum being predicted of minus 20 by the weekend. The media has announced that Britain is a standstill and current affairs programmes are pointing the fingers at the Met Office for not predicting this. Schools are shut and people are told not to travel if they don't have to. But what of childcare? What about those people who have to be at work, such as hospital staff and community nurses? If the council workers can't get out to grit the roads, how can supermarkets get their deliveries? How can we eat? How will we get petrol? Why aren't there plans for teachers to go to nearby schools and help there, if only for childcare? Questions, questions, questions and all too familiar to public health. It could be snow, a natural disaster or pandemic 'flu. We've been here before, it is called emergency planning.
Emergency planning is vital for any business, organisation or community. Too often, people wait until they are hit by a catastrophe before they do anything about it. It ends up costing more, including human lives. True many events are unpredicted. But if there is a likelihood of something happening (e.g. pandemic flu) then you should have plans in place so you can minimize disruption as much as possible. Furthermore, your plans for flu can be utilized for other disasters, like snow or flooding.
Elements of an Emergency Plan
1. What crisis are you preparing for? (Flu, flooding, heatwave etc). Define the context of this crisis.
2. Potential impact of the crisis on services - include key planning assumptions, key planning principles and be sensitive to the local population.
3. Estimated impact on your business - if this crisis happened, what would this mean to your business? What are the business's key roles and responsibilities? What are the legal implications?
4. Business Continuity - how will your business continue to operate during the crisis? Your plans should include operations on a skeleton staff, how to deal with staff absences, plans to get extra staff (mindful of pressures on other services), training and support for staff capacity, plans for supplies and resources, childcare arrangements and/or arrangements for working from home if necessary.
5. Recovery plans.
NB: All plans should be updated regularly and most importantly, tested regularly. This can be in the form of a simulated exercise or a table-top exercise. Sometimes, cascade systems can be tested unannounced (with the words 'it is a test', so that you can see how easy or difficult it is to contact the necessary people. 'Lessons Learnt' should be written up and included in any amendments to the plan.
Emergency Planning in the NHS
The aim in the NHS is to ensure that essential health care needs are met effectively when normal services become overloaded, restricted or non-operational for whatever reason. The principle is focus on what needs to be done to respond to emergency. For NHS (during pandemic flu for instance) this would be (1) deal with new patients; (2) take steps to safeguard the health of the population at large from possible adverse effects of emergency and (3) continue to provide care and services for existing patients
Terms to Know
Routine activities - met within existing capacity and procedures, not abnormal load
Major incident - any emergency that requires implementation of special arrangements by one or more of emergency services/NHS/local authority
Major situation - requires special mobilisation /redeployment of staff; interruption to routine activities
Emergency Response (for disaster/flood/fire/plague e.g. SARS)
Think APPRR!
Assess (is there surge capacity in wards?)
Prevent (vaccinate; travel restrictions)
Prepare (outbreak plan, stocks of face masks etc)
Respond (epidemiology for hot spots)
Recover (from event including psychological care)
See the Department of Health's website for further information.
Emergency Planning in Local Authorities
While the immediate response to a major incident is carried out by the emergency and health services, local authorities provide a major support role. This is especially true when it comes to supporting the community and helping to restore normality. All councils should have emergency response plans which are tested and updated regularly. They should also be mindful of the Civil Contingencies Act (2004).