DOCUMENT CONTROL: Version: 7 Ratified by: Corporate Policy Approval Group Date ratified: 1 November 2018 Name of originator/Author: Emergency Planning Officer Name of responsible committee/individual:

Accountable Emergency Officer/ Corporate Policy Approval Group

Date issued: 1 November 2018 Review Date: November 2021 Target Audience: All Trust staff Amendments: It is the duty of all plan holders to inform the emergency planning officer of any information concerning changes which will consequently impact upon this plan.

Severe Weather & Winter Plan

Contents 1. Authorisation & Agreement of Plan 3 1.1 Distribution List 3 1.2 Plans to be used in conjunction with this Plan 3 1.3 Aim & Scope of Plan 3 1.4 Introduction 3 1.5 Risk Assessment 4-6 2. Activation of Plan 7 2.1 Cold Weather Alert 7 2.2 Cold Weather Alert Reporting Diagram 8 2.3 Cold Weather Alert Levels 10 2.4 Trust Action on receiving a Cold Weather Alert 10 3. Met Office Severe Weather Warnings 11 3.1 Example Severe Weather Warning 11 3.2 Trust Action on receiving a Severe Weather Warning 11 3.3 Out of Hours 13 4. Environment Agency Flood Warnings and Flood Guidance

Statements 13 4.1 Environment Agency Flood Warning Codes 13 4.2 Environment Agency Flood Guidance Statements 14 4.3 Trust Action on receiving a Flood Guidance Statement 15 4.4 Environment Agency Targeted Flood Warning Service 16 4.5 Targeted Floor Warning Service TFWS 17 5. Business Continuity 18 6. Example Staff Advice 18 6.1 Example Staff Advice upon receipt of Severe Weather Warning 18 6.2 Example Staff Advice for Extreme Low Temperatures and Heavy Snow 18 6.3 Example Staff Advice for Storms and Gales 19 6.4 Yorkshire 4x4 Response 19 7. Managing Patient Safety 20 8. Winter Planning Groups, Multi-Agency Local Response and

Governance Arrangements 20 9. Debrief and Lessons Learned 21 10. Links to Trust Policies 21 Annexe A Generic Actions for Cold Weather Alerts 22 Annexe B Generic Actions for Met Office Severe Weather Warnings 23 Annexe C Flu Vaccination Programme 26 Annexe D Exercise & Testing 27 Annexe E Amendments Procedure 28 Annexe F 4x4 Volunteer Booking Form 29 Annexe G Record of Amendments 30 Annexe H Glossary 31 Annexe I MOU between RDASH and Yorkshire 4x4 Response 32

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1. AUTHORISATION & AGREEMENT OF PLAN

Accountable Emergency Officer hereby approved this plan: 1.1 Distribution List

Filled in by those distributing in locality

Copy No

Issued To & Date:

1 Accountable Emergency Officer (Chief Operating Officer)

2 Emergency Planning Officer

3 Copy available via Trust Internet site

4 Copy available via L:\Corporate\IGP\Emergency Planning\Emergency Planning Resilience and Response\Severe Weather & Winter Plan\Severe Weather & Winter Plan

5 Copy Available in Emergency Cupboard – Boardroom 2, Woodfield House, Tickhill Rd, Doncaster

6 Copy Available in Emergency Cupboard – Boardroom 2, Swallownest Court, Rotherham

7 Head of Communications 1.2 Plans to be read in conjunction with this plan

Major Incident Plan Heatwave Plan

1.3 Aim & Scope of Plan

This plan provides guidance and information to enable Rotherham Doncaster and South Humber NHS Foundation Trust to provide a response to an episode of severe weather where an emergency response is required. The plan assists with the decision of whether to invoke the Trust Major Incident Plan. This plan sets out the actions to be taken in the lead up to a Major Incident and also can inform decisions taken once a Major Incident has been declared. This plan explains the Met Office Cold Weather Alert system and Severe Weather Warning system. It also covers the Environment Agency’s (EA) Flood Warning system. The plan sets out the Trust response for each of the warnings received. This plan is covered by the overarching Trust Emergency Preparedness, Resilience and Response (EPRR) Policy.

1.4 Introduction

Severe weather can impact the Trust directly through physical damage (e.g.

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flooding of premises) or indirectly via disruption to the road network, school closures and other services which all may have an effect on the Trust’s staffing levels and its ability to provide both clinical and corporate services. The impact of severe weather may mean damage to buildings or the disruption or cancellation of clinics or other community based services. In other health providers (acute trusts/ambulance services) the impact is likely to be considerable due to an increase in casualties from injuries, exacerbation of long term conditions and conditions such as hypothermia all of which may require hospital admission or may affect our community teams. In addition there is often a delay in discharge as there is a reluctance to discharge vulnerable people into potential hazardous conditions and potential isolation if health and social care services have been reduced or suspended on a temporary basis.

1.5 Risk Assessment

Local Community Risk Registers have risk assessed the likelihood and impact that severe weather incidents would have on the delivery of critical services that the Trust provides. The following risks have been identified from the latest Community Risk Registers for South Yorkshire and the Humber. When preparing Business Continuity Plans each team take into account the risk rating of severe weather incidents. Likelihood 1=Low It is a conceivable but highly remote possibility. 2=Medium Low No significant incidents of this type have occurred,

but it is capable of happening. 3=Medium Has occurred and is capable of happening again. 4=Medium High Has occurred on multiple occasions and is capable of

happening again. 5=High Has occurred on multiple occasions and is expected

to occur in the future. Impact 5=Catastrophic Many deaths and injuries, widespread property or

infrastructure damage, complete social and economic disruption and widespread and long-term environmental effects.

4=Significant Major permanent harm. 3=Moderate Semi-permanent harm (up to 1 year) 2=Minor Non-permanent harm (up to 1 month) 1=Insignificant Very few injuries, little disruption, few environmental

effects.

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Overall Risk Low Equivalent to rating 1-5 Medium Equivalent to rating 6-9 High Equivalent to rating 10-15 Very High Equivalent to rating 16+

Risk Number

Risk

Description Likelihood Impact Overall Risk

H17 Storms and gales

Storm force winds affecting most of the region for at least 6 hours. Most lowland areas experience mean speeds in excess of 55 mph (50 knots) with gusts in excess of 85 mph (70 knots). A localised windstorm (eg "tornado") could also occur affecting a very limited area. Winds in such a storm often reach speeds well in excess of 120 mph.

Medium High (4)

Minor (2) Medium

H18 Low temperatures and heavy snow

Snow falling and lying over most of the area for at least one week and after an initial fall of snow, there is further snowfall on and off for at least 7 days. Most lowland areas experience some falls in excess of 10cm, a depth of snow in excess of 30cm and a period of at least 7 consecutive days with daily mean temperature below -3°C. Up to 1000 fatalities and thousands of casualties, mainly amongst the elderly and there is likely to be some disruption to transport networks, businesses, power supply and water supply, and also school closures.

Medium High (4)

Moderate (3)

High

H21 Flooding: Severe inland flooding affecting more than two UK regions

A sustained period of heavy rainfall extending over two weeks, or similar quantities falling over a shorter time, perhaps combined with snow melt, resulting in steadily rising river levels across the Region and adjoining areas.

Medium (3) Significant (4) Very High

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Risk Number

Risk

Description Likelihood Impact Overall Risk

HL18 Local/Urban Flooding (Fluvial or Surface Water Run Off)

River or surface water flooding of commercial and residential properties. 24,217 properties at risk in the Doncaster and 1525 in Rotherham. The major risk area is in the Flood Corridors, Washlands, and Drainage Systems in the Don Valley from Sheffield City Centre downstream through Rotherham to Doncaster and beyond.

Medium High (4)

Significant (4) Very High

HL19 Local Pluvial Flooding (Surface Water Flooding)

Sudden onset ("flash") flooding of 100-1,000 properties caused by very heavy localised rainfall leading to either local watercourses or surface water drainage systems (or both) being overwhelmed. Sometimes referred to as "pluvial" flooding.

Medium High (4)

Moderate (3)

Very High

HL20 Localised, extremely hazardous flash flooding

Heavy localised rainfall in steep valley catchments leading to extremely hazardous flash flooding (e.g. high velocities and depths). Likely that no flood defences are in place. Probably no flood warning service available / or suddenness of event means timely flood warnings are not possible. Flooding of up to 200 properties.

Medium (3) Moderate (3)

High

Humber area only H19

Major Coastal & Tidal Flooding

Serious flooding affecting parts of more than two UK regions with coastal flooding impacting up to 300,000 properties for 14 days causing widespread damage, evacuation and loss of lives.

Medium (3) Catastrophic (5)

Very High

Humber area only H17

Major Coastal & Tidal Flooding

Local coastal tidal flooding in one UK region. Medium High (4)

Significant (4) Very High

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2. Activation of Plan

Often severe weather can be predicted and this allows us to take suitable pre-emptive actions to mitigate the effects. This plan is activated when certain triggers are reached. These relate to the following alert systems through which severe weather is measured by the Met Office and Environment Agency.

• Cold Weather Alerts. • Severe Weather Warnings and Flash Weather Warnings. • Environment Agency Flood and Severe Flood Warnings.

In the sections below this plan sets out the response when the above alerts are received. Often one may receive a combination of the alerts above. Depending on the severity of the alert the response may be to invoke the Trust Major Incident Plan which may be used in conjunction with the Severe Weather & Winter Plan.

2.1 Cold Weather Alert

The following staff receive Cold Weather Alerts from the Met Office via email:

• Emergency Planning Officer (EPO). • Accountable Emergency Officer (AEO). • Care Group Directors. • Associate Nurse Directors. • Head of Estates and Facilities • Estates Environmental Project Manager. • Trust Communications Team. • Doncaster Care Group Heads of Service. • Doncaster Single Point of Access Team. • Doncaster Rapid Response Service Manager. • Doncaster North Locality Service Manager.

It provides brief information about upcoming winter weather in general detail and this allows us to set out clear triggers where actions are to be taken by Trust staff.The diagram below depicts the responsibilities at national and local level for alerting and response once a cold weather alert has been issued.

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2.2

The Cold Weather Alert service now includes five alert levels, as outlined below. Cold Weather Alerts are issued by the Met Office on the basis of either of two measures: low temperatures; or widespread ice and/or heavy snow. Often low temperature criteria are met at the same time as the ice and snow. However, sometimes one may occur without the other. The thresholds for what constitutes severe winter weather have been developed in consultation between the Met Office, DH, Cabinet Office and other experts.

• Level 0: Winter preparedness – long-term planning emphasises that to

build resilience for the coming winter requires long lead-in planning times. This level of alert is aiming to emphasise the need to prepare for, adapt to and mitigate climate change and develop long-term sustainable

Department of Health/Civil

Contingencies Secretariat

Other Government Departments

Winter Resilience Network

Met Office Cold

Weather Alert

Public Health England

4 Regions 15 PH

Centres

NHS Choices

Public via media - TV,

radio, newspapers

NHS England

Corporate Team National

NHS Yorkshire & Humber Team

Ambulance Trust

Clinical Commissioning

Groups

Health & Wellbeing

Boards

RDaSH

Local Authority Emergency Planners &

Directors of Public Health

Including Local Resilience Forums and Local Health Resilience

Partnerships

Schools

Residential Homes

Nurseries

Voluntary Orgs

Social Services

Day Care Centres

Pharmacies

GPs & District Nurses

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approaches which seek to ensure behaviour change across the general population, community and health care professionals. Level 0 denotes that these are actions that should be taken throughout the year, and certainly before Level 1 starts for winter preparedness at the start of winter.

• Level 1: Winter preparedness is in force throughout the winter from 1

November to 31 March and indicates that preparations should be in place to protect health and ensure service continuity in the event of severe cold and winter weather.

• Level 2: Alert and readiness is declared when the Met Office forecasts a

60% risk of severe winter weather in one or more defined geographical areas in the days that follow. This usually occurs two to three days ahead of the event. A Level 2 alert would be issued when a mean temperature of 2°C is predicted for at least 48 hours, with 60% confidence, and/or widespread ice and heavy snow are forecast, with the same confidence.

• Level 3: Severe weather action is issued when the weather described in

Level 2 actually happens. It indicates that severe winter weather is now occurring, and is expected to impact on people’s health and on health services.

• Level 4: National emergency is reached when a period of cold weather is

so severe and/or prolonged that its effects extend outside health and social care, and may include, for example, transport or power or water shortages; and/or where the integrity of health and social care systems is threatened. At this level, illness and death may occur among the fit and healthy, not just in high-risk groups, and will require a multi-sector response at national and regional levels. The decision to go to a Level 4 is made at national level and will be taken in light of a cross-Government assessment of the weather conditions, coordinated by the Civil Contingencies Secretariat (Cabinet Office). A Level 4 alert is a judgement made in light of this cross-Government assessment and, depending on the severity of the conditions and impact, could be declared over any time period. The Cold Weather Alert levels are summarised in Figure 2.2.

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2.3: Cold Weather Alert levels

Level 0 Long-term planning All year.

Level 1 Winter preparedness programme 1 November to 31 March.

Level 2 Severe winter weather is forecast – Alert and readiness Mean temperature of 2°C and/or widespread ice and heavy snow are predicted within 48 hours, with 60% confidence.

Level 3 Response to severe winter weather – Severe weather action Severe winter weather is now occurring: mean temperature of 2°C or less and/or widespread ice and heavy snow.

Level 4 Major incident – Emergency response Central Government will declare a Level 4 alert in the event of severe or prolonged cold weather affecting sectors other than health.

2.4: Trust Actions on receiving a Cold Weather Alert

Level 1 Alert – This signifies the start of the winter preparedness programme and is the trigger for the Emergency Planning Officer to check that the Winter Plan and Major Incident Plans are up to date and that Teams have their Business Continuity Plans available and up to date. Level 2 Alert - When this is received from the Met Office the Emergency Planning Officer (or in their absence the Communications Team) will liaise with the Accountable Emergency Officer or deputy to consider appropriate action and provide details of a message to be sent via all staff email and be placed on the Trust Intranet pages. This will direct staff to make appropriate preparations such as reading their Business Continuity Plans. It is likely that this alert will be received alongside a severe weather warning. Level 3 Alert – At this level the Emergency Planning Officer or deputy will liaise regularly with the Accountable Emergency Officer or deputy and Head of Communications to ensure that information is disseminated to staff. Depending on the severity of the weather the Accountable Emergency Officer or deputy (a fellow director) may decide to invoke a Major Incident “Standby” situation. This alert will usually be received alongside a severe weather warning. Level 4 Alert – The Accountable Emergency Officer or deputy will consider declaring a Major Incident and invoke the Major Incident Plan. This alert is likely to be in conjunction with a “red” weather warning.

3. Met Office Severe Weather Warnings

The Met Office issue warnings and alerts for rain, snow, wind, fog and ice. These are given a colour depending on a combination of both the likelihood of

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the event happening and the impact the conditions may have. Early warnings of severe or extreme weather These are issued when the Met Office has 60% or greater confidence that severe weather is expected in the next few days. Flash warnings of severe or extreme weather These are issued when the Met Office has 80% or greater confidence that severe weather is expected in the next few hours.

Both use the formats below.

An example of a “Red” Severe Weather Warning can be seen below. 3.1 Example Severe Weather Warning

3.2 In normal office hours when a weather warning/alert is received it is

reviewed by the Emergency Planning Officer (EPO) who may consult

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with appropriate members of staff. If the EPO is absent the AEO (who also receive this information) will review the warning/alert as follows:

Is there a potential impact on The Trust? YES NO Inform following: No Action

• Accountable Emergency Officer. • Head of Communications. • Appropriate On Call Staff. • Head of Estates & Facilities

• Issue advice to staff based upon predicted impact.

Weather Warnings rated Amber or Red will be automatically passed by the EPO or deputy to the dissemination list above. In addition the Doncaster Care Group Single Point of Access Team receives weather warnings from the Met Office so that it has warning of any potential disruption to community services and can deploy staff appropriately. Receipt of a Red Warning would signify a potential Major Incident and the Accountable Emergency Officer (or if absent Director) will consider moving to “standby” as set out in the Trust Major Incident Plan. Receipt of an Amber Warning would signify warning of a disruptive incident. In this event suitable advice to staff to encourage them to make appropriate plans to mitigate the effects of the impending weather would be issued via the Communications Team. For example, staff may be instructed to familiarise themselves with their Business Continuity Plans. This may be through an all staff email or via the Trust Internet and Intranet sites. Generic guidance on actions to take can be found here at Annexe B. An amber weather warning often triggers the Environment Agency to chair a telephone conference to inform emergency responders about likely impacts. The Trust receives invitations to such telephone conferences via email to the EPO and AEO. These emails contain the telephone number and passcode to join the conference.

A Standard Operating Procedure for communicating with staff during periods of winter weather and other potential emergency situations that may affect attendance at the workplace can be found on the Trust Intranet.

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3.3 Out of Hours when a weather warning/alert is received it is reviewed by the Emergency Planning Officer (EPO) who may consult with appropriate members of staff. If the EPO is absent the AEO and Care Group Directors (who also receive this information) will review the warning/alert as follows. The weather warning is also received by the Doncaster Care Group Single Point of Access Team (24/7) who will be able to deploy planned and unplanned services appropriately. If informed of a weather warning that may impact on Trust Services on call staff should ensure the following are informed.

Is there a potential impact on The Trust YES NO Inform following: No Action

• On Call Managers/ Care Group Director/Director/Medical Staff. • Accountable Emergency Officer. • Head of Communications. • Estates on Call.

• Issue advice to staff based upon predicted impact. 4. Environment Agency Flood Warnings and Flood Guidance Statements

The Environment Agency works with the Met Office in the joint Flood Forecasting Centre. They provide a complete picture of national flood risk, from developing weather through to the actual flood event itself.

They provide a national forecasting and alert service to all emergency responders. The Centre operates 24 hours a day, 365 days a year, giving emergency responders longer lead times and targeted information to prepare for flooding.

4.1 ENVIRONMENT AGENCY FLOOD WARNING CODES

For further information see the Environment Agency website https://flood-warning-information.service.gov.uk/

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Ref: Environment Agency (2008) 4.2 Environment Agency Flood Guidance Statements

The Trust receives the Flood Guidance Statement (FGS) from the Flood Forecasting Agency. This statement provides a flood risk assessment to assist with planning decisions. A typical Flood Guidance Statement will be issued when flooding is forecast. An example map of what may be received is below. The FGS are received by the Emergency Planning Officer, Accountable Emergency Officer, Trust Communications and Care Group Directors.

FLOOD WARNING Flooding is expected. Immediate action required.

Issued half an hour to one day in advance of flooding.

Move family, pets and valuables to a safe place.

Turn off gas, electricity and water supplies if safe to do so.

Put flood protection equipment in place.

FLOOD ALERT Flooding is possible. Be prepared.

Issued two hours to two days in advance of flooding.

Be prepared to act on your flood plan. Prepare a flood kit of essential items. Monitor local water levels and the flood forecast

on our website.

FLOOD WARNING Flooding is expected. Immediate action required.

Issued half an hour to one day in advance of flooding.

Move family, pets and valuables to a safe place.

Turn off gas, electricity and water supplies if safe to do so.

Put flood protection equipment in place.

SEVERE FLOOD WARNING Severe flooding. Danger to life.

When flooding poses a significant threat to life.

• Stay in a safe place with a means of escape. • Be ready should you need to evacuate from

your home. • Co-operate with the emergency services. • Call 999 if you are in immediate danger.

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4.3 Flood Advisory Service (FAS) Teleconference

The Trust may receive an email notification of a Flood Advisory Teleconference in the event that flooding of significant impact is forecasted. These telephone conferences are chaired by the EA and are available to all responding agencies to dial in. Taking part is not compulsory but may be advisable if there is a significant impact forecasted. Email notifications are sent to the Emergency Planning Officer, Accountable Emergency Officer and Trust Communications.

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4.4 RDaSH Actions on receipt of Flood Guidance Statements

In normal office hours when a Flood Guidance Statement is received it is reviewed by the Emergency Planning Officer (EPO) who may consult with appropriate members of staff. If the EPO is absent the AEO or Care Group Directors (who also receive this information) will review the warning/alert as follows:

Is there a potential impact on the Trust? YES NO Inform following: No Action

• Accountable Emergency Officer. • Head of Communications. • Appropriate On Call Staff. • Head of Estates & Facilities

• Issue advice to staff based upon predicted impact. EPO or AEO or deputy will take part in FAS Teleconference if held.

Flood Guidance Statements rated Yellow will be considered by the Emergency Planning Officer and disseminated further if they represent a risk to the Trust. Flood Guidance Statements rated Amber or Red will be automatically passed by the EPO or deputy to the dissemination list above. Receipt of a Red Warning would signify a potential Major Incident and the Accountable Emergency Officer or deputy (a Director) will consider moving to “standby” as set out in the Trust Major Incident Plan. Receipt of an Amber Warning would signify warning of a disruptive incident. In this event suitable advice to staff to encourage them to make appropriate plans to mitigate the effects of the impending weather would be issued via the Communications Team. For example, staff may be instructed to familiarise themselves with their Business Continuity Plans. This may be through an all staff email or via the Trust Internet and Intranet sites. Generic guidance on actions to take can be found here at Annexe B. A Standard Operating Procedure for communicating with staff during periods of winter weather and other potential emergency situations that may affect attendance at the workplace can be found on the Trust Intranet. Out of hours when a Flood Guidance Statement is received it is reviewed by the Emergency Planning Officer (EPO) who may consult

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with appropriate members of staff. If the EPO is absent the AEO or Care Group Directors (who also receive this information) will review the warning/alert as follows:

Is there a potential impact on the Trust? YES NO Inform following: No Action

• On Call Managers/ Care Group Director/Director. • Accountable Emergency Officer. • Head of Communications. • Estates on Call.

• Issue advice to staff based upon predicted impact. EPO or AEO or deputy will take part in FAS Teleconference if held.

4.5 Targeted Flood Warning Service TFWS

The Trust is registered on the web based Targeted Flood Warning Database so the Emergency Planning Officer is able to check for flood alerts and warnings where they may affect specific Trust estate. The EPO will check the TFWS database on a daily basis during periods of wet weather and if a Flood Alert is issued for an area near RDASH premises will notify the relevant Team Manager, Care Group Director and Head of Estates. If a Flood Warning or Severe Flood Warning is issued for an area in which the Trust has estate the EPO will:

• Inform the Accountable Emergency Officer/deputy and Care Group

Directors. • Inform the Service Manager of the affected services and a senior contact

at the location affected. • Inform Head of Estates and provide a brief of the situation. • Inform Head of Communications in order that appropriate messages to

staff can be distributed. • Liaise with NHS England Yorkshire & Humber Team, and other

appropriate external partners if required. • Issue Guidance to follow procedures as set out in the affected team’s

Business Continuity Plan and individual evacuation procedures if required.

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In the absence of the EPO all on call Estates Managers have access to the Targeted Flood Warning Service and will fulfil the actions above in collaboration with the Accountable Emergency Officer, Directors and Care Group Directors.

5. Business Continuity

All teams in the Trust have Business Continuity Plans, which identify the actions required for the service to continue to maintain essential services during severe weather. This includes plans for disruption to staffing to ensure sufficient numbers of staff are available. For Trust headquarters it will be necessary to maintain essential 24/7 telephone switchboard services and staff living close to this location may be asked to remain at work to ensure this building remains open. Teams will be instructed to refer to their Business Continuity Plans whenever a severe weather event is likely to have an effect on their team. Business Continuity Plans are held electronically and in hard copy by each team and by the Emergency Planning Officer. Once the alert has been disseminated local decisions can be made about service prioritisation. Teams may need to make special arrangements for vulnerable people.

6. Example staff advice

When the Trust receives notification of severe weather it may be appropriate to issue advice to staff via the Communications team or the Emergency Planning Officer using all staff email and/or Trust Intranet. In such circumstances some example advice is included below that may be adapted to suit the circumstances. For example reference to the Trust’s Snow and Ice Clearing Policy.

6.1 Example Staff Advice upon receipt of Severe Weather Warning

In the case of receiving warnings of heavy rain the advice may include details of the weather forecast and the location and amount of predicted rainfall along with expected impacts. The Trust receives emails from the Met Office that contain links to the Met Office website which contains this information. Amber and Red warnings for areas covered by the Trust will trigger a warning for all staff. Yellow warnings may be dealt with according to the judgement of the EPO and/or Care Group Directors.

6.2 Example Staff Advice for Dealing with Extreme Low Temperatures and

Heavy Snow

• Staff need to ensure they wear appropriate warm clothing to work, check their route to work is clear before setting off on a journey and always carry additional warm clothing and blankets and food and drink in the car especially if the journey to work is long.

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• It is advisable to carry a spade in your car’s boot especially when snowfall is heavy or is predicted to be heavy. It is also good practice to ensure that there is ample charge on your mobile phone or carry a car adaptor phone charger.

6.3 Example Staff Advice for Storms and Gales

The main risk to the Trust in these incidents would be disruption to services caused by damage to premises. If a building is damaged as a result of severe storms/gales, the Business Continuity Plan for that site/service would be implemented. If damage was to occur out of hours, then the relevant on call Director/Care Group Director should be contacted with referral to the Accountable Emergency Officer if required. Staff may also find it difficult to travel to work in these conditions and they should inform their manager so alternatives for work can be arranged. If the severe weather commences during the day then Directors/Care Group Directors/Managers may need to consider the safety of their staff as driving conditions may be very difficult in severe gales and heavy storms. When employees are unable to get into work (or their nearest base) due to inclement weather they will be required to take annual leave, flexi-time or unpaid leave (unless otherwise directed by the Human Resource Team in cases of severe weather). Where practicable, employees may work from home with the agreement of their manager or Director. Employees not able to get to work must inform their line manager of their absence as close as possible to the beginning of their shift/day’s work.

6.4 Yorkshire 4X4 Response

The Trust has a Memorandum of Understanding with Yorkshire 4x4 Response volunteers who are willing to use their own 4x4 vehicles to assist the Trust when business continuity measures have been exhausted. The MOU is included at Annexe I. Assistance may take the form of essential transport of:

a) Frontline medical staff to and from their place of work (whether this be at

healthcare premises or a patient’s home). b) Key staff and decision makers to and from their place of work or home to

work. c) Medicines, food and other vital supplies or equipment. d) Patients to and from healthcare premises, subject to medical assessment

that they are fit to travel. Must be transported safely in the company of a suitable carer or Trust member of medical staff.

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Should the 4x4 response be required it may only be requested by the following:

• Accountable Emergency Officer. • Care Group Director. • Associate Nurse Director. • Emergency Planning Officer. • Any Member of the Trust Gold Command in response to a Critical or Major

Incident.

Yorkshire 4X4 Response Contact Numbers and Email may be obtained via Trust Switchboard or Emergency Planning Officer. When contacting Yorkshire 4x4 Response, staff should ensure where possible that they coordinate with other Care Group Directors to avoid making multiple separate requests for assistance. During out of hours the On Call Care Group Director is authorised to request support from Yorkshire 4x4 Response. A booking form for using the service is included at Annexe F. Yorkshire 4x4 Response drivers will always have a photo identification card. Costs for using Yorkshire 4x4 Response Volunteer drivers will be as per the Memorandum of Understanding (MOU) which may be obtained from the Emergency Planning Officer. Costs will be charged to the budget of the service requiring assistance. If the 4x4 service is not available staff may request assistance via NHSE who will escalate this request via the Local Resilience Forum partners.

7. Managing Patient Safety

A severe weather incident may impact directly on patient safety e.g. in the event of damage to premises or if staff levels are severely reduced. In such circumstances it is the responsibility of patient facing staff to ensure they are aware of the effects this has on patient safety and how to mitigate it. Staff should refer to individual patient records, business continuity and evacuation plans.

8. Winter Planning Groups and Multi Agency Local Response and

Governance Arrangements

The Trust’s services are delivered across a large geographic area covering Rotherham, Doncaster, North and North East Lincolnshire. Different areas contain different multi agency planning groups that deal with issues like winter planning, capacity, surge and escalation management. These groups meet throughout the year to discuss normal business but often meet more frequently during the winter period. This allows different agencies to monitor usage of all services and work together to manage any “rising tides” if necessary.

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In the event of a severe weather incident these networks would likely be used to communicate to help facilitate response. In each case the CCG would chair and coordinate arrangements for meetings or telephone conferences.

9. Debrief and Lessons Learned

Critical and/or Major Incident At the conclusion of a Critical or Major Incident, the Accountable Emergency Officer will make arrangements for staff to be debriefed and may request other health organisations that have worked alongside the Trust in response to take part. This process will take place within 3 months of the incident “stand down”. The debrief may take the form of a pro-forma or a debrief meeting as appropriate to the incident. At the conclusion of the incident, the Accountable Emergency Officer will prepare a report on the Major Incident, to include issues identified by the debriefing process, together with an action plan to address the issues raised. The report and action plan will then be submitted to the Trust’s Board of Directors, NHS England and other agencies as appropriate, subject to the agreement of the Trust Board. The report should be submitted to the Board of Directors within 6 months of the incident “stand down”. Other Debriefs In the event of a period of severe weather affecting the trust but not triggering a Critical or Major Incident the Emergency Planning Officer will make arrangements for staff to be debriefed and will seek feedback from other organisations that have worked alongside RDaSH during the response. The debrief will take the form of a meeting attended by all affected services where feedback will be sought on the Trust’s response. The Emergency Planning Officer will prepare a report containing a list of “lessons learned” with an action plan to address these issues. The report and action plan will be submitted to the monthly Trust Quality and Safety Sub Group for comment.

10. Links to Trust policies

http://www.rdash.nhs.uk/24672/policy-relating-to-attendance-for-duty-during-periods-of-inclement-weather-or-disruption-to-the-public-transport-system/ http://www.rdash.nhs.uk/24072/snow-and-ice-clearing-policy/

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ANNEXE A Generic Actions to take at each Cold Weather Alert Level

Level 0 Level 1 Level 2 Level 3 Level 4 Long-term planning All year Winter preparedness programme1

November to 31 March Severe winter weather is forecast – Alert and readiness Mean temperature of 2°C and/or widespread ice and heavy snow is predicted within 48 hours, with 60% confidence

Response to severe winter weather – Severe weather action Mean temperature of 2°C or less and/or widespread ice and heavy snow

Major incident – Emergency responseCentral Government will declare a Level 4 alert in the event of severe or prolonged cold weather affecting sectors other than health

Work within your teams and with partner organisations to ensure that systems are developed to support the identification and sharing of information between agencies of people who may be vulnerable to cold weather and other seasonal variations. Systematically work to improve the resilience of vulnerable people to severe cold. Ensure that all staff have been made aware of the Winter Plan and the dangers of cold weather to health and know how to spot signs and symptoms.

Identify those at risk on your caseload and necessary changes to care plans for high-risk groups. For those with multiple agency inputs, ensure that the key worker is clearly identified. Work with individuals at risk, their families and carers to ensure that they are aware of the dangers of cold weather and cold housing and how to keep warm. Ensure that there are clear arrangements for ‘signposting’ those at risk clients and patients to other services (e.g. home insulation schemes, benefits entitlements) when identified in ‘clinical’ situations or consultations. Work with partners to ensure that vulnerable patients and clients have access to fuel supplies. Link to energy supplier priority service registers as required. Ensure that clients and colleagues are aware of, and take advantage of, flu and other vaccination programmes. Identify the resources available to you for raising awareness of health risks associated with winter weather and cold housing (for example, pharmacists have a key role in reminding people to have sufficient medicine and can help with preventive medicines management.

As appropriate, contact those most at risk and implement care plans. When making home visits, be aware of the room temperature in the household and be able to advise on recommended room temperatures. Know how to signpost clients onto other services, especially those at high risk. Remind clients of the actions they can take to protect themselves from the effects of severe cold. Consider how forecast weather conditions may impact on your work – and make appropriate arrangements.

Implement local plans for contacting the vulnerable. If appropriate, consider daily visits or phone calls for high-risk individuals living on their own who have no regular contacts. Ensure staff can help and advise clients. Other actions as per Level 2. Maintain business continuity

Continue actions as per Level 3 unless advised to the contrary

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ANNEXE B

Met Office Severe Weather Warning Generic Actions.

Know what to expect and what action to take

The table below provides examples of the kind of disruption that might be experienced for each impact level (high, medium, low) and for each weather type (rain, snow, fog, ice, wind). It also provides some general advice to try and mitigate the impacts. Note that weather assessed as having a "Very Low" impact may still have some minor impacts.

Very Low Low Medium High

Impact and

advice

applying to

ALL SEVERE

WEATHER

The weather is not expected to have any noticeable impacts but there may be some minor issues e.g. when travelling some extra care may be needed on occasions and there may be some disruption to outdoor events.

BE AWARE and ensure you access the latest weather forecast for up to date weather information. Expect some minor delays due to slower traffic. Outdoor events may be disrupted or cancelled.

BE PREPARED. Take precautions where possible and ensure you access the latest weather forecast. BE PREPARED for some disruption to normal daily routines. Travel only if well prepared and BE PREPARED for longer journey times.

TAKE precautionary ACTION and remain extra vigilant. Follow orders and any advice given by authorities under all circumstances. Ensure you access the latest weather forecast. EXPECT significant disruption to normal daily routines. Avoid all non-essential journeys. If you must make a journey carry emergency food/ clothing/ blanket etc.

Impact and

advice

associated

with RAIN

Some flooding of low lying fields, recreational land and car parks but little or no disruption to travel. Wet road surfaces and possibility of ponding water leading to difficult driving conditions. Take extra care when driving in affected areas.

Localised flooding of low lying fields, recreational land and car parks. Flooding of a small number of homes and businesses. Wet road surfaces and possibility of ponding water, especially in known trouble spots. Local disruption to travel - longer journey times. Water on roads - drive according to the conditions encountered.

Some flooding of homes, businesses and transport links possible. Disruption to travel likely. Disruption to gas, electricity, water supplies and telecoms. Some evacuations may be required. Be prepared to protect yourself and your property.

Widespread flooding of property. Severe disruption to travel. Loss of gas, electricity, water supplies. Significant disruption to communities. Evacuation expected. Significant risk to life. Take action to protect yourself and follow the advice of the emergency services.

Impact and

advice

associated

Debris dislodged and some branches removed. Perhaps some very limited travel disruption. Difficulties on some

Some branches or trees brought down. Localised travel disruption. Localised

More widespread tree damage & other debris, slates etc dislodged from roofs. Some minor structural damage

Widespread structural damage, e.g. roofs blown off, mobile homes overturned, power lines brought down.

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Very Low Low Medium High

with WIND prone routes e.g. cross winds on exposed or high level roads.

problems for high-sided vehicles on prone routes. Drive with care, especially on exposed routes. BE AWARE of possible debris being blown around.

possible. Risk of injury from flying debris. BE PREPARED for some travel disruption e.g. closed bridges. Potential for some localised interruptions to power.

Risk to personal safety from flying debris. Potentially widespread and/or prolonged interruptions to power. Expect widespread transport disruption due to e.g. roads blocked by fallen trees.

Impact and

advice

associated

with FOG

Some localised non-persistent fog affecting limited geographical areas. Take extra care when driving in affected areas. There may be some very limited impact on road transport.

More widespread, locally dense fog affecting significant areas of the country but not persisting beyond 1 - 2 days. Some airports may close for short periods. Take extra care when driving in affected areas. Journeys through affected areas may take longer than usual.

Widespread and dense fog affecting large areas of the country including a number of major airports and/or ports. The fog is persistent and may last for many days in some areas. BE PREPARED for some travel disruption. Take great care if driving and BE PREPARED for increased journey times. BE PREPARED for delays at affected airports and/or ferry ports

N/A

Impact and

advice

associated

with SNOW

Small amounts of snow lying on roads and pavements so some slippery road surfaces possible. Traffic may move generally slower than normal. Take extra care when walking, cycling or driving in affected areas.

More widespread snow lying on roads and pavements but road networks generally open. Care needed with only localised travel disruption. Problems mostly confined to usual prone areas. Take extra care when walking, cycling or driving in affected areas. Journeys through affected areas may take longer than usual.

Widespread snow with a number of road closures, others passable only with care. BE PREPARED for some disruption to road, rail and air transport with difficult driving conditions likely and longer journey times.

Widespread deep snow with many roads closed or impassable. Roads likely to become impassable with high risk of drivers becoming stranded. Significant disruption to road, rail and air transport. Risk to personal safety. Expect significant disruption to normal day to day life as a result of transport issues, school closures etc. Avoid making unnecessary journeys.

Impact and

advice

Localised icy stretches on some untreated roads and pavements are possible. Take extra care when

More widespread icy stretches on untreated roads and pavements but road networks

Widespread black ice, some roads passable only with care. Possibility of road collisions and

N/A

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Very Low Low Medium High

associated

with ICE

walking, cycling or driving in affected areas.

generally open. Take extra care when walking, cycling or driving in affected areas. Journeys through affected areas may take longer than usual.

significant increase in slips & falls.

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ANNEXE C Flu Vaccination Programme Flu vaccination programmes must be undertaken in line with the Department of Health guidance. There is currently a flu vaccination programme being undertaken with all staff being offered the flu vaccination. This is being monitored to understand staff uptake with communications being made to encourage a greater level of uptake by staff.

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ANNEXE D Testing and Exercising Elements of plan will be tested annually as part of the exercise programme of the Business Continuity Plans.

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ANNEXE E Amendment Procedure • It is ESSENTIAL that information in this plan is kept up to date • It will be the responsibility of the Trust Directors, Managers, and Human

Resources to immediately inform the Trust Emergency Planning Officer of any personnel details which have changed and which may have a subsequent impact upon the procedures outlined in this Plan.

• It is the responsibility of ALL plan holders to immediately inform the Trust

Emergency Planning Officer of any other details which have changed and which may have a subsequent impact upon the procedures outlined in this Plan.

• Plan holders are responsible for ensuring that their personal copy of the Winter

Plan is kept up to date. • In addition to the above amendments which can be issued at any point during the

year, the Severe Weather and Winter Plan will be subject to a comprehensive review once a year by the Emergency Planning Officer.

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ANNEXE F Yorkshire 4X4 Volunteer Booking Form

4x4 Volunteer Transport Booking Form

Name of person(s) to be transported including team and Care Group/directorate : Authorised by: Contact Number of person(s) to be transported. Tel home or work: Mobile: Pick up From: Postcode: General Area (for grouping pick-ups/ drops) Destination(s) – Include estimated mileage: Postcode: General Area ( for grouping pick-ups / Drops) Date: Time: Checklist: Allocated to driver (name): Driver Notified: Pick up actioned: Comments:

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ANNEXE G Record of Amendments

Amendment Number Date: Page Number

Amended Amended by:

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ANNEXE H GLOSSARY OF TERMS AEO Accountable Emergency Officer (Chief Operating Officer) BCP Business Continuity Plan CBRN Chemical Biological Radiological & Nuclear CCG Clinical Commissioning Group COBR Cabinet Office Briefing Rooms CRIP Commonly Recognised Information Picture (A Sitrep by

another name) DMBC Doncaster Metropolitan Borough Council EA Environment Agency EPO Emergency Planning Officer EPRR Emergency Preparedness Resilience and Response FGS Flood Guidance Statement GLO Government Liaison Officer HAZMAT Hazardous Materials HPA Health Protection Agency ICC Incident Control Centre LHRP Local Health Resilience Partnership LRF Local Resilience Forum MIP Major Incident Plan PHE Public Health England SCG Strategic Coordinating Group SITREP Situation Report STAC Scientific and Technical Advice Cell TCG Tactical Coordinating Group TFWS Targeted Flood Warning Service

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ANNEX I

Memorandum of Understanding (MOU)

Between

Rotherham Doncaster & South Humber NHS Foundation Trust

And

Yorkshire 4x4 Response

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This memorandum of understanding is made on 30 August 2017 Between:

1. Rotherham Doncaster and South Humber NHS Foundation Trust (RDaSH) of Woodfield House, Tickhill Road, Doncaster, DN4 8QN.

And

2. Yorkshire 4x4 Response Ltd, a charity registered in England and Wales (Registered Number 1144928) of 91 Front Street, Acomb, York, YO24 3BU. Yorkshire 4x4 Response Ltd is a limited company registered in England and Wales (Registered Number 07647604).

Yorkshire 4x4 Response is a volunteer group of ordinary people who are willing to use their own four wheel drive vehicles to assist the wider community in times of need. Yorkshire 4x4 Response is able to request assistance from 30+ similar groups from around the country. As a voluntary group Yorkshire 4x4 Response are not government funded and rely upon donations to operate. Yorkshire 4x4 Response offer assistance as required by their users, who are principally Category One and Two responders across Yorkshire and the Humber and have over 100 active members and supporting volunteers. This is often in extraordinary circumstances or extremes of weather, such as heavy snow or flooding. Whereas A. RDaSH is an NHS Foundation Trust providing Community and Mental Health

inpatient and community services to Rotherham, Doncaster, North Lincolnshire and North East Lincolnshire. RDaSH also provides community health care services in Doncaster;

B. RDaSH wishes to minimise disruption to services provided by it during periods

of severe adverse weather, major incident or civil emergencies; C. Yorkshire 4x4 Response is a voluntary organisation able to provide logistics

support using four wheeled drive motor (4x4) vehicles to RDaSH and other health care providers in adverse conditions, major incidents or civil emergencies within Yorkshire, Lincolnshire and North East Lincolnshire;

D. RDaSH wishes to enter into this Memorandum of Understanding (MOU) with

Yorkshire 4x4 Response to set out the terms under which assistance by Yorkshire 4x4 Response may be provided to it.

1. Nature of agreement 1.1 This MOU will form part of the emergency plans and procedures of RDaSH. It

will be used when RDaSH wishes to seek assistance from Yorkshire 4x4 Response.

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1.2 The MOU is an expression of the commitment of RDaSH and Yorkshire 4x4 Response to work together in a continuing spirit of cooperation and partnership for the benefit of the communities they serve.

1.3 The MOU will not create legal obligations between the parties, but represent a

statement of their goodwill and intention to follow its terms where possible to enable the effective and efficient provision of assistance.

1.4 Both parties undertake to give at least one month’s notice of termination of

this MOU. 1.5 The terms of this MOU may be varied from time to time by the agreement of

both parties, either by the production of a new MOU or an amendment to be attached to this original.

2. Assistance available from Yorkshire 4x4 Response.

2.1 Yorkshire 4x4 Response will make reasonable efforts to provide such assistance as is requested by RDaSH, subject to operational conditions and priorities of other users.

2.2 Assistance may take the form of essential transport of:

a) Frontline medical staff to and from their place of work (whether this be at

healthcare premises or a patient’s home); b) Key staff and decision makers to and from their place of work or home to

work; c) Medicines, food and other vital supplies and equipment; d) Patients to and from healthcare premises, subject to medical assessment

that they are fit to travel unaccompanied or may be transported safely in the company of a suitable carer or RDaSH member(s) of medical staff.

2.3 People under the age of 16 and vulnerable adults will only be transported if

accompanied by a carer or other suitable responsible adult.

3. Obligations of Yorkshire 4x4 Response

3.1 Yorkshire 4x4 Response will maintain a body of volunteers with 4x4 vehicles (Responders) who are willing to make themselves available to provide assistance to RDaSH. Responders will provide their own 4x4 vehicles.

3.2 Yorkshire 4x4 Response will provider Responders with appropriate training to

ensure adequate levels of competence to provide the service requested. 3.3 Yorkshire 4x4 Response will provide Responders with appropriate personal

protective equipment suitable for their role, or ensure Responders provide such items for themselves.

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3.4 Yorkshire 4x4 Response will provide Responders with a photo identification card.

3.5 Yorkshire 4x4 Response will maintain public liability insurance to cover its

activities and those of Responders. Such insurance may be provided by 4x4 Response UK or such other organisation that may exist to coordinate and represent the activities of 4x4 response groups.

3.6 Yorkshire 4x4 Response will maintain effective arrangements to ensure

Responders have the right to work in the United Kingdom, have suitable motor insurance covering voluntary activities and have a current driving license.

3.7 Yorkshire 4x4 Response will support its members in obtaining DBS checks

though users organisation as a umbrella organisation if required. Yorkshire 4x4 Response are not legally allowed to request DBS checks of their members.

3.8 Yorkshire 4x4 Response will provide records of mileage and activities

undertaken in response to a request for assistance made by RDaSH and will render invoices to RDaSH for the cost of such activities, quoting the number of any purchase order or orders raised by RDaSH in respect of such activities.

4. Obligations of Rotherham Doncaster & South Humber NHS Foundation Trust (RDaSH).

RDaSH will:

a) Consider use of its own resources and business continuity arrangements

before requesting assistance from Yorkshire 4x4 Response. b) Designate particular members of staff (the Authorised Persons) who will be

authorised to request assistance from Yorkshire 4x4 Response in accordance with the arrangements set out in paragraph 5 below and incur expenditure by doing so;

c) Undertake to reimburse Yorkshire 4x4 Response through the arrangements

set out in paragraph 5 below for mileage incurred by Responders in providing assistance or undertaking training directly related to the provision of assistance at the rate set out paragraph 5 below.

d) Reimburse for mileage within 30 days of the provision of assistance or

training. e) Pay any excess up to £250 if a Responder makes a claim on their motor

insurance or has a claim made against them on such insurance in respect of an incident when they were rendering assistance to RDaSH.

f) Provide reasonable subsistence (such as hot meals and drinks) to

Responders during a period of assistance where appropriate facilities exist.

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g) Provide reasonable support and assistance to Yorkshire 4x4 Response (which could include the provision of training, information and briefings and the load of equipment or use of premises or staff) where this would materially assist the efficiency and effectiveness of the arrangements set out in this MOU.

h) Consider supporting, when requested by Yorkshire 4x4 Response and

appropriate to do so, applications by it for grants and other financial aid from grant making bodies and Government Departments.

5. Coordination, call out and financial arrangements. 5.1 Yorkshire 4x4 Response will maintain and monitor one or more telephone

numbers for the purpose of receiving calls from RDaSH; 5.2 The RDaSH Authorised Persons listed below will make all requests for

assistance to Yorkshire 4x4 Response on behalf of RDaSH and will, so far as is possible, coordinate and prioritise those requests. RDaSH Authorised Persons: Accountable Emergency Officer Any Member of Gold Command in response to a Major Incident Any Care Group Director Any Associate Nurse Director Emergency Planning Officer

5.3 Costs incurred by RDaSH for assistance rendered by Yorkshire 4x4

Response will be assigned to the budget of the Care Group/directorate or team that requested the assistance and will be signed off by the budget holder.

5.4 Yorkshire 4x4 Response will maintain records of mileage and activities

undertaken on behalf of RDaSH and provide those records to RDaSH upon request.

5.5 Yorkshire 4x4 Response will invoice RDaSH using the mileage rate taken

from the Local Government Employers National Joint Council Casual Users Scheme of 65p/mile for vehicles when operating to provide assistance to RDaSH.

5.6 Yorkshire 4x4 Response reserve the right to make other charges for costs

directly associated with the mobilisation, tolls, parking charges etc. In the case of any such individual charge in excess of £10 reasonable measures will be made by Yorkshire 4x4 Response to contact RDaSH to gain authorisation.

6. Review and quality assurance

6.1 RDaSH and Yorkshire 4x4 Response will meet regularly and no less than

every year to review the arrangements set out in this MOU.

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6.2 If a complaint is made concerning the actions or conduct of a Responder or a member of staff or volunteer of RDaSH then the complaint will be investigated and determined by Yorkshire 4x4 Response in the case of a Responder and by RDaSH in the case of a member of its staff or a volunteer in accordance with its own procedures.

6.3 Both parties will inform each other of any such complaints and the outcome of

them. 7. Disputes 7.1 If a dispute arises between the Trust and Yorkshire 4x4 Response in relation

to any matter which cannot be resolved such dispute may be referred to the parties’ Key Managers.

7.2 If the dispute cannot be resolved within 14 days each of the parties shall

arrange for a more senior representative than those referred to above to meet solely in order to resolve the matter in dispute, i.e. a Trust Care Group Director. Such meeting(s) shall be minuted and shall be chaired by the Trust (but the chairman shall not have a casting vote). Such meeting(s) shall be conducted in such manner and at such venue (including a meeting conducted over the telephone) as to promote a consensual resolution of the dispute in question at the discretion of the chairman.

7.3 If the meeting(s) referred to above does not resolve the matter in question

then the parties will attempt to settle it by mediation in accordance with the Centre for Effective Dispute Resolution ("CEDR") Model Mediation Procedure. To initiate mediation either party may give notice in writing (a "Mediation Notice") to the other requesting mediation of the dispute and shall send a copy thereof to CEDR asking CEDR to nominate a mediator. The mediation shall commence within 28 days of the Mediation Notice being served. Neither party will terminate such mediation until each of them has made its opening presentation and the mediator has met each of them separately for at least one hour. Thereafter the Model Mediation Procedure will apply. Neither party to the mediation will commence legal proceedings against the other until 30 days after such mediation of the dispute in question has failed to resolve the dispute. The parties will co-operate with any person appointed as mediator providing him with such information and other assistance as he shall require and will pay his costs, as he shall determine or in the absence of such determination such costs will be shared equally.

For Rotherham Doncaster & South Humber NHS Foundation Trust Name……………………………………………………………………………………… Signed.......……………………………………………………………………………….. For Yorkshire 4x4 Response

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Name………………………………………………………………………………………….. Signed………………………………………………………………………………………… Signed Copy held by Emergency Planning Officer.