1. Emergency Incident Planning in the NHS Sam Moffitt Emergency Planning Manager KCH

2. Agenda INTRODUCTION LEGISLATION & DUTIES TYPES OF INCIDENT
Aims & Objectives
LEGISLATION & DUTIES
TYPES OF INCIDENT
ANATOMY OF AN INCIDENT
FOLLOW ON ACTIVITIES
POST INCIDENT ACTIVITIES

3. Aims & Objectives Aim:-
To provide a brief overview of Emergency Preparedness Resilience & Response (EPRR) within the NHS
Objectives:-
By raising awareness of what is occurring in the background to ensure successful incident response outcomes and how an incident is managed

4. LEGISLATION & DUTIES Civil Contingencies Act 2004
Contingencies Planning Regulations 2005
NHS Act 2006
Sect 252A
Emergency Planning
Statutory Guidance
Emergency Response and Recovery
Non-statutory Guidance
Health and Social Care Act 2012
NHS Emergency Planning Resilience & Response (EPRR) Framework 2013 Amended 2015

5. Categories of Responders
Category 1 (primary responders)
Category 1 responders for health are:-
Department of Health (DH) on behalf of Secretary of State for Health (SofS)
NHS England
Acute service providers
Ambulance service providers
Public Health England (PHE)
Local authorities (Inc. Directors of Public Health (DsPH))
or Category 2 responders (supporting agencies)
Category 2 responders for health are:-
CCGs

6. Categories of Responders
Uncategorised Responders:-
Primary care, including out of hours providers, community providers, mental health service providers, specialist providers, NHS Property Services and other NHS organisations (for example NHS Blood &Transplant, NHS Supply Chain and NHS 111) are not listed in the CCA 2004.
However, DH and NHS England guidance expects them to plan for and respond to emergencies and incidents in a manner which is relevant, necessary and proportionate to the scale and services provided.

7. Category 1 Responders’ Duties
assess the risk of emergencies occurring and use this to inform contingency planning
put in place emergency plans
put in place business continuity management arrangements
put in place arrangements to make information available to the public about civil protection matters and maintain arrangements to warn, inform and advise the public in the event of an emergency
share information with other local responders to enhance co-ordination
cooperate with other local responders to enhance co-ordination and efficiency

8. EPRR planning structure for the NHS in England

9. Integrated Emergency Management (IEM)
IEM Manage the Consequences not the Incident!
Consequences Are:-
Damage to People
Casualties
Damage to Property
Lack of Access
Damage to Process
Service Continuity (BCPs)

10. Types of Incident Business Continuity Incident Critical Incident
A business continuity incident is an event or occurrence that disrupts, or might disrupt, an organisation’s normal service delivery, below acceptable predefined levels .
Critical Incident
A critical incident is any localised incident where the level of disruption results in the organisation temporarily or permanently losing its ability to deliver critical services, patients may have been harmed or the environment is not safe requiring special measures and support from other agencies, to restore normal operating functions.
Major Incident
A major incident is any occurrence that presents serious threat to the health of the community or causes such numbers or types of casualties, as to require special arrangements to be implemented.

11. Anatomy of an Incident Becoming Aware Of An Undesired Event:-
Calls to 999
Ambulance Teams Attend the Scene
Ambulance Control Creates Response Strategy
Notifies Hospitals
Declare Major Incident
Treat Casualties
Restore Normality
Stand down Activities
Debrief

12. Becoming Aware Of An Undesired Event
Wednesday 22nd March 14:40

13. Becoming Aware Of An Undesired Event
Wednesday 22nd March 14:40
Vehicle collides at speed with pedestrians
Vehicle crashed into railings outside Parliament
Assailant exits car armed with 2 knives
Enters Palace of Westminster grounds
Fatally stabs unarmed police officer
Shot by armed police
Lasted 82 seconds

14. First 999 Call made to LAS at 14:40
In the next 10 – 15 mins calls received to various RTCs along the length of
Westminster
Bridge.
LAS Declared MI
At 14:51

15. The Cost
23 Patients conveyed to Hospitals
3 deceased at scene

16. KCH Response

17. KCH Response
Plus 43 Business As Usual Patients Through The Emergency Department

18. Types of Casualty Theatre 18:07 ICU Triage 16:15 CT 16:3436
male P1
Hit by car.   Unable to move lower limbs. Back pain ?#pelvis. Open leg fractures
Spinal precautions / analgesia
CT head-pelvis
C7 #
T5/6 # dislocation
Bilateral tib/fib # (Open on L)
Loss of lower limb power
Theatre
18:07
ICU

19. Patient Pathway A & E Triage Theatre Ward Discharge
Majors; Minors; Resus
CT - MRI - X-rays – etc.
Theatre
Intensive Care
High Dependency
Ward
Discharge

20. Advantages of Major Incident Declarations
It focuses the minds of staff generally
Additional Resources become available
Comms Team are involved
Warning & Informing
Security become involved (Lockdown)
Dignity for Friends and Relatives
Press Intrusions

21. Follow on Activities Police Evidence Gathering Police Casualty Bureaux
Dealing with Friends & Relatives
Dealing with Embassies
Counselling of:-
Patients
Friends & Relatives
Staff (Direct and Indirect)

22. Post Incident Hot Debriefing Cold Debriefing Lessons Learnt
Review of Plans
Training of New Processes

23. Conclusion Thank you for your time Any Questions? Sam Moffitt
Emergency & Business Continuity Planning Manager
Kings College Hospital