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Resilience Development Network

© NPAG 2016 The NPAG is a part of the East of England Ambulance Service NHS Trust 1

Dale Atkins, Facilitator Telephone: 01245 544600 Fax: 01245 544610 Email: [email protected] www.npag.org.uk

Cert No: 9210

mailto:[email protected]

http://www.npag.org.uk/



MISSION STATEMENT

To encapsulate the principles of inter-agency health and social care networking, with the intention of sharing experiences, knowledge and ongoing best practice initiatives and innovations, thereby enhancing the resilience of member organisations.

INTRODUCTION I have been facilitating the Resilience Development Network for several years now and as ever I have found the whole experience to be extremely rewarding and very interesting. Group members possess an amazing amount of knowledge in this area and seem ever more willing to share this with colleagues from other areas. This year, by agreement, the Resilience Development Network has held all of its meetings in London and it is currently proposed that this continue in the new round. However, in being a member-led group this can change if the majority of members decide that this is what they want. We have been very fortunate again to have had an excellent range of speakers and I would to extend my particular thanks to David Walker (Regional Head of EPRR (Midlands & East) at NHS England), Mandy Brokenshow (EPLO Basildon & Thurrock University Hospitals NHS Foundation Trust) and Joel Standing (EPLO. St George’s University Hospitals NHSFT). Aside from the first meeting of the next round which will be held on Thursday 23 June 2016 at the Imperial Hotel, London the venues and dates for subsequent meetings will be determined by agreement, depending on the geographical spread of the new annual membership. Hopefully the next round of meetings will be as successful as all those that have gone before. Dale Atkins RDN Facilitator

CHAIRS VIEW It has been a pleasure to chair the 3 Resilience Development Network meetings over the last year. The days have proved to be an invaluable opportunity to;

exchange ideas/discuss lessons learnt, with colleagues across the country

share organisational and partner agency challenges,

share good practice

actively supporting others going through similar resilience challenges. Whilst guest speakers and group members are unlikely to confess to being experts they have been willing to share their approach, pitfalls and gains to facilitating change within their (& respective) organisations; introducing new concepts or developing resilience arrangements, to meet legal requirements. This report highlights the diversity of subjects covered including social media, evacuation and providing emergency accommodation for vulnerable patients, as well as latest national developments on CBRN, major trauma networks and responses to recent flooding demands. Business continuity continues to be a major challenge to us all so it was heartening to hear from those who had persevered and achieved national accreditation as a result. All of this could not have been achieved without the support of Group Facilitator, Dale Atkins and the NPAG Team, for facilitating each event and developing the document reference library, available to all members. Claire O’Brien Chair - NPAG Resilience Development Network



MEMBERS COMMENTS A Selection of Past Member Testimonials “Membership of the Resilience Development Network has proven to be really good value for money. The year’s membership cost my trust something in the order of £350. However what I was able to take away from the meetings in terms of time-saving ideas, resources, lessons learned and really helpful information must have saved my trust this sum of money several times over. This is aside from all the extremely helpful network support between meetings. There’s no question for me that membership is beneficial for the Trust as well as my own personal development!”

Head of Resilience. Brighton & Sussex University Hospitals NHS Trust “As a new member this year I have found the warmth of the group and the willingness to share both experiences and good practise invaluable. Making new contacts and talking with people suffering the same or similar challenges is invaluable.”

Emergency Planning Officer. Maidstone & Tunbridge Wells NHS Trust

“This has been my first year involved in the group, I have found it to be an excellent networking forum, it covers a diverse range of topics, it is great to feel that there are other professionals out there who are equally as keen as me to face and respond to the many resilience challenges we face. It is a good group which ensures your involvement and recognises your contribution, with lots of sharing taking place”

Head of Emergency Planning & Business Continuity. The Royal Wolverhampton NHS Trust

“The RDN has proved to be an excellent forum for exchanging information on all emergency planning and resilience related issues. Over the last year, the group has covered a diverse range of subjects, bringing understanding of the challenges we all face, whilst sharing practical solutions that can easily be adapted locally.”

Emergency Planning & Liaison Manager. Plymouth Hospitals NHS Trust

“The Resilience Development Network is new to my Organisation for this round of meetings – I have been made to feel very welcome and the journey to London each time has certainly been fruitful in the networking and information gained. I will certainly be suggesting that we sign up for the next round of meetings!”

Clinical Risk Manager / Emergency Planning Lead. Calderstones Partnership NHS Foundation Trust

“The group provides an opportunity for members to share best practice and discuss common themes and issues. The meetings are very well facilitated and provide a professional but friendly approach and excellent networking opportunities”

Emergency Planning Liaison Officer. Basildon & Thurrock University Hospitals NHS Foundation Trust

"The sharing of information demonstrates a determination by the members to meet new challenges and move forward with a common purpose."

Resilience Manager. East of England Ambulance Service NHS Trust

DOCUMENTS/PRESENTATIONS/ANALYSES DISTRIBUTED DURING 2015/16 The following is a selection of the documents, presentations, etc. that have been distributed to group members during 2015/16. These also represent the range of topics covered during this period. Please note: copies of these are available upon request from the BVG facilitator on e-mail: [email protected] or by contacting the NPAG office on tel. no: 01245 544600

Presentation: Business Continuity and ISO 22301

(Mandy Brokenshow Emergency Planning Liaison Officer Basildon & Thurrock University Hospitals NHSFT)

Presentation: Hospital Lockdown




(Mandy Brokenshow Emergency Planning Liaison Officer Basildon & Thurrock University Hospitals NHSFT)

Presentation: LRF Multiagency Pandemic Resilience Exercise - Exercise Albireo (Sam Grundy Emergency Planning Officer Rotherham Doncaster & South Humber NHSFT)

Presentation: Planning For The Shelter And Evacuation Of People In Healthcare Settings ( David Walker. Regional Head of EPRR (Midlands & East) at NHS England)

Presentation: St Georges ED Temporary Divert ( Joel Standing. EPLO. St George’s University Hospitals NHSFT)

Presentation: SORT (Special Operations Response Team) ( Bob Mearns – EOE Ambulance Service)

Presentation: Skills for Justice National Occupational Standards for Civil Contingencies (Richard Greene - Cumbria Partnership NHS Foundation Trust)

Documents (a selection of):

i) Hertfordshire and South Midlands LHRP: Vision and Strategic Priorities

ii) On Call Policy – University Hospitals Coventry and Warwickshire NHST

iii) EPRR Shelter Evacuation Guidance

iv) BTUH BIA Template

v) Business Continuity Guide - July 2015

vi) Emergo Exercise Scoping Exercise (v.0.1) (Ashford & St. Peters Hospitals NHS FT)

vii) MERSCoV_Algorithm _v25

viii) CPE - Carbapenemase Toolkit December 2013

ix) Security and vigilance: guidance and advice (EoE Ambulance Service NHST)

Web links(a selection of):

NHS England EPRR: Planning for the Shelter and Evacuation of people in healthcare settings (NHS,

2014)

http://www.england.nhs.uk/ourwork/eprr/gf/

Cabinet Office Emergency preparedness:

https://www.gov.uk/government/publications/emergency-preparedness

Cabinet Office Emergency response and recovery

https://www.gov.uk/government/publications/emergency-response-and-recovery

Cabinet Office Evacuation and Shelter Guidance

https://www.gov.uk/government/publications/evacuation-and-shelter-guidance

‘Guidance for incidents involving hazardous materials’ (NHS London) videos http://play.webvideocore.net/popapp.php?l=&w=800&h=900&p=15258&title=HPA+Hazmat&bgcolor1=%23ffffff&bgcolor2=%23e0e0e0

SUMMARY OF MEETINGS, KEY THEMES AND HOT TOPICS FOR 2015/16 This section provides a brief summary of a selection of discussions that have taken place at the 3 meetings held this year. As can be seen from the range of topics covered, members have been provided with a significant level of information, guidance, ideas for improvement and suggested areas for cost savings. Please refer to the actual minutes of each meeting for a greater level of detail.





https://www.gov.uk/government/publications/emergency-response-and-recovery

https://www.gov.uk/government/publications/evacuation-and-shelter-guidance

http://play.webvideocore.net/popapp.php?l=&w=800&h=900&p=15258&title=HPA+Hazmat&bgcolor1=%23ffffff&bgcolor2=%23e0e0e0

http://play.webvideocore.net/popapp.php?l=&w=800&h=900&p=15258&title=HPA+Hazmat&bgcolor1=%23ffffff&bgcolor2=%23e0e0e0



Three meetings were held in this round: 1

st Wednesday 10 June 2015 at the Royal Asiatic Society, London

2nd

Wednesday 14 October 2015 at the Imperial Hotel, London 3

rd Wednesday 24 February 2016 at the Imperial Hotel, London

NPAG Network During the course of this round of meetings a new process came in to place for members to link with the broader network. This was as follows: 1. Please visit: http://www.npag.org.uk/npag-network/ 2. Complete the short enquiry form 3. Click Submit. A member of the NPAG Team will then be in touch within 48 hours. If a member’ enquiry includes attachments or they have any questions about the service, they are asked to email: [email protected].

‘Members Area’ on the website Access to the RDN ‘Members Area’ on the website was explained as follows: Accessed at: http://www.npag.org.uk/members-2/ Password for Nursing & Temporary Staffing BVG = Crocodile (this is case sensitive). Once you are logged into your page, you will see a lock feature which allows you to logout of the area. If you

do not logout, the cookie will remain on your computer for up to 10 days and you will not need to log back in. If you logoff, then you will need to re-enter the password.

Please remember this is a confidential page for members of the Nursing & Temporary Staffing BVG only.

Membership Referral Scheme Members were also encouraged to make use of the NPAG Membership Referral Scheme: Introduce a friend and get 1 meeting for free.

A member referral resulting in another Trust / Organisation registering for full membership of the same

group will result in the referring member qualifying for a one meeting discount (Equivalent to £137.50 for the

RDN)

The discount applies to the full membership fee only (not applicable to the 2nd member rate).

The discount will be applied once, at the start of the current meeting round. Mid round membership referral

discounts will be processed at the start of the following year’s membership round.

Multiple referrals will result in multiple discounts up to four referrals per meeting round. Second Club

Membership

10% discount will be applied when an existing NPAG member joins an additional Group.

Inter Meeting Email Discussions:

This was a relatively new agenda item and proved to be very useful to members. The following are

just a few examples of the some of the questions and issues raised in between meetings:

i) Supplier BC Questionnaires

RG asked the following question:

“Do you have any examples of: 1. business continuity questionnaires for suppliers tending for contracts 2. any memoranda of understanding in respect of use of other organisations’ premises as emergency accommodation. On both points, happy to share material generated”

ii) EPRR Communications Plans

NL asked this: “I wonder if you could please ask the group if they have any Comms Plans/Strategies for EPRR we could borrow/copy? Acute Trust plans particularly but any examples would be welcome. My Comms team is writing one and they don’t want to reinvent the wheel”

http://www.npag.org.uk/npag-network/


http://www.npag.org.uk/members-2/



iii) ED Surge – Table Top Exercises

MO put the following question to the group: “Has anyone got a table top exercise that tests ED surge escalation that is due to bed pressures as opposed to a major incident. I try and stay away from this kind of stuff normally but have been 'sucked in' due to my exercising skills!”

Business Continuity and ISO 22301 (Mandy Brokenshow Emergency Planning Liaison Officer Basildon & Thurrock University Hospitals NHSFT)

The following are some general notes and selected extracts from the presentation: In Support of Successful BC

Mandy having regular 1:1s with senior managers need for Senior Accountable Officer to recognise his/her responsibility for BC (as a performance issue) use CQC inspections as leverage for buy-in and ownership as these now focus heavily on EPRR

generally. for trusts to get alignment with ISO 22301 they need to focus on the ‘SHOULDS’ within the ISO

guidance (as against the ‘shalls’ which relate more to the full attainment of the ISO) good BC should also include a focus upon the supply chain. If this fails the business will fail. See other

discussions on Supplier BC Questionnaires.

NHS England BCN Framework All NHS organisations must use this framework and the associated core standards to align themselves

with ISO 22301 and fulfil all assurance processes.

Some elements of 22301 must be done in partnership with other health organisations, recognising the patient care pathway and patient’s needs

ISO 22301 Core Requirements

The ‘Plan Do Check Act’ cycle Business continuity policy Business continuity analysis Risk assessment and risk treatments Exercising Business continuity plans and strategy Internal audit Management review Non conformity and corrective action Improvements actions

PDCA – Definition for BCM

Plan

Establish business continuity policy, objectives, targets, controls, processes and procedures relevant to improving business continuity in order to deliver results that align with the organisations overall policies and objectives.

Do Implement and operate the business continuity policy, controls, processes and procedures.

Check Monitor and review performance against business continuity policy and objectives, report results to management review, and determine and authorise actions for remediation and improvement.

Act Maintain and improve the BCMS by taking corrective actions, results of management review, re-appraise the scope of the BCMS and business continuity policy and objectives.



The key BCM Stages

Top level management commitment

Identified potential impacts and Risks

Reviewed potential mitigation measures

Implemented agreed strategies

Risk Management undertaken

Trust Risk Register

Do’s and don’ts for accreditation to ISO 22301:2012

DO make sure that Top Management are fully aware of BIA findings and are able to discuss them

DO be able to justify the methodology & content of your BIA

DO adhere to every clause requirement

DON’T adopt a template mentality and copy someone else’s BIA format for the sake of it

DON’T over complicate the BIA so that it becomes a monster.

Lessons Learnt from implementing ISO 22301

Deliver a Business Continuity solution suitable for YOUR organisation

But, ensure you satisfy ISO 22301 or the auditor will expose weaknesses

Remember, it’s about your management system not your bespoke plans

The auditor is not there to catch you out – they DO help

Accreditation is only the start – maintain and challenge

Record your journey (Evidence – meetings, decisions, continual improvement

Seek contributions from your staff

Take sufficient time to get it right. If you do your BIA properly, writing plans becomes very easy

Make sure you have evidence that you have covered every element of the standard

Define your templates based on user feedback

Hospital Lockdown (Mandy Brokenshow Emergency Planning Liaison Officer Basildon & Thurrock University Hospitals NHSFT)

The following are some general notes and selected extracts from the presentation:

Lockdown Definition ‘Lockdown’ is the process of controlling the movement and access – both entry and exit – of people (including staff, patients and visitors) around the trust site or other specific trust building or area in response to an identified risk, threat or hazard that might impact upon the security of patients, staff and assets or, indeed, the capacity of that facility to operate’. ‘Lockdown Guidance’ - produced by NHS Security Management Service 2009

Includes:

Guidance on developing a risk profile and framework Best practice principles Lockdown toolkit NHS LA Requirements

Lockdown Checklist Identify potential threats and hazards that would require a lockdown Evaluate how threats and hazards could affect the trust and if lockdown would be an appropriate

response Always ensure approach to lockdown if PROPORTIONATE to level of risk Understand the different stages of a lockdown – partial, progressive and full Identify key stakeholders to prepare a lockdown areas of a site/building Review personnel to support lockdown and consider their respective lockdown roles (lockdown

marshal's) Using all of the information collected assess the capability of a trust site/building to lockdown to develop

a site specific risk assessment Test and review lockdown capability and consider a lockdown recovery plan

Planning a Lockdown



Market Place – Sharing Good Practice

Members had been reminded previously that the aim of this session was for there to be a more structured, all -engaging

approach to sharing good practice.

Members were asked to consider the following questions: a. what are you trading? b. What are the benefits? c. What (if any) are the cost savings? d. What (if any) are the pitfalls? e. What advice (if any) would you give to colleagues?

Items being traded and the method of presentation could range from a formal PowerPoint presentation to a more basic verbal presentation without materials.

The following are just two examples of input provided by members.

i) LRF Multiagency Pandemic Resilience Exercise - Exercise Albireo (Sam Grundy)

Sam took members through his presentation on the above noting that this was an exercise that had been

undertaken in South Yorkshire following the cancellation of the national Exercise ‘Cygnus’.


Aim

To validate the South Yorkshire Local Resilience Forum Pandemic Influenza Plan. Objectives

To assess multi agency preparedness and response to an influenza pandemic across South Yorkshire. To raise awareness of pandemic influenza arrangements. To exercise individual organisations Pandemic Influenza Plans – specifically to ensure alignment with

the LRF plan. To explore roles and responsibilities of the NHS, Public Health England and Local Authorities following

the NHS restructure in 2013.

Participants – a multi-agency exercise with participants representing:

NHS England.

Public Health England.

Clinical Commissioning Groups.



NHS hospital, community and mental health trusts.

Local Authorities.

South Yorkshire Police, the South Yorkshire Fire and Rescue Service, the Yorkshire Ambulance

Service.

Voluntary sector.

KEY LEARNING POINTS

Scenario 1 – Detect & Assess

External coordination unclear – SRG, Health Protection Committee, Local Resilience Groups – Chaired by LA? Who coordinates response locally? Overlap of groups a concern.

Action to agree in each locality who would be the pan flu coordination group. Chart required to map responsibilities/information flows/reporting etc. Role of CCGs unclear – system leader in winter teleconferences – would this apply with Flu? Interface

with SRG? Needed to include communications with wider health – nursing/residential homes, vol sector as well as

Community and Mental Health. Scenario 2 – Peak of Pandemic

Antiviral Collection – AVCPs not identified in SY. National specification for AVCPs outstanding. Information flows from NHS England to Coordination Groups to be defined to also include Primary Care. Mutual Aid – Complex. A matrix of commissioners and providers and a mutual aid protocol to be

developed. Vulnerable People – Each organisation has mechanisms to identify VP. Coordinating groups need to

agree a mechanism to identify and respond to VP. All organisations to review BC arrangements.

Sam reported that the exercise had been quite valuable particularly in highlighting the challenges that would be faced in the event of an actual pandemic outbreak.

ii) Prevent Agenda (Ian Kilroy / Jon Tynan)

The following was based upon Ian’s attendance at a Prevent Agenda event held in Manchester

Prevent Strategy

Prevent Strategy (2011) is part of our counter terrorism strategy, CONTEST. Its aim – “to stop people

becoming terrorists or supporting terrorism” through:

Countering ideology: taking down harmful internet content; supporting organisations to

develop effective responses;

Supporting individuals who are at risk of radicalisation notably (but not only) through

Channel;

Working with sectors and institutions where there are risks of radicalisation and

opportunities for countering radicalisation: education, health, local authorities, policing, prisons,

charities, faith based organisations etc.

Prevent deals with all forms of terrorism and with extremism, where extremist ideas are also used to justify

terrorism and where people with extremist views are at risk of being drawn into supporting terrorism or

terrorist activity.

Prevent Duty – First Principles

The purpose of the Prevent duty is to ensure a broadly consistent and common approach across different

sectors and areas of the UK at a time when the terrorist threat makes Prevent even more important. The

duty:

Connects back to the 2011 strategy; it does not mark a new way of doing Prevent;



Is intended to be applied proportionality, taking into account local and sector

specific risks;

May make no difference to way many areas and organisations implement Prevent

already;

Requires affected agencies and organisations to have ‘due regard to the need to

prevent terrorism’

Prevent Duty – Key Issues by Sector

Local authorities should be the key coordinators for much Prevent work, with an overall action plan,

Prevent coordinator(s) and key role in Channel.

Higher and further education are dealing directly with people in a key age range, need to understand the support available and how their premises can be abused to facilitate radicalisation.

Schools have become increasingly important because of the direction of the threat; and need to understand how and why radicalisation may happen (notably on-line) and what to do next.

The health sector can be critical in dealing with drivers of radicalisation and supporting the Channel process; and in enabling Channel referrals.

Prisons are at very high risk of radicalisation, will have programmes to handle TACT prisoners and those who may be vulnerable to their activities

Police will support all aspects of Prevent; but Prevent is not a ‘police programme’.

HOT TOPICS Discussions

This has been a regular agenda item where Members are invited to share a current, work related ‘hot topic’ with the group. The following is just one of the topics that arose during the course of the round:

Skills for Justice National Occupational Standards for Civil Contingencies (Richard Green)

Richard had kindly agreed to talk to this item and provided a set of accompanying slides (emailed to members separately). The following are a couple of extracts.

Overview NOS describe competent performance in terms of outcomes 18 NOS outline the core functions for preparing for, responding to, and assisting with recovery from

emergencies Relevant to Category 1 and 2 responders as well as not-for-profit organisations Also relevant to those with civil protection roles in other sectors (e.g. business management) NOS for Civil Contingencies are designed to be complimentary to sector-specific NOS (e.g. SfJ CC2

Formulate, monitor and review tactics to achieve strategic objectives for policing operations), hence emphasis on integrated emergency management

Response Levels CC AG1 Respond to emergencies at the strategic (gold) level CC AG2 Respond to emergencies at the tactical (silver) level CC AG3 Respond to emergencies at the operational (bronze) level CC AA3 Work in co-operation with other organisations

Bibliography

National Occupational Standards for Civil Contingencies. Skills for Justice 2008.

Planning For The Shelter And Evacuation Of People In Healthcare Settings ( David Walker. Regional Head of EPRR (Midlands & East) at NHS England)


Risk Assessments



Power and other utility failure

Explosion or suspect package

Adverse weather

Flooding

Fire

Hazardous materials

Terrorist event

Levels when evacuation may be necessary and the implications

Stages/Phases of an evacuation and the implications

Scenarios Group Exercise

David took the group through an exercise looking at a range of scenarios relating to evacuation and shelter. The

group split into pairs and examined a range of scenarios, The following are just two of them:

Example 1: A complex patient on multiple inotropes, who is unstable upon turning. Using the algorithm the decision would be that this patient is very high risk for evacuation and may die if moved. If the trigger for evacuation were a fire in a distant portion of building which whilst operating the fire alarms in the patient’s vicinity, but is currently at low risk of spread to the Intensive Care Unit, then the patient should remain in situ. Example 2: A complex patient on multiple inotropes, who is unstable upon turning. Using the algorithm the decision would be that this patient is very high risk for evacuation and may die if moved. If the trigger for evacuation were a fire in the ward below, which whilst operating the fire alarms in the patient’s vicinity, is considered very likely to involve the unit, then the dynamic risk assessment including the risks posed to staff caring for the patient should result in the patient being moved.

Future Planning – Coloured Zone Approach

In terms of future planning David informed members that the guidance would be for hospitals to organise

evacuations on a ‘coloured zone’ basis – similar for example to the evacuation system at large shopping

centres. Members were advised to start to examine their local environments with this in mind. The following

diagram provided an example of how this might be look:



St Georges ED Temporary Divert ( Joel Standing. EPLO. St George’s University Hospitals NHSFT)


Aim of Session

“To share mine, and the Trust’s, experiences when you have no Resus or Majors in a Major Trauma Centre.”

Why Necessary?

Saturday 28th March 2015 local ‘Change Over Panel’ failed

Left only one single source mains supply

No mains supply back up

Decisions

1. Do nothing and pray that we don’t have a power failure!

2. Fix the problem

Turn off Resus and Majors

Reconfigure ED

Date Sequence of Events

28.03.15 Changeover panel failed 10.04.15 Estates planning meeting 17.04.15 Notice of intent to request redirect 30.04.15 Internal & external stakeholder meeting 29.05.15 Table top exercise 01.06.15 NHSE(L) decline redirect request (06.06.15) 15.07.15 NHSE(L) approve redirect (18.07.15) 17.07.15 SGUHFT ED prepare department for redirect 18.07.15 Redirect commences and works undertaken

What did we learn

You find out who your friends are!

Communications

Pan London and beyond public events

NHS England (London) redirect policy didn’t reflect the operational experience



It is all consuming

It can be done with the right support and challenges

As part of Joel’s presentation he also provided members with the following documents/handouts:

Options Appraisal

Timetable of Significant Events / Dates

Overall Timings Schedule

Operational Phase

Lessons Learned

Some General Points

exercise required engagement with all stakeholders – but not the public as did not want to cause undue

worry/anxiety

discovered that St George’s was named in a number of Safety Advisory Group documents but that St

George’s hadn’t been made aware of this!

whole exercise proved to be a significant personal learning curve

SORT (Special Operations Response Team) ( Bob Mearns – EOE Ambulance Service)


3 Biggest Threats to UK plc

Flu

Flood

Terrorism

Hazmat v CBRNE

HAZMAT: Is an accidental release of an agent or material which results in illness or injury to the public, the

denial of an area, or the interruption of the food chain

CBRNE: (Chemical, Biological, Radiological, Nuclear, Explosive): is a deliberate murderous and malicious

act, the intention of which is to kill, sicken or prevent society from continuing with its normal daily business.

PPE

Body

Hands

Feet

Eyes

Respiratory system.

Decontamination Equipment

Scissors

Buckets with warm, clean water

Decontaminant

o Detergent

o Sponges

Towels / blankets / sheets / modesty clothing.

Command Activation

Standard - Ambulance via 999 system

EOC will mobilise

First resource on scene provides METHANES

EOC escalates to Tactical Advisor

SORT mobilised, if appropriate

What Does a SORT Cell Look Like?



1 x decontamination officer (CBRNE bronze commander qualified)

1 x entry control officer

5 x operatives (PRPS wearers)

1 x equipment officer

2 x rescue team operatives (PRPS wearers)

2 x forward triage officers (PRPS wearers)

The cell must include a minimum of one clinician

Pre-arranged resources and equipment will be put in place for pre-planned events (i.e. VIPs, party

conferences, and public order), dependent on the threat assessment.

A minimum of two operatives and a commander should be supplied.

Decontamination

Remove casualty from the source of contamination (HART/Fire and Rescue task)

Remove all clothing

Remove all jewellery.

The decontaminant of choice for most chemicals is weak, warm detergent solution.

10ml of household detergent in a standard 10 litre bucket of warm, clean water.

Triage

SIEVE

(First Look)

Groups casualties into priorities

Can be done quickly and efficiently

Best practice is to triage in pairs

SORT

(Clinical)

‘Triage in a more leisurely manner’

Usually commenced in the CCS

(Casualty Clearing Station)

METHODOLOGY

Triage Sorting is carried out using set of definitive measurements

These are based on the following CLINICAL signs:

Respiratory Rate

Systolic Blood Pressure

Coma Scale

GROUP MEMBERSHIP

Name Job Title Trust

Claire O'Brien Head of Emergency Planning & Resilience

Ashford & St Peters Hospitals Foundation Trust

Chris Bartram Emergency Planning Officer Bedford Hospital NHS Trust

Natasza Lentner Head of Resilience Brighton & Sussex University Hospitals NHS Trust

Jonathan Tynan Clinical Risk Manager / Emergency Planning Lead

Calderstones Partnership NHS Foundation Trust

Ian Kilroy NHS Security Management Specialist/Police Liaison

Calderstones Partnership NHS Foundation Trust

Richard Greene Resilience Manager Cumbria Partnership NHS Foundation Trust



Bob Mearns Resilience Manager East of England Ambulance Service

John Weeks Emergency Planning Manager Maidstone & Tunbridge Wells NHS Trust

Julie Elphick Emergency Planning Officer Maidstone & Tunbridge Wells NHS Trust

Terri Sowter Head of Corporate Governance and Assurance

Nottingham City Care Partnership

Sam Grundy Emergency Planning Officer Rotherham Doncaster & South Humber NHS Foundation Trust

Malcolm Keith Trust Emergency Planner Royal Bournemouth & Christchurch Hospitals NHS Foundation Trust

Diane Preston Head of Emergency Planning & Business Continuity

The Royal Wolverhampton NHS Trust

Kristel McDevitt EPRR Officer NHS England (National)

Matthew Overton Emergency Planning Lead Royal Cornwall Hospitals NHS Trust

Honorary Members:

Mandy Brokenshow

Emergency Planning Liaison Officer Basildon & Thurrock University Hospitals NHS Foundation Trust

David Walker Regional Head of EPRR (Midlands & East)

NHS England

A SELECTION OF THE TOPICS IDENTIFIED FOR THE 2016/17 BVG

ROUND

Dynamic Risk Assessment / Risk Assessment

during a MI

National Occupational Standards for Civil

Contingencies

Hazmat / CBRN

Disease Outbreaks

Identification of Vulnerable People

Core Standards – Assurance Process

(benchmarking)

NHSE BCM Toolkit

Refugee / Migrant Crisis

Terrorist Threats

Industrial Action

Natural Disasters (inc flooding)

NPAG DEVELOPMENTS CPD Certification The NPAG is a member of the CPD Certification Service. The Resilience Development Network has received CPD approval for 2015. CPD Certification is a formal recognition of the contribution that membership of the Resilience Development Network makes to members' continued professional/personal development.



At the end of the annual round of meetings, members will receive certificates of attendance for all meetings attended during the year to evidence the contribution made as part of lifelong learning. NPAG NetWork The NPAG NetWork provides the facility for members to ask questions of any individuals, group or groups within the overall NPAG membership. Questions can be sent to the NetWork Facilitator who disseminates them across the NPAG membership. Responses are collated and returned to the originator and others who declare an interest in the question asked. NPAG Library The NPAG Library holds presentations from NPAG best value groups and conferences, together with policy and other documents sent in by members. Access to these items is via the NPAG NetWork Facilitator. NPAG Website The NPAG website includes a private members Area for each of the NPAG BVGs. Through these sites, BVG members can access and download meeting agendas, minutes, presentations and survey forms. The areas are password protected.

MEMBERS REFERRAL SCHEME AND DISCOUNTS Members Referral Fee – Introduce a friend and get 1 meeting for free. A member referral resulting in another Trust / Organisation registering for full membership of the same group will result in the referring member qualifying for a one meeting discount* The discount applies to the full membership fee only (not applicable to the 2nd member rate).The discount will be applied once, at the start of the current meeting round. Mid round membership referral discounts will be processed at the start of the following year’s membership round. Multiple referrals will result in multiple discounts up to four referrals per meeting round. *Equivalent to £147 Second Club Membership - A 20% discount will be applied when an existing NPAG member joins an additional Group. This does not apply to the £195 second member rate. Introducing our Try Before You Buy option. Simply attend the first meeting of a group’s new round, see what it’s all about and if you decide it’s not for you walk away commitment free*. *Try before you buy option is available to new members only. New members must inform NPAG in writing that they wish to ‘try before they buy’ prior to first meeting attendance. If the new member continues membership beyond the first meeting then the full group membership fee applies.

NPAG BENCHMARKING & BEST VALUE GROUPS

The NPAG organises and facilitates a national network of Best Value Groups that enables members to share experience, identify good practice; innovation and information to assist individual managers develop their own service improvement action plans.

Clinical Engineering (North) BVG NHS Car Parking and Travel Planning Network

Clinical Engineering (South) BVG NHS Sustainability Leads Network

Estates Services (North) BVG NHS Transport and Logistics BVG

Estates Services (South) BVG Nursing and Temporary Staffing BVG

Facilities (North) BVG Operating Theatres BM Group

Facilities (South) BVG Project and Programme Management Group

Health, Safety and Risk Management Network Resilience Development Network



Health Visiting and School Health Services DN Sterile Services BVG

IT and Connectivity Network Waste Management BVG

National District Nurses Network

For further information on the NPAG and our future activities, please contact Marie Cherry, Gemma Aitchison or Victoria Combes by telephone on 01245 544 600, or by e-mail on: [email protected] [email protected] [email protected]

Available to all members of NPAG Benchmarking and Best Value Groups, and individual subscribers, the NPAGNetWork provides the facility for members to ask questions of any individuals, group or groups within the overall NPAG membership. The response to questions raised has been excellent. The NPAGNetWork provides a managed forum for colleagues to share information - saving time and money in not re-inventing the wheel! Questions raised in the past month have included the following topics:

Pathology waste policy Facilities audit tool tools Decontamination of portable medical equipment Ward hairdressers Laundering Heat Labile items Fleet vehicle insurance Use of latex gloves Use of chute system for waste disposal

Thank you all who have responded! For full details of how to use the NPAGNetWork, please contact the NPAG team on 01245 544600 or email: [email protected]

Forthcoming NPAG Events Please visit www.npag.org.uk for all our current course, workshops, training & BVG meetings. Phone: 01245 544600 / email [email protected], [email protected] or [email protected]

NPAG Annual Clinical Engineering Conference – 13th September, Stratford-Upon-Avon Contact Gemma for info

Putting the Patient First – Customer Care and Communication Skills in the NHS Training On-Site Workshop Contact Marie for info

New Occupational Health Workshop Programme to be launched this Summer! Contact Gemma for info











REGISTRATION FORM

RESILIENCE DEVELOPMENT NETWORK 2016-17 ORGANISATION ADDRESS

Type of organisation: NHS Social Enterprise Other PHONE NO. FAX NO.

Member 1 for a £440 fee (3 meetings) Member 2 for an additional £195

NAME POSITION EMAIL SPECIAL REQUIREMENTS (Dietary/Access)

Reservations Invoicing Please send completed booking form to: If the invoice address is different from that (Photocopies acceptable) above please enter address below National Performance Advisory Group 87 Coval Lane Chelmsford Essex, CM1 1TQ Tel: 01245 544600 Fax: 01245 544610 Email: [email protected] www.npag.org.uk

BOOKING CONDITIONS: A VAT invoice will be issued. VAT Registration No. 654 9195 01. VAT applies to any NHS organisation outside England and to any non-NHS organisation.

Payment is due on receipt of invoice. DO NOT send payment in advance of receipt of invoice. When invoice is received, payment should be made to ‘East of England Ambulance Service NHS Trust.’

ALL cancellations must be in writing. Cancellations received within 14 working days of receipt of the registration

form will receive a full refund. After this date refunds cannot be made. A substitute is acceptable. NPAG cannot

be held responsible for any travel expenses or accommodation costs in the event of a cancellation or

postponement of a meeting, workshop or an event.

A 20% discount will be applied when an existing NPAG member joins an additional Group. This does not apply

to the £195 second member rate.

I confirm that I have read and accept the above BOOKING CONDITIONS and would like to register as a

member of the ‘Resilience Development Network 2016-17’. Please invoice me for payment.

Authorisation Signature ………………………… Your Order Number……………………………………

Cert No: 9210

