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Public Health Emergency Response Preparedness Minimum Standards

Summary This Policy Directive sets out for Local Health Districts (LHDs) the Ministry of Health and Health Protection NSW's expectations for public health emergency preparedness and response capacity. This policy aims to support the statewide public health service's ability to prepare for, respond to and recover from major public health eventsby identifying a set of minimum preparedness standards for all LHDs. The standards address high level planning elements and more specific minimum requirements around knowledge, skills and equipment (including information systems).

Document type Policy Directive

Document number PD2019_007

Publication date 01 February 2019

Author branch Office of the Chief Health Officer

Branch contact (02) 9391 9188

Replaces PD2013_039

Review date 01 February 2024

Policy manual Not applicable

File number 18/2718

Status Active

Functional group Corporate Administration - GovernancePopulation Health - Disaster management

Applies to Local Health Districts, Specialty Network Governed Statutory Health Corporations, Public Health System Support Division

Distributed to Ministry of Health, Public Health System

Audience LHD Executive, JH&FMHN Executive, LHD Population Health Directors, Public HealthUnit staff, ED team

Policy Directive

Secretary, NSW HealthThis Policy Directive may be varied, withdrawn or replaced at any time. Compliance with this directive is mandatory for NSW Health and is a condition of subsidy for public health organisations.

POLICY STATEMENT

PD2019_007 Issue date: February-2019 Page 1 of 2

PUBLIC HEALTH EMERGENCY RESPONSE PREPAREDNESS

MINIMUM STANDARDS

PURPOSE

This Policy Directive defines a set of minimum standards for Local Health Districts (LHD) and Justice Health and Forensic Mental Health Network (JH&FMHN) public health emergency response preparedness.

MANDATORY REQUIREMENTS

LHDs must ensure that the basic immediate response capacity outlined in the policy directive is available

LHDs must ensure compliance with the general, overarching planning aspects of public health preparedness as outlined in Section 3. Governance, staffing and operational capabilities

PHUs must have staff members trained in the essential skills required in a public health emergency as described in:

o 4.1 New starter training o 4.2 Emergency response exercises o 4.3 Incident control system skills o 4.4 Technical and communicable disease skills o 4.5 Information management and analytics skills o 4.6 Privacy and confidentiality

PHUs must be equipped with a minimum set of tools and equipment to carry out rapid risk assessments of and the initial response to public health events as described in 5. Equipment

PHUs must have access to health information infrastructure and surveillance systems that are able to accept, process, analyse and share data for surveillance and epidemiological investigation activities as described in 6. Information Systems

IMPLEMENTATION

LHDs are responsible for annually self-assessing their compliance with the Policy Directive using the checklist provided in Appendix E. The Office of the Chief Health Officer will issue correspondence to Chief Executives requesting signed forms and any supplementary explanation annually.

REVISION HISTORY

Version Approved by Amendment notes

February 2019 (PD2019_007)

Chief Health Officer & Deputy Secretary, Office of Chief Health

The Policy Directive has been amended in the following areas:

• requirements for participation in emergency exercises, actual responses and training sessions, including debrief

POLICY STATEMENT

PD2019_007 Issue date: February-2019 Page 2 of 2

Officer • mass vaccination clinic activation timeframe • privacy, confidentiality and data security during an emergency • Information management and analytics skills section expanded • Uniform requirements updated • Mobile phone, GPS, satellite phone, laptop and printer requirements updated • Signatories to Public Health Preparedness Minimum Standards Annual Monitoring Checklist now expanded to: Chief Executive, Public Health Controller and Health Services Functional Area Coordinator

November 2013 (PD2013_039)

Deputy Director General

Policy directive introduced to define minimum standards for LHD public health emergency response preparedness

ATTACHMENTS

1. Public Health Emergency Response Preparedness Minimum Standards: Procedures


PROCEDURES

Issue date: February-2019

PD2019_007


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PD2019_007 Issue date: February-2019

Contents

CONTENTS

1 BACKGROUND ..................................................................................................................... 1

Introduction ................................................................................................................ 1

Meeting the requirements .......................................................................................... 1

2 AIM OF THE PUBLIC HEALTH EMERGENCY RESPONSE PREPAREDNESS MINIMUM STANDARDS ................................................................................................................................ 2

3 STANDARDS – GOVERNANCE, STAFFING AND OPERATIONAL CAPABILITIES ..... 2

Governance ............................................................................................................... 2

Staffing ...................................................................................................................... 2 Operational capabilities ............................................................................................. 3

4 STANDARDS – TRAINING AND REQUIRED SKILLS ...................................................... 4

New starter training ................................................................................................... 4 Emergency response exercises ................................................................................. 4

Incident Control System skills .................................................................................... 4 Technical and communicable disease control skills................................................... 5 Information management and analytics skills ............................................................ 5

Privacy and confidentiality ......................................................................................... 6

5 STANDARDS – EQUIPMENT............................................................................................. 7

6 STANDARDS – INFORMATION SYSTEMS ...................................................................... 8

7 APPENDICES ...................................................................................................................... 9

Appendix A – ‘Field kit’ storm case contents list ........................................................ 9 Appendix B – ‘PHEOC kit’ storm case contents list ................................................. 10

Appendix C – Competencies for Public Health Controllers in NSW ......................... 11 Appendix D – Competencies for Public Health Commanders in NSW ..................... 13 Appendix E - Public Health Preparedness Minimum Standards Annual Monitoring Checklist: ............................................................................................... 15 Appendix F – References and development ............................................................ 20


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1 BACKGROUND

Introduction

Public health responses occur on a spectrum from day-to-day investigations to major incidents. In some instances, these responses will require a sudden, sustainable and increased input of appropriately trained staff, reliable tools and further equipment resources to initiate a rapid risk assessment and commence the response.

The NSW Health Protection Service (i.e. Health Protection NSW and public health units) has a key role in identifying health risks and implementing response strategies during major incidents or emergencies which may affect the health of a population. Having a well-prepared workforce and effective, tested tools and systems to support disease control, environmental health responses and other mitigation activities is the foundation of a strong operational response.

The purpose of this document is to define the minimum planning, duties, skills, equipment and information system requirements that must be met by local health districts (LHDs) to support public health emergency responses.

Meeting the requirements

LHDs must ensure that the basic immediate response capacity outlined in this document is available within public health units (PHUs) or through partnerships with clinical services, particularly in LHDs spanning large geographical areas.

PHUs work closely with their LHDs on many emergency preparedness aspects, including participating in LHD planning and exercises and seeking support from LHDs for plans to access surge staff and resources. For major public health responses, support can also be arranged from other PHUs in the statewide network, Health Protection NSW and the Ministry of Health (MoH).

Assessing compliance

LHDs are responsible for annually self-assessing their compliance with this Policy Directive using the checklist provided in Appendix E. The Office of the Chief Health Officer will issue correspondence to Chief Executives requesting signed forms and any supplementary explanation annually.

Vulnerable populations may be disproportionately affected during an emergency and require special consideration when LHDs are preparing for and responding to emergencies. LHD must consider these groups when undertaking the self-audit.

Justice Health & Forensic Mental Health Network

The public health emergency response requirements of the Justice Health & Forensic Mental Health Network (JHFMHN) vary slightly to those of LHDs because


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of the unique work environment in a correctional setting and the lack of field deployment. The standards that apply to JHFMHN are noted in Appendix E.

2 AIM OF THE PUBLIC HEALTH EMERGENCY RESPONSE PREPAREDNESS MINIMUM STANDARDS

In order to promote a consistent approach to public health emergency preparedness across the state, the Ministry of Health, in consultation with Health Protection NSW and LHDs, has developed a set of emergency response capacity minimum standards for public health emergencies.

The Public Health Emergency Response Preparedness Minimum Standards aim to support the statewide public health service’s ability to prepare for, respond to and recover from major public health events by identifying a set of public health preparedness minimum standards for all LHDs. There is an emphasis on commencing and coordinating the first 48 hours of a local public health response.

These standards support the following strategies:

1. Investing in critical public health emergency response infrastructure;

2. Developing and delivering enhanced emergency response communication

tools;

3. Enhancing the emergency preparedness and response skill base of the

NSW statewide public health service workforce; and

4. Coordinating and providing guidance on public health emergency

preparedness, response and recovery.

3 STANDARDS – GOVERNANCE, STAFFING AND OPERATIONAL CAPABILITIES

LHDs must ensure the following aspects of public health preparedness are met:

Governance

Public health membership on the LHD(s) emergency committee Business continuity plans are in place

Working relationships exist between the public health service and: LHD disaster manager, local emergency departments, pharmacies, pathology

laboratories, local councils, general practitioners, primary health networks, Aboriginal medical services, LHD toxicologists and radiation safety officers in the context of public health preparedness

Staffing

The capability to surge public health staff in accordance with the Public Health Workforce Surge Guideline (GL2014_003)


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The capability to deploy locally in response to a public health incident within two hours of receiving a notification (noting that while best endeavours will be taken to meet the standard, an out-of-hours response may require additional time)

The capability to operate a staffing roster for a public health incident for up to 16 hrs/day for five days

The continual operation of a roster of on-call staff to assess after-hours public health notifications

Enough people available to fill each of the key Incident Control System positions described in Section 4.3 to allow for: absenteeism, shift rotation, fatigue management and, for rural areas, coverage over broad geographic areas

Protocols in place to ensure public health responder health and safety, including appropriate compliance with Occupational assessment, screening and vaccination against specified infectious diseases (PD2018_009)

Staff deployed to an incident must have access to a uniform that: o identifies the wearer as a NSW Health employee

o is safe, comfortable, functional and practical

o is appropriate for the activities to be performed

Operational capabilities

The capability to identify key risks / carry out rapid public health and epidemiological risk assessments

Documented arrangements in place with partners who could rapidly provide additional resources to a public health response (e.g. appropriately skilled staff and/or equipment, including IT capacity, not held by the PHU)

The capability to set-up and run a local public health emergency operations centre (PHEOC)

The capability to set up a mass vaccination clinic within 24 hours (for guidance refer to Mass Vaccination Clinics during an Influenza Pandemic, GL2018_008)

In many cases these requirements will be met through existing arrangements with the LHD Health Services Functional Area Coordinator (HSFAC), for example, coordination of an operations centre or broader surge planning.

Debrief procedure PHUs must have a procedure in place for conducting a debrief activity following a significant response. The debrief should review the response to identify lessons learned. A plan should be developed to convert the lessons learned from the response or exercise into measurable steps that will result in improved response capabilities.


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4 STANDARDS – TRAINING AND REQUIRED SKILLS

LHDs must ensure that the training and skill mix of available personnel is sufficient to meet the needs of public health emergencies.

In the event of an incident or response, PHUs may choose to source supporting staff from outside the PHU. Formal arrangements must be in place to ensure the correct skills, training and orientation requirements are met. For example, a checklist for surge staff involved in interviewing might include: an experience assessment, a list of required just-in-time training modules and a site orientation checklist.

New starter training

All new starters at PHUs who may take part in an emergency response must complete the online modules below (available through My Health Learning) within three months of commencement:

1. PHEM: Public Health Emergency Management, Course Code: 184674532

2. Introduction to Incident Control System (ICS), Course Code: 133756489

3. Public Health Incident Control Systems, Course Code: 184677169

New starters are also recommended to complete the module Environmental Health Emergency Responses as appropriate to their role (module available in GEM online training system).

Emergency response exercises

Exercises are integral to public health emergency preparedness. They help build organisational capacity to respond to public health incidents and emergencies.

Exercises are used to: review, test or assess plans, processes, standards and equipment;

evaluate and practice procedures, control and coordination arrangements

and;

evaluate how teams and agencies collaborate and perform together.

All PHU staff who may be involved in a public health emergency response are required to take part in at least one emergency exercise, actual response or relevant training session annually (e.g. Incident Control System training). This includes re-familiarisation with personal protective equipment if this is relevant to the risks identified in their response role.

Incident Control System skills

LHDs must be able to operate within an Incident Control System (ICS) structure during a public health response. At a minimum, sufficient staff must be prepared to fulfil the roles of:

Public Health Controller (competencies under Appendix C)

Public Health Commander (competencies under Appendix D)

https://gem.workstar.com.au/public/index.cfm?action=showPublicContent&assetCategoryId=670

https://gem.workstar.com.au/public/index.cfm?action=showPublicContent&assetCategoryId=670


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Liaison Officer (refer to Health Liaison Officer, IB2019_001 and NSW Health

Emergency Management Education Training Framework, IB2018_031).

Training for Public Health Commanders and Public Health Controllers is available through the Office of the Chief Health Officer.

Technical and communicable disease control skills

LHDs must have a documented process for PHUs to access skilled personnel (either within or external to the PHU) to:

Collect environmental samples in the field (for example water samples)

Collect clinical samples in the field (alternately the PHU must have access to

a facility where people can be taken to have their clinical samples urgently

collected)

Carry out clinical examinations (alternately the PHU must have access to a

facility where people can be taken to have their clinical examinations carried

out)

Conduct interviews with the affected population and case contacts (after just-

in-time training by the PHU)

Information management and analytics skills

The critical analysis of data can provide crucial support to a public health emergency response. To deliver this support PHUs must ensure that sufficient staff members are trained and experienced in the use of the following systems and applications:

Applicable Staff Name of system / application

Requirement

Staff performing

Surveillance

Contact

tracing

Management

of outbreaks

NSW Public Health

Rapid, Emergency,

Disease and

Syndromic

Surveillance

(PHREDSS) system

Understand how to:

Access PHREDSS reports for LHD

emergency presentations and

ambulance call outs

Analyse reports to support

epidemiological enquiry

Obtain further information from the

Ministry’s Rapid Surveillance team

Notifiable Conditions Information Management System (NCIMS)

Access is restricted to staff involved in public health follow up of notifiable conditions. Staff must be trained to use the system before full access is provided. Users must be able to navigate a series of menus, tabs, wizards, and

mailto:[email protected]


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Applicable Staff Name of system / application

Requirement

NCIMS (Cont’d from previous page)

workflows to view and edit information, and generate reports, letters and surveys.

Secure Analytics for Population Health Research and Intelligence (SAPHaRI)

Where PHU staff are using SAPHaRI to perform data analysis they must understand how to access, extract and analyse data securely. PHUs without data analytics staff may source expertise from other PHUs or Health Protection NSW.

A-Z infectious diseases portal

PHU staff must understand the purpose and use of this application.

Spread sheet program

PHU must have staff that are able to securely share and review line lists.

All staff

PopNet Understand how to locate emergency management documents

Privacy and confidentiality

Practices to protect privacy and confidentiality must be maintained regardless of the status of an emergency situation, or the requirement to work off site.

Standard processes for accessing, collecting, analysing, using, maintaining and disseminating data should not be compromised due to a sense of urgency.

There are a number of privacy and confidentiality modules that are targeted at NSW Health staff in particular roles. Attention is drawn to the modules below, which are available in My Health Learning. Please note that this is not an exhaustive list.

Targeted at Module

All NSW Health staff (Mandatory)

Privacy Module 1 - Know Your Boundaries - Course Code: 39966648 Privacy Module 2 - Handling Personal Information and Personal Health Information - Course Code: COM938

NSW Health staff performing data analysis or data release

Use and Disclosure of NSW Health Data for the Purpose of Analytics - Course Code: 160761816


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NSW Health clinical staff MHPOD: Confidentiality and Privacy in Practice - Course Code: 97548274

5 STANDARDS – EQUIPMENT

PHUs must be equipped with a minimum set of tools and equipment to carry out rapid risk assessments of and the initial response to public health events. An effective and timely initial response can reduce adverse health, social and economic consequences.

Further benefits include evidence informed decision-making, implementation of appropriate and timely control measures, more effective operational and risk communication and overall improved preparedness.

PHU offices should have immediate access to the following items:

At least two sets of wet weather gear

At least two broad-brimmed hats

At least four high visibility safety vests (tabards) clearly marked with ‘NSW

Health’, ‘Public Health’

At least one ‘field kit’- see Appendix A for detailed contents list

At least one ‘PHEOC kit’ – see Appendix B for detailed contents list

At least one influenza point of care testing (POCT) kit, or another rapid,

reliable means of influenza testing

At least one water testing kit - Hach DR/820 and/or Palintest

At least one Legionella emergency response kit

Water sampling containers (microbiological, chemical, pesticide)

Refrigerated storage (isothermal shipper or freezer bricks and cooler)

Maintenance, testing and rotation strategies must exist for equipment. LHDs are responsible for maintaining the PHEOC and field kits and replacing outdated/used equipment.

Electronic equipment (including that in kits) may need regular use in order to maintain contracts, receive software updates and ensure the battery is charged.

LHDs may choose to integrate electronic equipment into regular use outside of emergencies to facilitate maintenance and currency. Equipment must be ready to be deployed at any time, but not necessarily stored within the kit.

Formal arrangements must be in place to allow PHUs rapid access to the following equipment (usually with LHD EDs, pathology laboratories or pharmacies):

Clinical sample collection containers

Personal protective equipment (PPE) for identified risks

Cold chain management equipment - in compliance with the National

Vaccine Storage Guidelines Strive for 5


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Transport/cars

6 STANDARDS – INFORMATION SYSTEMS

PHUs must have access to health information infrastructure and surveillance systems that are able to accept, process, analyse and share data for surveillance and epidemiological investigation activities. Plans must be in place to address local information systems to minimise disruption to local networks, applications and platforms during planned or unexpected downtime.

Certain information infrastructure features should be standard in a PHU.

They are:

Internet connectivity

Secure Local Area Network (LAN)

Records Manager installed on computers

PHU offices must also be equipped with:

Computers running more than one web browser

Fax, dedicated phone line and analogue phone


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7 APPENDICES

Appendix A – ‘Field kit’ storm case contents list

Not required for the Justice Health & Forensic Mental Health Network.

Computer Equipment

*Laptop – with mobile wireless internet access X1

USB memory stick – 16GB X1

Field Backpack

Hand sanitiser (small) X2

Reflective vests – public health X2

Writing pad and paper X2 pads

Clipboard X2

Stationery (e.g. pencil case containing waterproof markers, red/ blue/ black pens, hi-lighters in various colours)

X1 pack

A3 and A4 laminated sheets for whiteboard/note board 2 each

PHU-provided contact numbers ( recommended) X 1

Operator log X1

Envelopes (A4) X25

**Smartphone – handset and charger ( including PHU-provided plan including data) X1

**Digital camera X1

**GPS device X1

First aid kit X 1

NSW HEALTH public health stamp X1

Surgical masks X 6

Washing up gloves X 2

Leather riggers gloves X 2

Disposable nitrile gloves (XL) X 6

Safety goggles X 2

Snap lock bags (L) X 4

Sunscreen X 1

Insect repellent X 1

Duct tape X1

Earplugs X 4

Torch and batteries X 1

Sticky notes X 2 pads

***Satellite phone for rural PHUs (optional) x 1

Powerboard or double adaptors X1

* Physical storage inside kit is not required. Refer to section 5. **Where all deployable staff in the PHU have been provided with a work smart phone and data access, inclusion of a GPS device, mobile phone and/or a digital camera in the kit is optional.*** Rural LHDs who choose not to maintain a satellite phone should consider including alternative communication methods/tools in emergency preparedness plans and kits.


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Appendix B – ‘PHEOC kit’ storm case contents list

Not required for the Justice Health & Forensic Mental Health Network.

*Laptop with mobile wireless internet access (including power, mouse and network cable)

1

Portable printer (including batteries, power cables and spare ink cartridges) or process for arranging rapid access to printer

1

A3 and A4 laminated sheets for whiteboard/note board 2 each

Ream of A4 paper 1

A4 notepad/writing pad 1

Clipboards 2

Manilla folders 10

Pack of black and red pens 1 pack each

Hi-lighters in various colours 4

Permanent markers 2 each

Whiteboard markers 2 each

30cm ruler 1

Stapler and staples 1

Variety of sticky notes 2

‘Completed’ self-inking stamp 1

‘Entered’ self-inking stamp 1

Pack of blu-tack 1

Double sided tape 1

Power board (4 port) 1

5M extension cord 1

AA batteries (4 pack) 1

AAA batteries (4 pack) 1

USB flash drive (2GB) 2

ICS vests (1 x Controller, 1x Deputy Controller, 1 x Operations, 1 x Logistics, 1 x Planning)

1 set

Public health vest with ‘liaison’ inserts 1

**Smartphone – handset and charger (including PHU-provided mobile phone plan including data)

1

Equipment ‘how to’ guide 1

Screwdriver (cross head for changing batteries on printer) 1

Scissors 1 pair

Sheets of labels 5 sheets

Plastic folders 5

Operator log X1

* Physical storage inside kit is not required. Refer to section 5. **Where all deployable staff in the PHU have been provided with a work smart phone and data access, inclusion of a mobile phone in the kit is optional.


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Appendix C – Competencies for Public Health Controllers in NSW

Background information

A Public Health Controller is responsible for coordinating the public health response to a major incident, as outlined in Healthplan. The position is usually held by the Chief Health Officer (State Public Health Controller) or Public Health Unit Director (Local Public Health Controller) or a senior public health staff member identified by the CHO or PHU Director.

Following identification of an incident with potential public health implications, the Public Health Controller may activate an Incident Control System structure and public health emergency operations centre. The Public Health Controller works with the incident management team to identify the key objectives of the response and provides regular briefings and situation reports to senior leaders or groups (e.g.: Secretary, State HSFAC or LHD HSFAC).

Job action sheets should be provided during training and at the time of role designation, to ensure that the Public Health Controller understands the position’s roles and responsibilities.

A Public Health Controller must be able to:

1. Describe the public health role in an emergency response in a range of emergencies that might arise, following completion of the NSW Health public health emergency management e-learning course or equivalent.

2. Understand and be able to apply the Incident Control System (ICS), following completion of the NSW Health public health ICS e-learning course or equivalent.

3. Understand and be able to apply methods for addressing the media, following media techniques training.

4. Describe the governance arrangements in emergency response: a. Between the Local Public Health Controller and the Local Health

District (LHD) Health Services Functional Area Coordinator (HSFAC) b. Between a LHD Public Health Controller and the State Public Health

Controller 5. Understand the links between local, state and national responses to public

health emergencies. 6. Be familiar with NSW Emplan, NSW Healthplan, relevant emergency

standard operating procedures and public health unit plans and relevant sub plans.

7. Describe the functional role of a Public Health Controller (as per Healthplan) and demonstrate that role in regular drills.

8. Assess risk and deploy resources to mitigate risk and reduce impact. 9. Demonstrate awareness of the communications equipment likely to be used

in an emergency response, including accessing relevant websites and ensuring the incident management team has access to those with expertise who are able to use all likely methods of communication (eg: radio, fax-stream).

10. Describe the communication arrangements in an emergency response:


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a. within the local public health unit b. between the Health Communications Controller (as per Healthplan)

and the Public Information Functional Area Coordinator (as per Emplan)

c. between the State HSFAC and State Controllers (as per Healthplan) d. between LHD HSFACs and LHD Controllers (and per LHD

Healthplan) e. with laboratories f. with partners (e.g. local government) g. with the media h. with the general public i. with local health providers (divisions of GPs, pharmacies etc.) j. with clinicians within LHDs

11. Communicate public health information/roles/capacities/legal authority accurately to all emergency response partners, such as the NSW Food Authority, water utilities, other health agencies and other government agencies during planning, drills and actual emergencies (e.g.: includes contributing to effective community-wide response through leadership, team building, negotiation and conflict resolution).

12. Maintain regular, timely and accurate communication with emergency response partners (includes maintaining a current directory of partners and identifying appropriate methods for contact in emergencies as per Healthplan and Emplan).

13. Have the capacity to and recognise the value of emergency management exercises to ensure the quality of public health responses. Public Health Controllers are required to demonstrate participation in one exercise or actual emergency response annually.

14. Identify limits to own knowledge/skill/authority and identify key system resources for referring matters that exceed these limits.

15. Apply creative problem solving and flexible thinking to unusual challenges within functional responsibilities and evaluate effectiveness of all actions taken.

16. Recognise deviations from the norm that might indicate an emergency and describe appropriate action (e.g.: communicate clearly within the chain of command, be willing to activate an ICS structure to ensure human and other resources are managed appropriately).

17. Evaluate every emergency response, including practice exercises to identify and implement needed internal and external improvements.

18. Identify what further training opportunities are available through the NSW Office of Emergency Management or other organisations.


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Appendix D – Competencies for Public Health Commanders in NSW

Background information

A Public Health Field Command Team (led by a Public Health Commander) may be appointed either when a field operational task requires senior command or if multiple field responses are occurring simultaneously (e.g. response teams at several venues being used for a mass gathering). The Field Command Team remains part of the Operations Team.

The functions of the Public Health Field Command include, but are not limited to:

• Management of the public health field aspects of the response

• Supply of public health advice to other agencies in the field (e.g. waste

management or provision of clean drinking water)

• Coordination of public health aspects of case and contact management in the

field (e.g. collecting swabs from contacts during an institutional outbreak)

• Provision of information to the Operations Team Leader about field technical

aspects

• Gathering of information to support rapid, medium-term and long-term health

needs assessments

• Collection of epidemiological data (e.g. how many people with particular

symptoms have reported to the event first aid station?)

• Keeping the Health Commander (if one has been appointed) informed of

onsite public health activities

Following identification of an incident with potential public health implications, a Public Health Commander may be delegated command of information gathering to support a rapid health needs assessment. In some cases this may lead to medium and long-term health needs assessments for ongoing recovery.

Whilst the Commander may not be expert in all areas of public health field management it is imperative that the position holder understands the urgency of requests of the team, the skill sets required for different tasks in the field and the command and control structures (e.g. linking with the Health Commander, if one has been appointed) in use in a particular operation.

Job action sheets should be provided during training and at the time of role designation to ensure that the Public Health Commander understands the position’s roles and responsibilities.

A Public Health Commander must be able to:

1. Define a major incident, emergency and disaster. 2. Be familiar with LHD uniform and deployment protocols. 3. List the hierarchy of command during an emergency response.


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4. Describe the public heath role in emergency response in a range of emergencies that might arise, following completion of the NSW Health public health emergency management e-learning course.

5. Understand the Incident Control System (ICS), following completion of the NSW Health public health ICS e-learning course.

6. Define the command and control structures and state their importance and interrelationship (including Site Control, Health Commander and Operations Team relationships).

7. Understand how to keep safe in a potentially dangerous environment and communicate those requirements to team members.

8. Be able to lead field teams to assess, mitigate and to reduce public health risk.

9. Be proficient in preparing incident action plans and understand the need for structured briefings (e.g. SMEAC formula), debriefings and reporting (e.g. field situation reports).

10. Describe the importance of communication during a major emergency, especially in the coordination and management of the scene.

11. Be familiar with the various ways that public health services communicate with field team members including:

a. Radio (including radio models networks and voice procedures and phonetic alphabet and numbers)

b. Satellite phone c. Internet (including email and secure systems such as Popnet and

Citrix) d. Secure data collection (e.g. NCIMS)

12. Demonstrate an ability to consult with expert advisors regarding the resources required for a particular type of field operation (e.g. environmental inspection vs immunisation clinic vs medication dispensing) and request those resources from the logistics team.

13. Consider the needs of the team for the safe delivery of public health services (e.g. adequate clinic space for an immunisation clinic, space for data collection in an evacuation centre) and communicate these to the site controller.

14. Describe the responsibilities and functions of other response officers in the field.

15. State the dynamics of a well organised health service emergency response with different components that work together and complement each other.

16. State the importance of exercising, training and maintenance of the equipment in relation to work efficacy and cost-effectiveness.

17. State how to undertake welfare checks with team members and how to identify and manage issues or conflicts that arise amongst team members.

18. State how to obtain assistance for team members who may require medical assistance or psychological first aid.

19. Identify what further training opportunities are available through the NSW Office of Emergency Management or other organisations.


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Appendix E - Public Health Preparedness Minimum Standards Annual Monitoring Checklist:

LHDs and JHFMHN are responsible for annually self-assessing their compliance with the Minimum Standards using this checklist. The Office of the Chief Health Officer will issue correspondence to Chief Executives requesting signed forms and any supplementary explanation annually. *Please note: any ‘in progress’ or ‘no’ responses must have comments provided about actions underway to meet the minimum requirement.

Public Health Preparedness Minimum Standards

Status

Comments Yes In

progress* No*

1. Standards – Governance, staffing and operational capabilities (refer to Section 3)

Governance

1.1 Public health membership on the LHD’s (*or JHFHMN ) emergency committee ☐ ☐ ☐

1.2 Business continuity plans for public health services are in place ☐ ☐ ☐

1.3 Working relationships between the public health service and: LHD disaster manager,

local emergency departments, pharmacies, pathology laboratories, local councils,

general practitioners, primary health networks, Aboriginal medical services, LHD

toxicologists and radiation safety officers in the context of public health preparedness

(JHFHMN only where relevant)

☐ ☐ ☐

Staffing 1.1 Capability to surge public health staff ☐ ☐ ☐

1.2 Capability to deploy locally in response to a public health incident within two hours of

receiving a notification ☐ ☐ ☐

1.3 Capability to operate a staffing roster for a public health incident for up to 16 hrs/day

for five days ☐ ☐ ☐

1.4 On-call staff arrangements in place to respond to after-hours public health responses

assessments ☐ ☐ ☐

1.5 Compliance with PD2018_009 Occupational Assessment, Screening and Vaccination

Against Specified Infectious Diseases ☐ ☐ ☐


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Status

Comments Yes In

progress* No*

1.6 Protocols in place to ensure that staff deployed to an incident have access to a uniform

that clearly identifies the wearer as a NSW Health employee, is safe, comfortable,

functional and practical and is appropriate for the activities to be performed ☐ ☐ ☐

Operational Capabilities ☐ ☐ ☐

1.7 Capability to identify key risks / carry out rapid public health and epidemiological risk

assessments ☐ ☐ ☐

1.8 Documented arrangements in place with partners who could rapidly provide additional

resources to a public health response ☐ ☐ ☐

1.9 LHDs: Capability to set-up and run a local public health emergency operations centre

*JHFMHN: Capability to contribute to JHFMHN emergency operations centre ☐ ☐ ☐

1.10 Capability to set up a mass vaccination clinic within 24 hours ☐ ☐ ☐

1.11 Procedure in place for conducting a debrief activity following a significant response ☐ ☐ ☐

2. Standards –training and required skills (refer to Section 4)

General

2.1 All new starters have completed compulsory online emergency management modules

with three months of commencement ☐ ☐ ☐

2.2 All PHU staff who may be involved in a public health emergency response have taken

part in at least one emergency exercise, actual response or relevant training session

annually. ☐ ☐ ☐

2.3 Relevant staff familiarised with personal protective equipment annually ☐ ☐ ☐

2.4 Nominated staff able to perform the following roles within an Incident Control System

structure: Public Health Controller, Public Health Commander and Liaison Officer ☐ ☐ ☐

Technical and communicable disease control skills


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Status

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LHDs must have a documented process for PHUs to access skilled personnel (either within or external to the PHU) to:

2.1 Collect environmental samples in the field (for example water samples) ☐ ☐ ☐

2.2 Collect clinical samples in the field (alternately the PHU must have access to a facility

where people can be taken to have their clinical samples urgently collected) ☐ ☐ ☐

2.3 Carry out clinical examinations (alternately the PHU must have access to a facility where

people can be taken to have their clinical examinations carried out) ☐ ☐ ☐

2.4 Conduct interviews with the affected population and case contacts (after just-in-time

training by the PHU) ☐ ☐ ☐

Information Technology Skills

PHUs must have sufficient staff trained to use the following systems and applications:

2.5 PHREDSS ☐ ☐ ☐

2.6 NCIMS ☐ ☐ ☐

2.7 PopNet (All staff) ☐ ☐ ☐

2.8 Secure Analytics for Population Health Research and Intelligence (SAPHaRI) ☐ ☐ ☐

2.9 A spreadsheet program (and secure sharing of line lists)

3 Standards – equipment (refer to Section 5)

3.1 Maintenance, software update, testing and rotation strategies in place for all equipment

used in public health emergency operations. ☐ ☐ ☐

PHUs have immediate access to the following equipment: 3.2 Two sets of wet weather gear ☐ ☐ ☐

3.3 Two broad brimmed hats ☐ ☐ ☐


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Status

Comments Yes In

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3.4 Four high visibility safety vests (tabards) clearly marked with ‘NSW

Health’, ‘Public Health’

Not applicable to

JHFMHN

☐ ☐ ☐

3.5 One ‘field kit’ ☐ ☐ ☐

3.6 One ‘PHEOC kit ☐ ☐ ☐

3.7 One influenza point of care testing (POCT) kit in PHU, or another rapid reliable means of

influenza testing ☐ ☐ ☐

3.8 One water testing kit (Hach DR/820 or Palintest) ☐ ☐ ☐

3.9 One Legionella emergency response kit ☐ ☐ ☐

3.10 Water sampling containers (microbiological, chemical, pesticide) ☐ ☐ ☐

3.11 Specimen containers and preservatives (for swabs, stools and urine) ☐ ☐ ☐

3.12 Refrigerated storage ☐ ☐ ☐

3.13 Clinical sample collection containers ☐ ☐ ☐

3.14 Personal protective equipment (PPE) for identified risks ☐ ☐ ☐

3.15 Cold chain management equipment ☐ ☐ ☐

3.16 Transport/cars ☐ ☐ ☐

4 Standards – Information systems (refer to Section 6 )

PHU information systems must be equipped with the following:

4.1 Internet connectivity ☐ ☐ ☐

4.2 Secure Local Area Network (LAN) ☐ ☐ ☐

4.3 Records Manager installed on computers ☐ ☐ ☐

4.4 Computers running more than one browser ☐ ☐ ☐


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Status

Comments Yes In

progress* No*

4.5 Fax, dedicated phone line and analogue phone ☐ ☐ ☐

I have reviewed the self-assessment performed against the Public Health Emergency Response Preparedness Minimum Standards. Any gaps in preparedness have been noted and are being addressed.

Name of LHD/JH&FMHN:

Chief Executive name: Signature: Date:

Public Health Controller Name: Signature: Date:

HSFAC name: Signature: Date:


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Appendix F – References and development

Framework for a Public Health Emergency Operations Centre - World Health Organization, Rapid Risk Assessment of Acute Public Health Events – World Health Organization, 2012. Public Health Preparedness Capabilities: National Standards for State and Local Planning – US Department of Health and Human Services, Centers for Disease Control and Prevention, Office of Public Health Preparedness and Response, March 2011. Public Health Preparedness & Response Core Competency Model; Knowledge, Skills, Attitudes – Centres for Disease Control and Prevention: Office of Public Health Preparedness and Response & Association of Schools of Public Health, September 2012. NSW Health Services Emergency Management Education Framework - NSW Health Emergency Management Unit, July 2018 (IB2018_031) New South Wales Health Services Functional Area Supporting Plan (NSW HEALTHPLAN) - NSW Health Emergency Management Unit, May 2014 (PD2014_012) Health Liaison Officer Information Bulletin - NSW Health Emergency Management Unit, January 2019 (IB2019_001) A structured framework for improving outbreak investigation audits - Craig B Dalton, Tony D Merritt, David N Durrheim, Sally A Munnoch and Martyn D Kirk. BMC Public Health 20099:472 https://doi.org/10.1186/1471-2458-9-472

https://doi.org/10.1186/1471-2458-9-472

public health emergency response preparedness minimum ...€¦ · districts (lhds) to support...

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