SECTION A: RESPONSE
1.1 IDENTIFYING AN INCIDENT
The information contained in the following flowchart is ONLY a guide. If the Director On-call believes that the incident warrants putting the organisation at Critical or Major Incident ‘Declared’ or ‘Standby’ status then as the PROVIDE Incident Director they the authority to activate the plan. This is true even if the incident does not fit into the criteria below as long as the activation is reasonable and justifiable
2.1 DEFINITIONS
2.1.1 Incident
For the NHS incidents are classed as either.
• Business Continuity Incident is an event or occurrence that disrupts, or might disrupt, an organisation’s normal service delivery, to below acceptable pre-defined levels. This would require special arrangements to be put in place until services can return to an acceptable level.
Examples include surge in demand requiring temporary re-deployment of resources within the organisation, breakdown of utilities, significant equipment failure or hospital acquired infections. There may also be impacts from wider issues such as supply chain disruption or provider failure.
• Critical Incident is any localised incident where the level of disruption results in an organisation temporarily or permanently losing its ability to deliver critical services; or where patients and staff may be at risk of harm. It could also be down to the environment potentially being unsafe, requiring special measures and support from other agencies, to restore normal operating functions.
A Critical Incident is principally an internal escalation response to increased system pressures/disruption to services
• Major Incident is any occurrence that presents serious threat to the health of the community or causes (or is likely to cause) such numbers or types of casualties as to require special arrangements to be implemented For the NHS, this will include any event defined as an emergency, detailed below in 2.1.2
2.1.2 Emergencies
In Section 1 of the Civil Contingencies Act (CCA) 2004 defines an emergency as:
“(a) an event or situation which threatens serious damage to human welfare in a place in the United Kingdom;
(b) an event or situation which threatens serious damage to the environment of a place in the United Kingdom; or
(c) war, or terrorism, which threatens serious damage to the security of the United Kingdom”.
2.2 INCIDENT
TYPES
Major incidents/emergencies may manifest in a number of different ways, including but not restricted to:
2.2.1 Rapid Onset
A serious transport or industrial accident, or series of smaller unforeseen incidents e.g., a train crash or explosion at a gas storage depot.
2.2.2 Rising Tide
A developing infectious disease epidemic or outbreak e.g. pandemic
2.2.3 Cloud on the Horizon
A serious threat such as a major chemical or nuclear release developing elsewhere and needing preparatory action e.g., Chernobyl and Fukushima.
2.2.4 Headline News
Public or media alarm over a health issue/scare e.g., reaction to the MMR vaccine link to autism in 1998.
2.2.5 Cyber Security Incident
Breach of a system’s security policy to disrupt its integrity or availability or the unauthorised access or attempted access to a system.
2.2.6 Chemical Biological Radiological, Nuclear and Explosives (CBRNe)
The intentional release of CBRNe material either real or hoax e.g., Tokyo sarin gas attack in 1995 or, American anthrax attacks 2001. This may also involve the existence of an explosion with the potential for contaminated casualties.
2.2.7 HAZMAT
The unintentional release of a CBRN material through an industrial accident e.g., Chlorine release.
2.2.8 Mass Casualty
An incident (or series of incidents) causing casualties on a scale that is beyond the normal resources of the emergency and healthcare services ability to manage
2.2.9 Severe Weather
Any dangerous or extreme weather-related events e.g., severe flooding, heatwave or snow fall/cold weather
2.3 ALERT LEVELS
2.3.1 Major Incident Standby
When the situation is unclear, at an early stage or has the potential to escalate. The purpose of the Critical or Major Incident Standby is to get the organisation ready to implement special arrangements if these become necessary.
2.3.2 Major Incident Declared
When the situation requires special arrangements to be implemented in part or in full. The Incident Declared message starts the implementation of special arrangements to deal with the incident.
2.3.3 Major Incident Cancelled (only used externally)
The situation is not as serious as thought and special arrangements will not be required
2.3.4 Major Incident Stand Down & Debrief
The organisation has completed its response and normal working arrangements are now re-instated. The PROVIDE Incident Director (Strategic (Gold)) is responsible for issuing the ‘STAND DOWN’ instruction after a critical or major incident. No other person has the authority to do this.
2.4 INCIDENT ALERT & RESPONSE LEVELS
NHS England has determined incident alert and response levels, to standardise the categorisation of incidents as described in table 1 below. The alert levels will be agreed in liaison with NHS England and will be used in communication.
Table 1
Level Response levels
1 – Green An incident that can be responded to and managed by an NHS-funded organisation within its respective business as usual capabilities and business continuity plans
2 – Yellow An incident that requires the response of a number of NHS-funded organisations within an ICS and NHS coordination by the ICB in liaison with the relevant NHS England region.
3 – Amber An incident that requires a number of NHS-funded organisations within an NHS England region to respond. NHS England to coordinate the NHS response in collaboration with the ICB. Support may be provided by the NHS England Incident Management Team (National).
4 – Red An incident that requires NHS England national command and control to lead the NHS response. NHS England Incident Management Team (National) to coordinate the NHS response at the strategic level. NHS England (Region) to coordinate the NHS response, in collaboration with the ICB, at the tactical level
2.5 INCIDENT RESPONSE
2.5.1 Triggers
The PROVIDE Director on-call will receive information and alerts which may require the activation of the PROVIDE response to a major incident these include:
• Receipt of a Major Incident Standby Message
• Receipt of a Major Incident Declared Message
• Receipt of information from the PROVIDE manager on-call, NHS England (NHSE), or our commissioners pertaining to an internal incident, surge in demand for services or disruption to business as usual operations
An Alert, Cancellation or Stand Down may have been declared by another organisation (e.g. NHSE) but this does not necessarily mean that the same instruction will be issued to PROVIDE. For example – NHSE East might declare a major incident following a serious train crash in Harlow but PROVIDE might only be slightly affected so would not need to declare a major incident itself.
The PROVIDE Director on-call will always make the decision whether to activate the organisation’s major incident procedures based on the information they have at the time; this response may be different from that of other organisations.
2.5.2 The Director on-call is responsible for undertaking a dynamic risk assessment of the information received to ascertain if the situation/incident can be managed using business as usual arrangements or if specialist arrangements are required. They may also use the METHANE report to determine organisation’s status. The METHANE report is contained within the Director On-Call Pack. The information from the METHANE report can be used when sharing information with partners.
Major incident – standby or declared?
Exact location
Type of incident
Hazards present or suspected
Access – routes that are safe to use
Number, type, severity of casualties
Emergency services present and those required
2.5.3 Protracted Incidents
In most cases incident responses do not last for long periods however this is not always the case. This may be an incident lasting for an extended duration (normally more than 3 weeks), of significant complexity and may require continued enhanced measures, resources and/or mutual aid over and above those required to respond to an isolated incident.
A recent example of a protracted incident is the response to coronavirus (SARS-CoV-2) where response varied dependent on impact that changed in severity throughout multiple months. It is recognised that prolonged incidents will impact on business as usual arrangements both in terms of service delivery and also in terms of Incident Management. Therefore, it is important to constantly monitor the incident and scale up/scale back as appropriate to both maximise business as usual service delivery where possible and also to maximise the response where required.
2.5.4 Concurrent Incidents
In the event of concurrent incidents, the Provide Incident Director will consider, in consultation with the Chief Executive or AEO as appropriate, the options of either appointing an incident management team (IMT) to manage each individual incident or retaining one IMT. The Provide Incident Director will retain the strategic overview of all incidents
2.5.5 Major Incident Alerting Messages in PROVIDE
A Major Incident ‘STANDBY’ or ‘DECLARED’ for PROVIDE can ONLY be issued by:
• The PROVIDE Director on-call; or
• Another PROVIDE Executive Director (in their absence).
No distinction will be made between the organisations business units when responding to a Critical or Major Incident, with the whole organisation being put at ‘DECLARED’ status and the most appropriate Incident Response Team (Tactical/SILVER) selected depending on the location and type of incident.
2.5.6 The Director on-call has the authority to activate any change in the level of PROVIDE’s response i.e., escalation, de-escalation and stand down based upon on-going dynamic risk assessments.
2.6 NOTIFICATION PROCESS
2.6.1 The primary route for notification and escalation is from Provider to ICB and ICB to NHS England via the regional on-call team using the PageOne system. For a business continuity, critical incident or major incident standby or declared, the following notification process must be used.
• Mid & South Essex (MSE) ICB
Call - 0345 600 0025 (CALLEEAST)
You will be asked to leave a message and your message will be passed to the MSE ICB On-call Team who will then respond to the message
MSE ICB should then inform:
• NHS England East (Essex)
NHSE East (Essex) (call pager 07623 51592 or if not answered in 15 mins contact 07623 515955) immediately and inform them of the situation.
2.6.2 In declaring a critical incident we are required to submit a SBAR report
‘Critical incident declared by PROVIDE (then state reason why, i.e. pressure on Community step down beds)’
Table 3
SBAR Report
Situation
Describe situation/incident that has occurred
Background Explain history and impact of incident on services/patient safety
Assessment Confirm your understanding of the issues involved
Recommendation Explain what you need, clarify expectations and what you would like to happen
Ask receiver to repeat information to ensure understanding
2.7 PROVIDE ON-CALL ARRANGEMENTS
2.7.1 Overview
The PROVIDE Chief Executive has ultimate responsibility and remains accountable for PROVIDE’s business delivery throughout all situations; however, in a response to extreme pressure, major incidents or emergencies this is usually discharged through the Director on-call.
PROVIDE has a 24-hour On-Call system for the Director on-call that operates across the organisation If the Director on-call decides to activate the organisation’s Major Incident response arrangements they will contact the appropriate staff to set up the incident command teams.
2.7.2 Allocation of Roles
Should the incident occur in hours, roles in the Strategic (Gold) and Tactical (Silver) Command Teams will initially be filled by the most appropriate staff that are available. Out of hours, the on-call staff available will initially fill roles. However, if there is a more appropriate member of staff who has local knowledge or skills that better match a specific major incident role, then the PROVIDE Incident Director is able to re-allocate the role accordingly.
2.7.3 Responsibilities of all staff
• It is the responsibility of all staff to familiarise themselves with the general outline of this plan, the location to which they should report when an emergency situation is declared and the emergency roles and responsibilities pertinent to their appointment as detailed in the action cards.
• Managers need to ensure that all employees for which they have responsibility are aware of procedures should a major/critical/business continuity incident occur.
• It will be the responsibility of all managers to ensure that telephone numbers of all staff to be contacted in an emergency are reviewed at regular intervals.
• A copy of the key telephone numbers will be provided in the on-call pack accessible to each Director and Manager on call
• Staff may be required to attend premises out of hours and must have a photo ID card.
2.7.4 Additional Responsibilities of the Director on-call
• Is the nominated first point of contact for all Major Incident messages when on-call
• Will assume the role of PROVIDE Incident Director, see Action Card 1
• Will activate the appropriate command and control arrangements
2.8 INCIDENT COORDINATION CENTRE (ICC)
2.8.1 When a Critical or Major Incident is declared, the organisation can set up a dedicated and equipped Incident Coordination Centre (ICC)
The ICC is the Oak Room, 900 The Crescent, Colchester Business Park, Colchester. Essex. CO4 9YQ.
All activities will be co-ordinated through this room. All personnel will vacate this area to free space and facilities, unless part of the Major Incident support, i.e., PA’s, secretaries, help line staff.
The Executive Director on call will be advised if the normal ICC cannot be utilised. If the Oak meeting room cannot be used an alternative venue should be considered; this could be another room within HQ or the ICC at Kestrel House.
The dedicated ICC should be set up and used wherever possible; however, it is acknowledged that there will be circumstances when this is not possible because either on-call staff cannot physically get to an incident coordination centre, or they are physically unusable. In this case a virtual ICC can be set up using a digital platform. All on-call staff should have an organisation mobile phone, web access to email addresses, access to the electronic on-call folder, MS Teams and On-Call pack that will aid them in their response until a suitable ICC can be set up and staffed
2.8.2 Strategic (Gold) Command Room
The Strategic (Gold) Command Room will be separate to the ICC (which will normally be Tactical (Silver)) and can be any room with a phone and computer accessibility The Strategic (Gold) Command Room must always be in a physically separate room from the Tactical (Silver) Control room
3. COMMAND AND CONTROL ARRANGEMENTS
3.1 PROVIDE INCIDENT
DIRECTOR (STRATEGIC/GOLD)
The Director on-call or, in their unavoidable absence, another of the organisation’s Executive Directors will initially take the role of PROVIDE Incident Director (Strategic/Gold). However, as the incident progresses the initial Director On-Call can be replaced by a more appropriate Executive Director (for example the Accountable Emergency Officer (AEO)) if the situation requires it.
The PROVIDE Incident Director (Strategic/Gold) is in command of the organisations overall response to a critical or major incident, including setting the strategic objectives, responding to any NHS E resource requests and is responsible for providing MSDE ICB and NHS E East with situation reports with the support of Strategic (Gold) Command. The PROVIDE Incident Director will only make strategic level decisions in regard to the incident and will delegate the tactical control of the Incident to the Tactical (Silver) Command Team. The appropriate Team will vary depending on the type and location of the incident and be activated by the PROVIDE Incident Director. When a Critical or Major Incident is ‘DECLARED’ within PROVIDE normal management arrangements are over-ruled until incident ‘STAND DOWN’ is declared.
To create capacity to deal with the incident the PROVIDE Incident Director may:
• Draw resources (e.g., staff) from any area of the organisations business.
• Scale down any area of organisation business.
• Temporarily suspend any area of business.
During critical or major incidents with a medium or long-term impact the PROVIDE Incident Director (Gold) and Chief Executive will review decisions about resources in consultation with the Executive Directors and the Board.
3.2 STRATEGIC (GOLD) COMMAND
3.2.1 Strategic (Gold) Command is a small group of staff led by the PROVIDE Incident Director (Strategic/Gold) who will look at the strategic and longer-term issues arising from the incident affecting PROVIDE. Whilst it is important for there to be regular updates from the Tactical (Silver) Command, it is important to understand that Strategic Command must not start to take over the tactical role of the incident. The PROVIDE Incident Director is responsible for updating the CEO and Board of the incident response and escalating longer-term issues through the formal Strategic Meetings.
The Strategic (Gold) Command team may be made up of:
• The PROVIDE Director on-call (or another PROVIDE Executive Director in their absence);
• Communications Manager (if available) (Incident Communications Officer);
• Estates and Facilities Lead
• IT Lead
• Operations/Clinical Lead
• Finance Lead (if required)
• Loggist.
In the event of an external major incident the Police, who have the responsibility to co-ordinate the overall response, may establish a ‘Strategic (Gold) Co-ordinating Group’ (SCG). NHS representation is normally fulfilled by NHSE or a nominated ICB representative. However, if deemed necessary by the SCG, in the unlikely scenario that PROVIDE are asked to send a representative, usually this will be Chief Executive or Accountable Emergency Officer (AEO).
3.3 TACTICAL (SILVER) COMMAND
3.3.1
Overview
Tactical (Silver) Command is a tactical level and each responding agency may have a Tactical (Silver) Command Team operating. If a major incident is declared within PROVIDE, the incident response team will be known as the ‘Tactical Command’.
3.3.2 In hours the PROVIDE Incident Director (Strategic/Gold) will appoint the most appropriate senior manager as the Tactical (Silver) Controller. Out of hours the most Senior On-call Manager available will, on the request of the Incident Director (Gold), assume the role of Tactical (Silver) Controller and co-ordinate the tactical response to an incident
The Tactical (Silver) Command will ONLY manage the tactical incident response and will not make strategic decisions on an area outside of their usual remit. If enquiries come in to the Tactical (Silver) Command, which are felt to be outside of the silver remit the request, will be cascaded up to the PROVIDE Incident Director who will address it directly.
On the request of the PROVIDE Incident Director (Gold) the Tactical (Silver) Incident Controller CAN –
• Over-rule all normal tactical and operational management arrangements.
• Direct any member of staff (however senior) to perform any duty made necessary by the tactical response to the incident.
• Direct any existing resource (e.g., rooms, transport, computers) to be used in connection with the tactical response to the incident.
• Invoke the Business Continuity Plans (including prioritising and/or temporary suspending any services pre-agreed within the plans).
• Request the further prioritisation or temporarily suspension of any service (this will have to be agreed by the PROVIDE Incident Director.
3.4
MEMBERSHIP OF THE TACTICAL (SILVER) COMMAND TEAM
3.4.1 PROVIDE Command Teams
• Tactical (Silver) Incident Controller (In hours – most appropriate Senior Manager, out of hours On-call Manager)
• Loggist (Trained loggist or available member of staff)
• ICC Officer
• Other members of staff as required (see Section B action cards for examples of roles)
In addition to these designated roles, the Incident Director (Gold) may appoint, at any time, any other members they consider necessary to support the Tactical (Silver) Command Team
3.5 TERMS OF REFERENCE OF THE TACTICAL (SILVER) COMMAND TEAM
• To make regular assessments of the situation and communicate this to the PROVIDE Incident Director (Gold) via situation reports.
• To make tactical emergency management and business continuity decisions updating the PROVIDE Incident Director (Gold) as and when necessary.
• To identify potential impacts of the incident and communicate this to the PROVIDE Incident Director (Gold)
• To activate any appropriate specific incident plans.
• To manage the internal resources required to deal with the incident ensuring that all major incident arrangements reflect the strategic direction given by the PROVIDE Incident Director (Gold)
• Communicate any estimated or actual shortfalls of resources that might require mutual aid to the PROVIDE Incident Director (Gold)
• To seek expert advice via the PROVIDE Incident Director (Gold) where the expertise does not exist within the silver command team.
• To ensure there is an effective internal and external communications within the command and control structure(s)
• Responsibility for creating operational (bronze) command(s).
3.6 OPERATIONAL (BRONZE) COMMAND/S
3.6.1 Operational (Bronze) level staff provide the operational (hands on) response to any incident and usually refers to people who are actively carrying out actions related to the incident, for example Community Healthcare staff or Nurse in Charge of an inpatient ward may have been instructed to undertake certain duties.
3.6.2 The member of staff instructing staff will become the ‘Operational (Bronze) Controller’, there can be one or multiple Operational (bronze) controllers who feed into the Tactical (Silver) Command. Dependent upon the impact of the incident this may by locality and corporate teams
An example of a command and control structure can be found in box 1 below Box 1
Example of a command and control structure for PROVIDE
3.7 RECORD KEEPING & SITUATIONAL REPORTING
3.7.1 Logging Messages
During a major incident, all messages must be logged. Anyone who receives a message relating to a major incident must:
• Record the date and time they received the message;
• Record the exact wording of the message;
• Record the name and contact details of the person giving the message.
It is very important that the message is passed on quickly using the exact wording of the original message. Anyone who passes a message on to other people must:
• Record the time the message was passed on;
• Record the name(s) of the person(s) it was passed to;
• Record the name(s) of anyone who could not be contacted.
3.7.2 Record-Keeping
An essential element of any response to an incident is to ensure that all records and data are captured and stored in a readily retrievable manner. These records will form the definitive record of the response and may be required at a future date as part of an inquiry process (judicial, technical, inquest or others). Such records are also invaluable in identifying lessons that would improve future response. The Incident Director (Gold) or nominated deputy is formally responsible for signing off the situational reports, decision logs and all briefing papers and documents relating to the incident
During a major incident, records must be kept of all actions taken in relation to the response to the incident. This will be aided by the use of loggists, who will record all the decisions made in a dedicated Log Book, see Action Card 2
It is considered best practise for incident logs to be recorded by ink and paper (non-volatile media), logged at the time, checked as an accurate account and signed off by both the loggist and decision maker. This will
normally entail the Incident Management Team (IMT) including the loggist being located in the same Incident Coordination Centre (ICC). It is acknowledged that there may be times where this is not always possible, for example a prolonged incident or adverse weather.
Should this occur then the option of logging the meeting virtually will be considered. It must be noted that this risks losing the contemporaneous nature of the log and open the log up to accusations of improper alteration should there be contradictory evidence. Therefore, it is recommended that the decision rationale as to why the meeting is being held totally virtually is recorded at the start of the meeting. The decision as to how the log (manually or electronically) will be maintained will be made by the Strategic (Gold) and Tactical (Silver) commanders
3.7.3 Situation Reporting (SitRep)
In response to an incident, it is highly likely that we will be asked by NHSE and/or the ICBs to complete situational reports (SitReps) The type and frequency of SitReps will be determined, depending on the type of the incident.
The SitRep submission is likely to be made through either an excel spreadsheet return or the Strategic Data Collection Service (SDCS) which is a secure data collection system used by health and social care organisations to submit data to NHS Digital. This will require support from the Performance Bi team.
3.8 MUTUAL AID
3.8.1 During an external major incident, there will be a strong emphasis on mutual aid, PROVIDE may be involved in this in both receiving mutual aid (example receiving small number of staff to support emergency treatment centres) and potentially giving mutual aid (i.e., community nurses helping in local hospitals).
3.8.2 The organisation has a number of mutual aid agreements already in place However, it is recognised that requests for mutual aid may need to be made at the time of the incident. If this is the case the mutual aid protocol as at Appendix B will be followed
3.8.3 The organisation has a specific requirement, in conjunction with other organisations, to ensure that at risk groups and vulnerable persons are specifically cared for in the response. To aid the responders the organisation should, where available and practical, supply data (name/address/type of support required) on services users they deem as possibly requiring extra support in a major incident. This should happen as soon as the organisation is made aware of an external major incident within a geographical area where it provides services.
3.8.4 Military Assistance to the Civil Authorities (MACA) is the collective term used by the Ministry of Defence (MOD) for the operational deployment of Armed Forces personnel in support of the civilian authorities, other Government departments or the community as a whole. All requests for military assistance must be referred to the NHS England regional team for escalation. A Health Minister will authorise all Health MACA requests. The Department of Health and Social Care will lead and coordinate the arrangements with MOD. Local providers should not attempt to contact the military directly for support. If Provide believes that MACA support is required they will discuss with the MSE ICB in the first instance.
3.8.5 All requests for mutual aid will be made and/or agreed by the PROVIDE Incident Director (Strategic/Gold)
3.9 MAINTAINING BUSINESS CONTINUITY
When a PROVIDE major incident is declared, organisational resources (e.g. staff, vehicles, equipment) may be diverted to deal with the incident. Some services will therefore have to be scaled down or cancelled. For example, non-urgent clinics or client home visits may be cancelled, some staff may be sent home and others may be sent to work in different locations. However, it is essential that the organisation maintains its critical services and that patient care is maintained during the disruption caused by the incident as far as is reasonably practicable in the circumstances. The organisations business continuity plans should be referred to and all decisions that impact on the delivery of our services must be logged and the decisions why. This must also be communicated to the MSE ICB, NHS E and/or commissioners at the earliest opportunity, together with the reasons why this action has been taken
As part of each services business continuity plan, each service has identified key partners and suppliers. Additionally, the procurement team hold a list of all key suppliers and require suppliers to have business continuity plans in place. In the event of an incident the Procurement Team may be asked to provide a core information service for obtaining any relevant goods and services required in the response and recovery. The team will provide a stores and supplies focal point for staff during the incident. See Action Card 13 Procurement Coordinator
3.10 MANAGEMENT OF PERSONNEL IN A CRITICAL OR MAJOR INCIDENT
To ensure that the organisation’s essential services continue to function during a ‘DECLARED’ Critical or Major Incident, the organisation will require all staff to work flexibly both in terms of their role and their working arrangements. There are a range of measures (detailed below) that the PROVIDE Incident Director (Strategic/Gold) and Tactical (Silver) Incident Controller can put in place to ensure the organisation’s essential services continue to function.
Please note: All changes made to staff working arrangements have to be clearly documented within the Major Incident Log Book and relayed to HR as soon as reasonably practicable. Staff are not obliged and cannot be forced to make changes to their contract.
3.10.1 Changing Working Hours
In a ‘DECLARED’ Critical or Major Incident, the Tactical (Silver) Incident Controller can temporarily create extra staff capacity by inviting staff to change their working hours. This could include:
• Asking part time staff to temporarily increase their contractual hours;
• Asking staff who work flexible hours to temporarily alter them;
• Allowing staff to work hours in excess of 48 hours;
• Allowing staff who have recently retired to assist the response (HR has a list of applicable staff);
• Suspending and cancelling pre-booked leave.
3.10.2
Redeployment
During a major incident staff may be directed to work at locations other than their usual workplace, this is supported in all existing staff contracts. Examples include:
• Working at or near the site of the major incident;
• Working at a local authority evacuation rest centre;
• Working in a different department;
• Working at another site managed by PROVIDE (e.g. if the site where they normally work is inaccessible due to the major incident);
• Working at an acute hospital or at a site managed by another Trust/provider
All staff working away from their normal location must inform their office base:
• When they come on duty;
• If they are directed to work somewhere else;
• When they go off duty.
Each head of service will carry out a risk assessment of their areas locally capturing acuity and dependency in relation to service user’s needs. The outcome of the local risk assessment will determine any necessary redeployment.
3.10.3 Cancelling or Suspending Training and Meetings
In a ‘DECLARED’ Critical or Major Incident within normal office hours, the PROVIDE Incident Director (Strategic/Gold) can ask for the suspension of all current and scheduled internal training. The PROVIDE Incident Director (Strategic/Gold) can also cancel or suspend any current or future meeting in the identified Incident Coordination Centres or if unavailable any meeting room deemed appropriate Where PROVIDE staff are at external training courses or meetings the Tactical (Silver) Incident Controller can request (directly or indirectly) that staff return to the organisation as soon as is practicable and advise staff not to attend training and meetings until the Critical or Major Incident is ‘STOOD DOWN’.
3.11 STAFF WELFARE
An emergency is a stressful time where staff are likely to be called in unexpectedly from home and expected to work in unfamiliar environments for extended periods. The PROVIDE Incident Director (Strategic/Gold) and Tactical (Silver) Incident Controller have the responsibility to ensure the wellbeing, health and safety of all staff that are assisting in the incident response.
3.11.1
Rest Breaks
Whenever possible, staff must take regular breaks to avoid them becoming overtired and ‘burnt out’. The PROVIDE Incident Director and Tactical (Silver) Incident Controller have the responsibility for ensuring staff welfare and will develop realistic rotas early on in the response for all key roles in the Strategic (Gold) Command and Tactical (Silver) Command Teams
3.11.2 Shift Arrangements
In the event of a major incident or emergency having a substantial impact, it may be necessary to continue operation of the ICC for a number of days or weeks. In particular, in the early phase of an emergency the ICC may require to operate continuously for an extended period of time.
A robust and flexible shift system will need to be in place to effectively manage an incident. The PROVIDE Incident Director (Strategic/Gold) and Tactical (Silver) Controller will schedule suitable staffing and shift arrangements for all staff to deliver the ICC. Outline shift arrangements are presented below:
• Requirements for each shift should be monitored at each handover
• Handover briefings must be appropriately detailed
• During the first two shift changes 1-2 hours of hand over time may be required.
• Shift changes should be considerate of both staff welfare and operational requirements
• Where possible initial shift changes in teams should be staggered
• Where possible there should be continuity of staffing
• Staff welfare and health and safety policies must be followed
3.11.3 Health and Safety
In a ‘DECLARED’ Critical or Major Incident, the organisation will continue to ensure that it complies with legal obligations to ensure employee’s health, safety and welfare at work as far as is reasonably practicable.
In doing so, the PROVIDE Incident Director (Strategic/Gold) and Tactical (Silver) Incident Controller will need to take account of the following when making decisions:
• Any known/stated restriction on work that could safely be undertaken by an individual on health grounds. This may include, for example, in the case of communicable infection, whether the individual had received an appropriate vaccination.
• Any training or professional qualification that would be a prerequisite to carrying out response duties safely or other circumstance that may make working unreasonably unsafe, for example severe staff shortages.
• Any official communication from bodies with emergency powers by law, for example, advising against travel/other activity in all/some circumstances; and the
• The need for personal protective equipment for example in Chemical, Biological, Radiological, Nuclear (CBRN) incidents
3.12 FINANCIAL MANAGEMENT
3.12.1 PROVIDE Management
It is acknowledged that during the response to or recovery from an incident additional cost may be incurred either through the procurement of additional supplies and services or through the alteration of existing contracts. It is the responsibility of the PROVIDE Incident Director (Strategic/Gold) to ensure that all additional costs are appropriately authorised and recorded. A unique cost centre and budget code(s) should be made available to ensure that all costs are tracked It is recommended that a senior Finance representative is part of the Strategic (Gold) team (Action Card 14).
3.12.2
Delegated Authority to Approve Payments to Staff
During a major incident the PROVIDE Incident Director (Strategic/Gold) had delegated authority to call in additional staff to assist in the management of the incident. Such staff may be called in for work outside normal office hours. In the event of staff being required to work outside normal office hours they will be recompensed for all hours worked and will be entitled to repayment of travel costs at usual rates for the journey to the place at which they are asked to work.
Subsistence allowances will be paid where appropriate, if arrangements for the supply of meals etc. cannot be made.
3.12.3
Recording Financial Information
It is the responsibility of PROVIDE Strategic (Gold) Command to maintain adequate logs and records of all activity undertaken in respect of the response to a major incident. Where the action has financial implications, it is essential that the records are adequate to identify:
• The expenditure that has been incurred and for what item or service
• When and where the item or service is to be provided
• To whom the expenditure is payable – the company or organisations name and address, and a named individual as contact
• On whose behalf the expenditure was incurred, particularly if acting as an agent for a provider
• The relevant terms and conditions of sale
• When the bill is payable
• The name of the individual approving the expenditure at the time
• The date of the transaction
In order to provide an appropriate audit trail, copies of such information will be supplied as soon as possible to the PROVIDE Group Chief Finance Officer, or an officer nominated by the Chief Finance Officer to oversee the financial implications of the incident.
4. SPECIFIC INCIDENTS
4.1
MASS CASUALTY INCIDENTS
NHS England defines a Mass Casualty incident for the health services as an incident (or series of incidents) causing casualties on a scale that is beyond the normal resources of the emergency and healthcare services’ ability to manage.
A Mass Casualty incident may involve hundreds or thousands of casualties with a range of injuries, the response to which will be beyond the capacity of normal major incident procedures to cope and require further measures to appropriately deal with the casualty numbers.
Some of the factors that distinguish a mass casualty incident from a more typical major incident are its likely scale, duration, intensity and the probability that there will be other compounding factors such as loss of services/infrastructure, shortage of essential supplies or the possibility of civil dislocation. They are likely to involve greater numbers, both in terms of casualties and fatalities and could involve either incidents occurring simultaneously, or at multiple sites.
Based on their assessment at the scene the responding Ambulance Service will declare a mass casualty incident and will notify NHS E. NHS E will then activate the Mass Casualties Framework and implement various options based on their assessment of the situation. Once a mass casualty incident has been declared all relevant organisations, which dependant on locality and severity of incident will activate their own Major Incident.
If a mass casualty incident is declared in a region neighbouring PROVIDE, we may be required to provide mutual aid (if available).
4.1.1 Responsibility of PROVIDE
During an incident with mass casualties (or a significant surge incident), NHS E may request that PROVIDE support acute hospitals to increase their ability to deal with incoming patients by assisting with the accelerated discharge process and the provision of alternative care for minor injuries (e.g. Urgent Care Centres, Minor Injuries Units or healthcare clinic facilities) in conjunction with local healthcare providers We may also be asked to establish treatment centres for low priority patients in spaces close to the incident scene. The Voluntary Services via Local Authority arrangements, or other commissioned clinical providers may augment these services
In the event of a major incident, Local Authorities are responsible for establishing reception centres for evacuated / displaced persons. PROVIDE might be asked through NHSE to provide staff and/or resources to support primary care or provide community health within reception centres, although voluntary services may attend. There are several types of reception centres as listed below in Table 5:
Table 5
Friends & Relatives
Survivor Reception Centre
Humanitarian Assistance Centre
Rest Centre
Community Assistance Centre
PROVIDE’s response to a mass casualty incident will involve the command and control arrangements as contained within this plan The Incident Director (Strategic/Gold) will;
• Liaise with NHS E regarding the provision of additional community health services for minor illnesses and injuries to individuals involved in the incident
• Reprioritise community-based services to free up staff to attend the incident scene, designated treatment centres or a local authority reception centre.
• Create capacity in the community to enable acute hospitals to discharge patients to community hospitals or home
• Defer non-urgent planned community activity
• Expedite discharges from community beds
• Maintain access to critical and essential community health services (business continuity measures)
• Assist when necessary with the distribution of countermeasures or other medication for individuals involved in the incident. This may include vaccines, antivirals (AVs), antitoxins and antibiotics etc., and the treatment of prophylaxis (oral or vaccination) to the identified population.
• Ensure staff are trained in the use of any Patient Group Directions, clinical methods and health and safety requirements before administering mass countermeasures or other medication out with their normal duties
• Assist with the identification of vulnerable or specific groups of individuals who should be prioritised to receive primary or mental healthcare interventions (e.g., pregnant women may require different medication or additional advice before receiving medication)
• Ensure any regional or local public health advice in relation to the incident is made available for PROVIDE service users (in collaboration with the local health and social care economy).
• Ensure the discharge areas are supported with suitable staff able to give advice on where to seek treatment and support and the issuing of the post incident leaflet; Access to post incident mental health services leaflets, https://www.healthylondon.org/resource/london-incident-support-pathways/
Additionally, the Tactical (Silver) Incident Controller on the request of the PROVIDE Incident Director, will ensure that any available resources are deployed where possible to support accelerated hospital discharge and in preventing any unnecessary hospital, admissions to reduce pressure on the acute hospital trusts
4.2 CBRNE, HAZMAT OR COMAH
INCIDENTS
4.2.1 Internal CBRNE or HAZMAT Incidents
Chemical, Biological, Radiological, Nuclear or explosive (CBRNE)) incidents or other Hazardous materials (Hazmat) response is coordinated by the UKHSA (formally Public Health England) Centre for Emergency Preparedness and Response. Copies of the UKHSA guidance for identifying and responding to CBRN incidents are available in every ICC and electronically on the shared on call drive.
4.2.2 Initial Operational Response (IOR)
The IOR programme has been introduced by the Home Office across all blue light emergency services and to key first responders including the NHS, to improve patient outcomes following contamination with hazardous materials (HAZMAT) or a chemical, biological, radiological or nuclear (CBRN) incident.
It is assumed that the majority of people involved in an incident involving potential exposure to hazardous chemical, biological and radiological substances will have been disrobed and decontaminated at the scene by the emergency services. However it is recognised that there may be a number of self-presenters. These may be people who have left the scene of an incident before the emergency services arrive and have not undergone disrobe and /or decontamination and later re-robe and present at a healthcare facility, or where an incident has not yet been reported to the emergency services and people arrive at a healthcare facility without notice
The IOR is aimed at ensuring an immediate “first aid” type approach that is capable of being delivered by non-specialist staff in any setting without delay.
All community care facilities within PROVIDE have been provided with guidance based on the IOR principles for managing the consequences of a CBRN incident (copies are contained within the control rooms) and training has been provided. The guidance contains the following information.
• Procedures for identifying potential CBRN incidents.
• Steps for managing the initial response to a CBRN incident (IOR);
• Lockdown procedures for any contamination incident occurring within the organisation.
• Contact details for the relevant Ambulance Service’s Hazardous Area Response Team (HART) who will come immediately and assess the situation and treat any affected staff and patients immediately at scene.
• Inventories of all appropriate Personal Protective Equipment (PPE)
The importance of early recognition of contamination, and immediate command and control measures to contain any contaminated casualties and premises is of the highest importance. This includes the ‘Lock Down’ of any main patient interface location.
4.2.3
External CBRNE or HAZMAT Incidents
• All NHS Acute Trusts have a duty of care and responsibility to decontaminate the walking wounded from a scene of any local Hazmat/CRBNE incident.
• A Chemical, Biological or Radiological (CBRNE) event is significantly different to a HAZMAT (hazardous materials) incident, as it is deemed to be a terror attack.
• At the scene of any HAZMAT incident, casualties and the affected public will be decontaminated by their respective Ambulance Service, and in large-scale Hazard incidents, by the Fire Brigade.
• Radiation (Emergency Preparedness and Public Information) Regulations, (REPPIR) 2001 are in place to advise how organisations will respond to an actual or potential radiation emergency. NHS E will provide instruction on any actions required in response to an incident
4.2.4
Distribution of Counter Measures or Prophylactic Treatments
In an incident that affects a wide geographical area or involves a large number of people being exposed without immediate detection; it is conceivable that the national stocks of countermeasures would be called upon as part of the response to the incident. In response to this all Acute Trusts have Mass Prophylaxis Centre Plans in place and PROVIDE may be requested to provide assistance dependant on the severity of the incident.
4.2.5
Control of Major Accident Hazards (COMAH)
The Control of Major Accident Hazards Regulations (COMAH) 2005, apply mainly to the chemical industry specifically sites that have large stores of chemicals such as chlorine, liquid petroleum gas, explosives etc. They ensure that businesses take all reasonable measures to prevent major accidents involving dangerous substances; and limit the consequences to people and the environment of any major accidents, which do occur. Top tier sites are deemed more hazardous and require an off-site plan, which details the response of the emergency services, health service and local authority. These plans are confidential, and copies are held within the PROVIDE control rooms.
Within the organisation footprint there are a number of sites, which would be classified under the COMAH banner; a full list of all sites are held within the Incident Coordination Centres and on the shared on call drive.
In response to a COMAH incident, it should be noted that PROVIDE is a secondary responder and via NHS England actions may include the following
Follow any advice or actions required requested by NHSE/UK Health Security Agency (UKHSA)
Liaise with MSE ICB, NHSE, Acute Hospital Trusts and Commissioners where necessary.
Establish and maintain communications with other responding agencies.
Provide advice to staff and service users
Provide public advice regarding health issues and disseminate advice
Liaise with UKHSA/NHS England/MSE ICB and provide health monitoring as required.
Provide community health support to Local Authority Emergency Reception Centres as appropriate.
4.3 EVACUATION, SHELTER AND LOCKDOWN
4.3.1 Evacuation and Shelter
The purpose of evacuation is to move people away from an actual or potential danger to a place that is safer for them. Shelter is a place where evacuees can stay and receive support. Evacuation may pre-empt an event or occur in the wake of an incident.
All PROVIDE inpatient areas have specific evacuation plans and service evacuation procedures are contained within the service and site business continuity plans.
Where a full evacuation is required the decision would be made locally, taking into account the overall risk to patients, the availability of appropriate transport, patient-tracking mechanisms and whether a suitably equipped destination can be identified.
Evacuation may need to take place in a range of circumstances:
• Danger from spreading fire and/or smoke
• A siege or hostage situation
• Serious flooding or the threat of flooding
• Damage to the fabric of WARD/DEPARTMENT caused by severe weather, such as storms
• Threat of environmental contamination which could have detrimental effects on health, for example following an accident or fire involving chemicals
• Threat of explosion, either from explosives such as a suspicious item/package, from gas pipelines or installations, or from chemicals involved in an accident or fire
• Loss of essential services such as power or safe water supplies
A decision to evacuate for incidents other than a fire will be governed by assessing risk, both immediate and in the longer term. Advice from specialists such as Police, Fire or Local Authority wil also be taken into consideration.
Evacuation will be the last resort and will occur following a risk assessement whereby the risk to life of remaining in situ is assessed as being greater than the risk of evacuation. In exceptional cases the Police may insist on evacuation although they will always do so in cooperation with the organisation’s staff.
A total evacuation of an inpatient area will require the declaration of a Major Incident A Tactical (Silver) Control Team will tactically manage the organisation’s response. It will receive information from and give advice to those staff located at the scene of the incident and managing the evacuation (Bronze Team). It will also supply information to the Strategic (Gold) Team.
The MSE ICB and NHS England must be informed if we need to evacuate patients from a part or whole of our premises.
4.3.2 Lockdown
Lockdown procedures are invoked to control the movement and access of people (NHS staff, patients and visitors) around the site or specific building/area in response to an identified risk, threat or hazard that might impact the security of patients, staff and assets or the facilities capacity to operate. Lockdown is achieved through a combination of physical security measures and the deployment of security personnel
Requests for Lockdown may come from the police (or another partner agency) or be invoked directly by the PROVIDE Incident Director if the incident is deemed by them to warrant it. The Incident Director can refer to the organisation’s Lockdown policy and procedures
4.4 SUSPICIOUS PACKAGES / BOMB
THREATS
A bomb threat or suspicious package will be escalated to the Director on-call. All bomb threats must be reported to the police.
A search will need to be conducted to identify any suspicious packages/parcels The initial search if felt safe to do so may be conducted by Provide staff If an exact location has been stated in the bomb threat call it may be necessary to evacuate the immediate area to that location. This can be to another safe area within the building.
The police will not generally tell us to evacuate therefore this decision will need to be made by the Director on-call. It is only advisable to evacuate if a suspect device has been found, if not it may be advisable to conduct a more intensive search.
If a device is found, a full or partial evacuation will be required. At this point the Director on-call must take the decision to declare a major incident; this may be taken with advice form the emergency services. In the event that a part or full evacuation is undertaken the Director on-call must ensure that NHSE is advised irrelevant of whether a major incident is declared.
5. COMMUNICATIONS
5.1
INCIDENT COMMUNICATIONS OFFICER
In the event of a ‘DECLARED’ critical or major incident, a senior staff member from the Communications team will attend the PROVIDE Strategic (Gold) Command as soon as possible. That person will be designated the Incident Communications Officer (ICO) for the duration of the incident or until relieved.
The ICO will have overall responsibility for all internal and external communications, as well as liaising with the NHSE communications office(s), Commissioners and external partners communications office(s), the DHSC communications office and the media specialists for Strategic (Gold) Command (if not NHS England) See Action Card 3.
5.2
COMMUNICATIONS RESOURCES
The following systems are in place for communications during a major incident:
• PROVIDE 24/7 call centre that is able to notify all senior staff of a ‘DECLARED’ Major Incident
• Direct dial BT (analogue) lines in the ICC’s;
• Generic Email address PROVIDE.ep@nhs.net
• Mass messaging system
Located in the ICC and electronically on the on call shared drive are:
• Registers of key internal and external contact numbers;
• List of key contacts in non-statutory/voluntary organisations;
• Site addresses and maps for all services/buildings
All services and teams are responsible for maintaining a register of the current contact details for their staff for use during major incidents and other emergencies
5.3 INTERNAL COMMUNICATIONS
It is vital that staff are kept up to date with accurate information about the incident, not only for their own information but also to share with service users, patients and visitors. All communications with staff will be mindful of the personal, as well as the professional, impact of the incident. Even if we don’t have all the details of the incident, its important to make staff aware and ensure them that information will be provided as soon as possible, adding time frames where relevant.
5.3.1 Staff who are on call to respond to a major incident
The Director on-call declaring the major incident shall have responsibility for contacting staff on call to respond to a major incident. This may be personally, or by asking another Director to make the appropriate calls or through the switchboard.
5.3.2 Staff who are on duty and on site at the time of the incident
The Communications and Media Manager or ICO will draft core messages / Frequent Questions and Answer (FAQs) pages which will be shared with staff via:
• Email – the ‘PROVIDE Communications’ email address will be used to send out information to all staff, using the distribution lists used for the weekly update. Information will be sent at regular intervals as required (e.g. every hour). Information should not be sent out from any other source, to avoid confusion. All email communication will invite questions to the provide.communications@nhs.net address, so that FAQs can be answered in subsequent messages on or on the intranet as appropriate.
• Intranet – the organisation’s Intranet, Community Platform, will be updated regularly (will be dependent on incident severity and longevity) with the latest messages sent out by email and answers to FAQs. A banner can also be added to the home page as a quick link to information relating to the incident.
• All staff mass SMS messaging system
• Telephone – where electronic means of communication are not available; the telephone will be used to contact key contact points for verbal cascade within their Divisions. Divisional leads may therefore need to identify ‘runners’ at each site to help distribute information and instructions to staff.
• Microsoft Teams – subject to the nature of the incident, an all colleague message/group can be set up on Microsoft Teams with one way information (locked down so staff cannot reply if required)
5.3.3 Staff who are off duty and
off site
In the event of a DECLARED major incident, staff may be away from their office base, working at a remote site, working in the community or off duty. All staff therefore have the responsibility for contacting their office base as soon as they are made aware of a major incident. This is so that they can:
• Assure their manager of their personal safety;
• Inform their manager of their location;
• Receive instructions from their manager about any changes to their duties arising from the incident.
There may be circumstances in which the organisation issues a public appeal for staff to attend, seeks assistance from neighbouring Trusts/providers or where staff living locally make their way to the site to help. In these cases the appropriate teams will establish a staff reception points where such staff can be registered and deployed as appropriate
5.4 EXTERNAL COMMUNICATIONS
5.4.1
Communications with External Agencies
When placing the organisation on ‘DECLARED’ critical or major incident status the PROVIDE Incident Director (Gold) will ensure that the MSE ICB, NHSE, and all other relevant external agencies have a direct dial point of contact and email address for the Strategic (Gold) Command. This direct dial line can be a mobile phone number. External agencies should not be phoning Carecall, as this will lead to delays in relaying information
5.4.2 Communications between Strategic (Gold) Command and Tactical (Silver) Command
When operating out of HQ, or other dedicated rooms within the organisation, telecommunications between Strategic (Gold) Command and Tactical (Silver) Command should wherever practicable be via the usual organisation extension numbers to keep landlines clear for external communications.
5.4.3 Communication with Service Users, Patients and the Public
It is important that information for service users, patients and the public is kept simple, clear, concise, accurate and consistent. They should also be timely. To ensure the messages are consistent and accurate the PROVIDE Incident Director (Gold) and ICO will liaise with emergency services, the ICB and NHSE
Telephone helpline
Depending on the nature of the incident, it may be necessary to establish a telephone helpline or multiple helplines for staff and/or service users/public. The need for advice or support to be provided in different languages must also be considered. This will divert traffic away from the main switchboard to dedicated call handlers. It will also provide a destination for calls being made inappropriately to other known direct dial numbers.
Provide website & social media sites
The Provide Community website and social media accounts will be regularly updated (as appropriate to the incident) with information about the incident, and details of the telephone helpline if appropriate.
A banner can be added to the home page of the website with information on the incident, this can be updated as necessary.
Any proactive press statements will also go onto the Provide Community website and the Communications Team will drive the media to this information where appropriate.
5.5 MEDIA ENQUIRIES
Staff must not respond to any media questions directly, if approached by the media please refer them to the Communications Team.
All media enquiries will be referred to the Communications Team, who will keep the Strategic (Gold) Command up to date with the enquiries and support a written response for approval and then response. Strategic Command will inform the ICO and they will work with the Communications and Media Manager (or Director) to agree the response. The ICO will then agree the response with the Provide Incident Director. Before issuing any statements the ICO will ensure the information is consistent and accurate and where appropriate will check it against statements from the:
• Strategic (Gold) Command (if running);
• NHS England;
• ICB;
• Department of Health & Social Care (DHSC) media office;
• Media Leads for the emergency services and partner organisations
No member of staff other than the Communications and Media Manager, ICO or somebody identified by the PROVIDE Incident Director (Gold) and ICO should discuss any aspect of the incident with the media unless expressly requested to do so by the Gold Command or ICO.
The Communications Team will respond to all media enquiries, which will also be logged.
Should the media attempt to enter any Provide sites they must be advised that they should leave and wait at the site/building perimeter. If available, it is advisable to identify a holding room for the media and ensure they are regularly updated
6. RECOVERY
6.1
INCIDENT RECOVERY
Recovery normally begins as the incident starts and runs in parallel with the response; the response should inform the recovery and form the basis for the recovery process. Activation of the PROVIDE Recovery Group will be carried out by the organisations Accountable Emergency Officer (AEO) or authorised deputy. It needs to be formed as soon as possible to influence the local recovery response. The communication cascade arrangements for the activation will also be via the AEO who will decide, depending on the emergency, who needs to be on this group
The PROVIDE Recovery Group will assess the disruption to the organisation’s operational functions caused by the incident, including any long-term implications and how to return to business as usual. This assessment will include:
• Effects on staffing (e.g., loss of staff through injury or sickness, impact of overtime worked by staff during the incident on staffing levels).
• Support needs of staff affected by the incident (including trauma support).
• Disruption caused to patient care.
• Disruption caused to other PROVIDE functions.
• Damage inflicted to PROVIDE property or property the organisation shares.
• Financial losses.
• Future provision of services in the short, medium and long term.
An important part of the work of the PROVIDE Recovery Group, in the response phase of the incident, is to develop a recovery strategy The Chair of the PROVIDE Recovery Group, in discussion with the group members will decide when it is appropriate to stand-down the Group.
The length of time that the PROVIDE Recovery Group is required to continue meeting will vary according to the nature and scale of the emergency. Pandemic Influenza may have long-term issues to consider, such as health monitoring, recovering back-log, introducing new ways of working etc.
6.2 INCIDENT PSYCHOSOCIAL AND MENTAL HEALTHCARE
During and after a Major Incident, the organisation recognises that large scale traumatic events will have an impact directly or indirectly, across families, professionals and the community. In line with current guidance and good practise the organisation will provide a coordinated, accessible information and support to all those who may be affected.
Key approaches considered will be;
• Acknowledge the importance of anticipated reactions (stress response) to a major incident
• Support people to develop and sustain their resilience
• Utilise a multi-agency stepped model of care that provides a continuum of care that is holistic
• Ensure approaches are evidence based and proportional, flexible and timely to respond to the emerging phased needs
• Provide clear and consistent messages and communication
• Ensure professionals and staff providing support have access to training, consultation and supervision
The organisation will consider taking a stepped approach to psychosocial support that prioritises prevention throughout which is as follows;
• Adults
Phase 1 – immediate response first two weeks; provision of psychosocial support
Phase 2 – weeks two to four; provision of psychosocial and psychological support
Phase 3 – from four weeks onwards; provision of psychological support.
While individuals may be monitored or assessed after four weeks the majority of people will be resilient and will not require specialist treatment. Therefore, interventions will not commence for most adults until 12 weeks has elapsed
A wider and more varied intervention strategy is likely to be required for children and young people and may commence before the 12 week time point. This phase will need to be sustained for two to three years.
• Children & Young Persons
Phase 1 Guidance: Victim Support is currently operating its 24/7 support line, offering emotional and practical support for anyone affected. The number is 0808 168 9111 and is free to call.
Phase 2 Guidance: Provision of Psychosocial Support and Mental Healthcare (targeted offer). This multiagency care pathway will support implementation of the Phase 2 Guidance including targeted support for CYP at risk of mental health needs.
Phase 3 Guidance: Provision of Mental Healthcare (specialist offer).
6.3 STAFF POST INCIDENT COUNSELLING SERVICES
Information about counselling services is available from the Human Resources Department. Staff are also able to self-refer to Occupational Health or the Employee Assistance programme for counselling should they find it necessary. This service is available for all staff experiencing psychological distress for whatever reason.
7. DEBRIEF
7.1
INCIDENT DEBRIEF
In order to identify lessons from any incident it is important to capture as much detail about the incident. A series of debriefs will be held as follows;
7.1.1
Hot Debrief
Within 24 hours of a Critical or Major Incident STAND DOWN a series of ‘hot debriefs’ will be held. The Incident Director will have the responsibility for debriefing all director level and Strategic (Gold) Command staff and the Tactical (Silver) Incident Controller will debrief all staff involved in the response.
A ‘hot debrief’ is:
• A process for learning lessons from the incident;
• A forum for staff to express up to two immediate issues which may concern them;
• An opportunity to thank staff
A ‘hot debrief may help the organisation identify staff who may need further support but should NOT:
• be allowed to become over-emotional or confrontational.
• be used to criticise individuals.
• be overly detailed.
• be used to provide any form of post incident psychological support.
The hot debriefs should be minuted and last no more than an hour. Once the hot debriefs have been conducted the emergency preparedness and resilience manager will organise a series of ‘Cold’ structured debriefs.
7.1.2 Cold debrief
The key aspects of a cold debrief are as follows;
• It should be held within 2 weeks of the incident
• It should include key players within PROVIDE who were involved in the response to the incident
• It should address organisational issues, not personal or psychological issues
• It should look for both strengths and weaknesses and ideas for future learning
• It provides an opportunity to thank staff and provide positive feedback.
7.1.3 Multi-agency debrief
If a multiagency debrief is convened, the key aspects are as follows;
• It should be held within 4 weeks of the incident
• It should address organisational issues, not personal or psychological issues
• It should look for both strengths and weaknesses and ideas for future learning
• It provides an opportunity to thank staff and provide positive feedback
7.1.4 Post Incident
Post Incident the following action will be undertaken;
• The PROVIDE post incident report will be completed within 6 weeks of the incident
• Lessons identified from the incident will be developed into an action plan
• Lessons identified will be shared with our partners
• The EPRR Manager will be responsible for collating and storing all the records, logs and reports associated with the incident. At the same time the PROVIDE SLT will consider the implications of how the debrief and plan should be reconsidered in light of the lessons identified.
7.1.5 Incident report
The PROVIDE Post Incident report, collated by the EPRR Manager and signed off by the SLT, will be sent to MSE ICB, NHSE, commissioners and/or partners as appropriate. The report will;
• Summarise the sequence of events
• Identify the individuals involved
• Describe the actions of staff
• Provide an accurate timeline
7.2 INCIDENT DOCUMENTATION
After a major incident all documents including logs, notes, post-its, flip charts, electronic documents, photos, and mobile phone messages including texts and WhatsApp must be retained. Documents are to be sent to the EPRR Manager as soon as possible after stand-down.
SECTION B – ACTION CARDS
INTRODUCTION TO ACTION CARDS
During a major incident members of PROVIDE staff may be asked to perform a key role on behalf of the organisation, these roles might be different from their usual responsibilities so action cards have been developed to support staff in this situation.
At the request of the PROVIDE Incident Director (Gold) any member of organisation staff may be allocated an action card to perform a key role on behalf of the organisation Usually this will be the On-call Member of staff with the relevant knowledge and experience, but it is acknowledged that this maybe not always be the case especially if they have been caught up in the incident themselves. Once allocated it may be necessary for another member of staff to take over the action card role (because they are providing relief, or they have more localised appropriate experience) this can only happen after a full briefing has to been given, in writing, on the actions taken to-date and outstanding issues. Until this has taken place, the member of staff originally assigned to the action card will be considered as still in place and responsible for the actions associated with the role.
It may also become apparent that due to the nature of the incident, that specialist advice is required and that staff from specialist areas may be contacted to attend the Incident Coordination Centre (ICC) to provide advice and support PROVIDEs response.
Action Cards Summary:
• Are role specific (not designed for designated individuals)
• Proves a useful checklist of actions to be considered
• Provide essential information needed to perform a specific role
• Help people focus on their role
• Give useful guidance
• Prevent important tasks being forgotten or delayed
• May remove the need to consult large or complex plans during an incident
• May be used by other people who are required to perform a specific role during a major incident
Job Title - Director On-Call (or Other Executive Director)
Incident Role: PROVIDE INCIDENT DIRECTOR (STRATEGIC/GOLD)
ROLE DESCRIPTION
The Director on-call is the nominated first point of contact for all internal Critical and internal or external Major Incident ‘STANDBY’ messages. The Director on-call is also responsible for putting the Organisation at Critical Incident DECLARED and Major Incident ‘STANDBY’ or ‘DECLARED’ status and for activating the Strategic (Gold) and Tactical (Silver) Commands
When the organisation activates its Major Incident procedures the Director on-call or other Executive Director takes the role of the PROVIDE Incident Director (Strategic/Gold) and is in charge of controlling the Organisations overall response to a critical or major incident and has the support of the Strategic Command team
PROVIDE ON-CALL MANAGER INITIAL ACTIONS
1. Contact the caller and gather the information required to fill in the METHANE report contained within the Director On-call Pack
2. Determine from METHANE report whether to put the organisation on Critical Incident or Major Incident ‘STANDBY’ or ‘DECLARED’ status (for assistance refer to the Director On-Call Pack).
3. Record your initial decision and rationale regarding the organisation’s Critical or Major Incident Status
NOTIFICATION ACTIONS
1. For either a critical or major incident standby or declared the following notification process must be used.
• Mid & South Essex (MSE) ICB - Call – 0345 600 0025 (CALLEEAST)
You will be asked to leave a message and your message will be passed to the MSE ICB On-call Team who will then respond to the message
MSE ICB should then inform:
• NHS England East (Essex)
NHSE East (Essex) (call pager 07623 51592 or if not answered in 15 mins contact 07623 515955) immediately and inform them of the situation.
Also consider contacting the relevant commissioners, stakeholders and partners (i.e. local authorities)
Refer to section 2.6 of the plan
MAJOR INCIDENT STANDBY ACTIONS
1. Contact staff to set up the Strategic (Gold) Command Team to inform them of the ‘STANDBY’ status and any appoint the Tactical (Silver) Incident Controller.
2. Monitor the situation closely to decide if the ‘STANDBY’ needs to be escalated to ‘DECLARED’ or ‘STOOD DOWN’ (when changing the status use the same procedure above for cascading the ‘STANDBY’ message).
DECLARED MAJOR INCIDENT ACTIONS
1. Contact the staff required to fulfil the Strategic (Gold) Command Team roles and the Tactical (Silver) Incident Controller (if appointed) to alert them of the Major Incident and request they start their Major Incident Actions.
2. If required, consider the requirement to open the Incident Coordination Centre (ICC) at Head Office (or back up location if unavailable) or to run it virtually.
3. Start the initial logbook and if possible, find trained loggists to support both you and the Tactical (Silver) decision makers (loggist list retained on shared drive and within ICCs)
4. Allocate roles to available staff using action cards if required. Ensure staff are fully briefed and understand their roles.
5. Agree the PROVIDE organisational strategy, aims and objectives (see Director on-call pack) and ensure liaison with MSE ICB and NHSE including SitRep reporting.
6. Set up regular meetings/teleconferences with Tactical (Silver) Command and establish a daily schedule for the incident.
7. Consider any legal implications that may arise from the incident or decision made regarding the incident.
8. Decide on what resources are needed and consider the need for or provision of mutual aid
9. Develop with the Incident Communications Officer (ICO) the media and communications strategy.
10. Alert the organisation of the incident status including details of communication rhythm
ONGOING RECOVERY AND STAND DOWN ACTIONS
1. Ensure an adequate Rota has been set up for all members of Strategic (Gold) and Tactical (Silver) Command so every member (including the loggist) can be relieved after an appropriate period.
2. Continue to monitor the overall response and ensure that all the actions taken on behalf of the organisation are lawful, necessary and proportionate and that all relevant legislation has been considered (for assistance refer to Director On-Call Pack)
3. Monitor the situation closely to decide if the ‘DECLARED’ status needs to be ‘STOOD DOWN’ (when changing the status use the same procedure above for cascading the ‘STANDBY’ message)
4. Before STANDING DOWN the incident response ensure recovery arrangements have started and arrangements are in place for debriefing including a hot debrief for all involved
IMPORTANT WELFARE INFORMATION FOR ALL RESPONDERS
A Major Incident is a stressful time, to ensure you are fully prepared for your role you should take the following key actions:
1. Notify your family, partner or significant other, that you are involved in the emergency and give them a contact number that they should be able to contact you on. If they are not available, leave a note;
2. Call the above regularly to keep them updated, and advise them not to speak to the media;
3. Ensure you take your staff and personal ID, money, cards, car, house and any work keys, mobile phone, pager (if you have one), torch and coat with you.
4. If you are called from home may also to bring want personal cosmetics / toiletries if think you will be away for a while and ensure that you bring any medications and dietary foods with you.
5. If at all possible you should not work for longer than eight hours without going off duty and please ensure that you make arrangements for meal breaks early on and take regular breaks.
REMEMBER - Staff and their families may be caught up in any emerging incident, and duty staff need to be mindful of this for two reasons 1) Its potential effects on the Organisations response 2) That effected staff need to be followed up and support services are offered where necessary. If you feel that you will be unable to cope, for whatever reason, with what is expected of you for the role you are required to undertake please let someone know immediately so a replacement can be found.
IMPORTANT INFORMATION TO ALL GOLD CONTROL ROOM STAFF
Incident Log Is maintained and held by the loggist who will record all decisions crossreferenced with all messages.
Personal Logs It is important that all other decisions, requests within the control room to support staff etc are logged by each individual; this can be done via pocket note books.
Job Title – Loggist
Incident Role: LOGGIST
ROLE DESCRIPTION
Action Card –PROV 2
The loggist plays an integral part in the command teams by supporting the PROVIDE Incident Director (Gold) and Tactical (Silver) Incident Controller The loggist role is to record all of PROVIDE Incident Director’s (Gold) or Tactical (Silver) incident Controller decisions in relation to the incident and the rationale behind them. It is essential that the loggist follows best practice standards (detailed below) when filling in the log as it has evidential value and may be used in court after the incident
MAJOR INCIDENT STANDBY ACTIONS
1. Prepare yourself to get to the designated Incident Coordination Centre (ICC) and read the welfare information contained on this card.
2. If asked to log virtually ensure you are aware of the virtual logging process.
3. Familiarise yourself with the Loggist Grab Pack and Action Card.
DECLARED MAJOR INCIDENT ACTIONS
1. Work closely with PROVIDE Incident Director (Strategic/Gold)/Tactical (Silver) Incident Controller to log actions and decisions only
2. Use the green sequentially numbered professionally bound logbook with hardback cover. If this is not available, then use an operational log and ensure pages are numbered.
3. If logging virtually, complete the operational log with all the usual logging rules being applied. The log should start an entry recording the rationale on why the decision was made to log virtually
4. Log location and sketch table plan with attendee initials.
5. Ensure notes are contemporaneous, legible, chronological, dated and timed using 24 hour clock
6. Use black ink for records (apart from annotations)
7. Mistakes must not be overwritten and correction fluid must not be used.
8. Subsequent mistakes should be crossed through with a SINGLE straight line and referenced at end of the log in red ink.
9. Do not use shorthand or ‘minute’ the meeting.
10. Do not assume
11. Blank spaces must not be left between words, lines or at either end of lines. Any blank spaces must be lined through with ruler with continuous blank space should be ruled off with ‘Z’ lines.
12. Avoid using abbreviations/acronyms but if used ensure they match control room glossary of terms and if not included in this are inserted in red ink at the end of the log.
13. When using annotations insert a letter i.e. (a) where appropriate in text and insert the comment at the end of log in red pen following consecutive numbering with time and date.
14. Record exhibits using initials of person producing or introducing exhibit and consecutively number
15. At the end of shift check with Incident Officer that all records are accurate making amendments as necessary and sign at the end of the log with the decision maker
ONGOING, RECOVERY AND STAND DOWN ACTIONS
1. Ensure arrangements have been made for your replacement if possible within 6-8 hours
2. Ensure you attend any debriefs.
IMPORTANT WELFARE INFORMATION FOR ALL RESPONDERS
A Major Incident is a stressful time, to ensure you are fully prepared for your role you should take the following key:
1. Notify your family, partner or significant other, that you are involved in the emergency and give them a contact number that they should be able to contact you on. If they are not available, leave a note;
2. Call the above regularly to keep them updated, and advise them not to speak to the media;
3. Ensure you take your staff and personal ID, money, cards, car, house and any work keys, mobile phone, pager (if you have one), torch and coat with you.
4. If you are called from home you may also to bring want personal cosmetics / toiletries if you think you will be away for a while and ensure that you bring any medications and dietary foods with you.
5. If at all possible you should not work for longer than eight hours without going off duty and please ensure that you make arrangements for meal breaks early on and take regular breaks
REMEMBER - If you feel that you will be unable to cope, for whatever reason, with what is expected of you for the role you are required to undertake please let someone know immediately so a replacement can be found.
IMPORTANT INFORMATION TO ALL INCIDENT COORDINATION CENTRE STAFF
Incident Log Is maintained and held by the loggist who will record all decisions cross-referenced with all messages.
Personal Logs It is important that all other decisions, requests within the control room to support staff etc are logged by each individual; this can be done via pocket note books.
Job Title –Director of Communications or Communications Officer
Role:
ROLE DESCRIPTION
The Incident Communications Officer (ICO) will have the responsibility for liaising with the NHSE communications offices, Essex ICB’s communications offices, the DHSC communications office and the media specialists for Strategic (Gold) Command (if not NHSE), the emergency services and partner organisations. This will ensure information is consistent and accurate.
MAJOR INCIDENT STANDBY ACTIONS
1. Prepare yourself to get to the designated Incident Coordination Centre (ICC) and read the welfare information contained on this card.
2. Familiarise yourself with the Communications Action Card.
DECLARED MAJOR INCIDENT ACTIONS
1. Liaise with Director on-call/Incident Director (Gold) to establish the key facts of the incident.
2. Establish, and be responsible for, the communications activity log.
3. Inform partner organisations (i.e. NHS England, Essex ICB’s Communications Offices), and organisation communications staff, of the incident.
4. Review the organisations communications activity to ensure sufficient resources are allocated to the major incident.
5. Confirm with the Communications and Media Manager, Director on-call the available channels for communication with staff, service users and patients, visitors the general public and the media.
6. Consult with the Communications and Media Manager, Director on-call/ CEO regarding information / key messages for staff, service users and patients, visitors the general public and the media.
7. Communicate information with staff, including switchboard and helpline staff (if applicable) via channels identified. Ensure staff know they should forward media enquiries to the communications office, and how to do this.
8. Communicate information with service users, patients, visitors and the general public via channels identified.
9. Prepare media information working with partner organisations NHSEs & ICB’s communications offices, the DHSC communications office and Commissioner’s communications, the emergency services and others as appropriate; ensuring information is consistent and accurate.
10. Before publication, check information with CEO / Director on-call
11. Before publication check that individuals and / or families have been informed of any circumstances that involve them.
12. Arrange for information briefings to be updated and issued regularly.
13. Ensure the Provide website and social media accounts are regularly updated and monitored.
14. Ensure staff feel sufficiently supported to provide accurate information in response to requests, monitoring questions submitted via provide.communications@nhs.net email.
15. Keep the Director on-call (Gold) informed of media enquiries and coverage.
ONGOING, RECOVERY AND STAND DOWN ACTIONS
1. Ensure arrangements have been made for your replacement if possible within 6-8 Hours
2. Ensure you attend any debriefs.
IMPORTANT WELFARE INFORMATION FOR ALL RESPONDERS
A Major Incident is a stressful time, to ensure you are fully prepared for your role you should take the following key actions:
1. Notify your family, partner or significant other, that you are involved in the emergency and give them a contact number that they should be able to contact you on. If they are not available, leave a note; 2. Call the above regularly to keep them updated, and advise them not to speak to the media;
3. Ensure you take your staff and personal ID, money, cards, car, house and any work keys, mobile phone, pager (if you have one), torch and coat with you.
4. If you are called from home you may also to bring want personal cosmetics / toiletries if you think you will be away for a while and ensure that you bring any medications and dietary foods with you.
5. If at all possible you should not work for longer than eight hours without going off duty and please ensure that you make arrangements for meal breaks early on and take regular breaks
REMEMBER - If you feel that you will be unable to cope, for whatever reason, with what is expected of you for the role you are required to undertake please let someone know immediately so a replacement can be found.
IMPORTANT INFORMATION TO ALL INCIDENT COORDINATION CENTRE STAFF
Incident Log Is maintained and held by the loggist who will record all decisions crossreferenced with all messages.
Personal Logs It is important that all other decisions, requests within the control room to support staff etc are logged by each individual; this can be done via pocket note books.
Job Title – IT Manger
Incident Role: IT SUPPORT OFFICER
ROLE DESCRIPTION
The IT Support Officer plays an integral part in supporting the incident response and is responsible for setting up all IT telecommunications systems in both control rooms. The IT Support Officer should monitor the overall resilience of the organisations IT and Telecommunications systems throughout the incident. Any IT or Telecommunications problems, either real or anticipated, should be communicated to the PROVIDE Incident Director (Gold) as quickly as possible for resolution.
MAJOR INCIDENT STANDBY ACTIONS
1. Prepare yourself to get to the designated Incident Coordination Centre (ICC) if required to do so (or set up for virtual meetings) and read the welfare information contained on this card.
2. Familiarise yourself with the IT Action Card.
DECLARED MAJOR INCIDENT ACTIONS
1. Assist, where requested, with the set-up of the Incident Coordination Centre (ICC).
2. Provide specialist IT and communication systems advice as required/necessary.
3. Agree and mobilise any specialist ITC resources as appropriate/required. This may include setting up helplines.
4. Undertake other appropriate duties as requested by the PROVIDE Incident Director (Strategic/Gold).
ONGOING, RECOVERY AND STAND DOWN ACTIONS
1. Ensure arrangements have been made for your replacement if possible within 6-8 hours.
2. Ensure all documents and logs are passed, signed off and retained by the Emergency Preparedness Team.
3. Assist with decommissioning the Incident Coordination Centre (ICC) ensuring all IT equipment is suitably returned to storage
4. Participate in any hot debrief and subsequent cold debrief as required.
IMPORTANT WELFARE INFORMATION FOR ALL RESPONDERS
A Major Incident is a stressful time, to ensure you are fully prepared for your role you should take the following key actions:
1. Notify your family, partner or significant other, that you are involved in the emergency and give them a contact number that they should be able to contact you on. If they are not available, leave a note;
2. Call the above regularly to keep them updated, and advise them not to speak to the media;
3. Ensure you take your staff and personal ID, money, cards, car, house and any work keys, mobile phone, torch and coat with you.
4. If you are called from home you may also to bring want personal cosmetics / toiletries if you think you will be away for a while and ensure that you bring any medications and dietary foods with you.
5. If at all possible you should not work for longer than eight hours without going off duty and please ensure that you make arrangements for meal breaks early on and take regular breaks.
REMEMBER
- If you feel that you will be unable to cope, for whatever reason, with what is expected of you for the role you are required to undertake please let someone know immediately so a replacement can be found.
IMPORTANT INFORMATION TO ALL INCIDENT COORDINATION CENTRE STAFF
Incident Log Is maintained and held by the loggist who will record all decisions cross-referenced with all messages.
Personal Logs It is important that all other decisions, requests within the control room to support staff etc are logged by each individual; this can be done via note books or a digital log if ICC is virtual.
Job Title – Estates Manager
Incident Role: ESTATES SUPPORT OFFICER
ROLE DESCRIPTION
Action Card –PROVIDE 5
The Estates Support Officer plays an integral part in supporting both Strategic (Gold) Command and Tactical (Silver) Control and is responsible for all estates issues. The role of the Estates Support Officer is to monitor the overall resilience of the organisation’s estate and advice on any damage throughout the incident. Any major Estates problems, either real or anticipated, should be communicated to the PROVIDE Incident Director as quickly as possible for resolution. The Estates Support Officer will also liaise with NHS Property Services and/or all landlords where PROVIDE operate on behalf of the PROVIDE Incident Director (Gold), about any Estate issues.
MAJOR INCIDENT STANDBY ACTIONS
1. Prepare yourself to get to the designated control centre and read the welfare information contained on this card.
2. Familiarise yourself with the Estates On-call Pack and Action Card.
DECLARED MAJOR INCIDENT ACTIONS
1. Provide specialist estate and facilities advice as required/necessary.
2. Agree and mobilise any specialist facilities resources as appropriate/required.
3. Liaise with all property landlords and/or facilities management teams as required/necessary.
4. Undertake other appropriate duties as requested by the PROVIDE Incident Director (Gold)
ONGOING, RECOVERY AND STAND DOWN ACTIONS
1. Ensure arrangements have been made for your replacement if possible within 6-8 hours
2. Ensure all documents and logs are passed are signed off and retained by the Emergency Preparedness Team.
3. Assist with decommissioning the Incident Coordination Centre (ICC).
4. Participate in any hot debrief and subsequent cold debrief as required.
IMPORTANT WELFARE INFORMATION FOR ALL RESPONDERS
An Major Incident is a stressful time, to ensure you are fully prepared for your role you should take the following key actions:
1. Notify your family, partner or significant other, that you are involved in the emergency and give them a contact number that they should be able to contact you on. If they are not available, leave a note;
2. Call the above regularly to keep them updated, and advise them not to speak to the media;
3. Ensure you take your staff and personal ID, money, cards, car, house and any work keys, mobile phone, pager (if you have one), torch and coat with you.
4. If you are called from home you may also to bring want personal cosmetics / toiletries if you think you will be away for a while and ensure that you bring any medications and dietary foods with you.
5. If at all possible you should not work for longer than eight hours without going off duty and please ensure that you make arrangements for meal breaks early on and take regular breaks.
REMEMBER - If you feel that you will be unable to cope, for whatever reason, with what is expected of you for the role you are required to undertake please let someone know immediately so a replacement can be found.
IMPORTANT INFORMATION TO ALL INCIDENT COORDINATION CENTRE STAFF
Incident Log Is maintained and held by the loggist who will record all decisions cross-referenced with all messages.
Personal Logs It is important that all other decisions, requests within the control room to support staff etc are logged by each individual; this can be done via pocket note books.
Job Title – Manager On-Call
Incident Role: TACTICAL (SILVER) INCIDENT CONTROLLER
ROLE DESCRIPTION
Action Card –PROVIDE 6
When the Organisation activates its Major Incident procedures in-hours the PROVIDE Incident Director (Gold) will appoint the most appropriate senior manager as the Tactical (Silver) Controller. Out of hours the Manager On-call, on the request of the Incident Director (Gold), assume the role of Tactical (Silver) Controller and co-ordinate the tactical response to an incident. The Tactical (Silver) Incident Controller is also responsible for providing the PROVIDE Incident Director (Gold) with regular updates and escalating any strategic issues for resolution by the gold command.
MAJOR INCIDENT STANDBY ACTIONS
1. Contact directly (using the numbers in the On-call manual) or indirectly the Incident Response Team and to the cascade to inform them of the ‘STANDBY’ Status.
2. Monitor the situation closely and inform the PROVIDE Incident Director (Gold) if you believe the impacts you are seeing could warrant the ‘STANDBY’ status being upgraded to a ‘DECLARED’ status. Remember: you are the PROVIDE Incident Director (Gold) and Gold Command’s eyes and ears on the ground.
DECLARED MAJOR INCIDENT ACTIONS
1. Contact appropriate staff to form the Tactical (Silver) Command Team request they start their Major Incident Actions.
2. Set up the ICC as per the Incident Coordination Centre (ICC) if required.
3. Support Strategic (Gold) Command with delivering the tactical aims of the response, where this may require the mobilisation of resources in conjunction with partner agencies in response to an incident.
4. Liaise with partner agencies as required
5. Start the initial log book and identify a loggist to support you. Ensure appropriate data is logged (date, time and signature) including all calls taken and sent, as well as decisions and actions taken.
6. Liaise with all involved to facilitate communications, support resources and issue resolution.
7. Ensure robust communication between Strategic (Gold) Command and Operational (Bronze) teams.
8. Set up the daily schedule (battle rhythm) to ensure all meetings are appropriately attended.
9. Develop rotas where an incident is likely to continue for more than eight hours, covering all key roles.
10. Arrange for systems/processes to be out in place to ensure all submission of any SitRep requests
ONGOING RECOVERY AND STAND DOWN ACTIONS
1. Ensure an adequate Rota has been set up for all members of the Tactical (Silver) Control so every member (including the loggist) can be relieved after 6-8 hours.
2. Continue to monitor the overall response and ensure that all the actions taken on behalf of the organisation are lawful, necessary and proportionate and that all relevant legislation has been taken into account
3. Monitor the situation closely and report any changes in the situation (escalations or de-escalation) to the PROVIDE Incident Director (Gold) and Strategic (Gold) Command.
4. Before STANDING DOWN the Major Incident response ensure recovery arrangements have started and arrangements are in place for debriefing including a hot debrief for the Tactical (Silver) Control and any Operational (Bronze) groups IMPORTANT WELFARE INFORMATION FOR ALL RESPONDERS
A Major Incident is a stressful time, to ensure you are fully prepared for your role you should take the following key actions:
1. Notify your family, partner or significant other, that you are involved in the emergency and give them a contact number that they should be able to contact you on. If they are not available, leave a note;
2. Call the above regularly to keep them updated, and advise them not to speak to the media;
3. Ensure you take your staff and personal ID, money, cards, car, house and any work keys, mobile phone, pager (if you have one), torch and coat with you.
4. If you are called from home may also to bring want personal cosmetics / toiletries if think you will be away for a while and ensure that you bring any medications and dietary foods with you.
5. If at all possible you should not work for longer than eight hours without going off duty and please ensure that you make arrangements for meal breaks early on and take regular breaks.
REMEMBER - Staff and their families may be caught up in any emerging incident, and duty staff need to be mindful of this for two reasons 1) Its potential effects on the Organisations response 2) That affected staff need to be followed up and support services offered where necessary. If you feel that you will be unable to cope, for whatever reason, with what is expected of you for the role you are required to undertake please let someone know immediately so a replacement can be found.
IMPORTANT INFORMATION TO ALL INCIDENT COORDINATION CENTRE STAFF
Incident Log Is maintained and held by the loggist who will record all decisions cross referenced with all messages
Personal Logs It is important that all other decisions, requests within the control room to support staff etc are logged by each individual; this can be done via pocket note books.
Job Title – PROVIDE staff (any available)
Incident Role: INCIDENT COORDINATION CENTRE (ICC) SUPPORT STAFF Action Card –PROV 7
ROLE DESCRIPTION
To provide general administrative support within the ICC during the incident.
MAJOR INCIDENT STANDBY ACTIONS
1. Receive initial communication from Tactical (Silver) Incident Controller/Incident Officer and start a log if required.
DECLARED MAJOR INCIDENT ACTIONS
1. Assist in setting up the Incident Coordination Centre (ICC) (Organisation Head Office or back up ICCs) using supplies stored in the major incident team cabinets.
2. Confirm the initial level of response required
ONGOING RECOVERY AND STAND DOWN ACTIONS
1. Assist in compiling action lists as required
2. Routine call handling.
3. Ensure that all calls, emails and messages are logged and allocated to senior staff for action
4. Ensure media calls are always forwarded to the Incident Communications officer
5. Send emails and faxes as instructed by ICC Manager/Tactical (Silver) Controller/Incident Director (Gold)
6 Liaise with other support staff based outside of the ICC over requests/information/data
7 Maintain a chronological action log.
8. Report any issues, difficulties or problems to the Silver Incident Controller as appropriate for resolution
IMPORTANT WELFARE INFORMATION FOR ALL RESPONDERS
A Major Incident is a stressful time, to ensure you are fully prepared for your role you should take the following key actions:
1. Notify your family, partner or significant other, that you are involved in the emergency and give them a contact number that they should be able to contact you on. If they are not available, leave a note;
2. Call the above regularly to keep them updated, and advise them not to speak to the media;
3. Ensure you take your staff and personal ID, money, cards, car, house and any work keys, mobile phone, pager (if you have one), torch and coat with you.
4. If you are called from home may also to bring want personal cosmetics / toiletries if think you will be away for a while and ensure that you bring any medications and dietary foods with you.
5. If at all possible you should not work for longer than eight hours without going off duty and please ensure that you make arrangements for meal breaks early on and take regular breaks.
REMEMBER - Staff and their families may be caught up in any emerging incident, and duty staff need to be mindful of this for two reasons 1) Its potential effects on the Organisations response 2) That affected staff need to be followed up and support services offered where necessary. If you feel that you will be unable to cope, for whatever reason, with what is expected of you for the role you are required to undertake please let someone know immediately so a replacement can be found.
IMPORTANT INFORMATION TO ALL INCIDENT COORDINATION CENTRE STAFF
Incident Log Is maintained and held by the loggist who will record all decisions cross referenced with all messages
Personal Logs It is important that all other decisions, requests within the control room to support staff etc are logged by each individual; this can be done via pocket note books.
ACTION CARD 8 – OPERATIONAL (BRONZE) COMMANDER
Job Title – PROVIDE Senior staff member(s)
Incident Role: OPERATIONAL (Bronze) Commander
ROLE DESCRIPTION
Action Card –PROV 8
The Operational (Bronze) commander is responsible for the command of a group of resources and carrying out functional or geographical responsibilities related to the tactical plan. The number of Operational (Bronze) commanders and their roles/specialisms is determined by the scale and nature of the incident. The bronze commander will manage the local response to the incident.
MAJOR INCIDENT STANDBY ACTIONS
1. Receive initial communication from Tactical (Silver) Incident Controller and start a log if required.
DECLARED MAJOR INCIDENT ACTIONS
1. Receive initial communication from Tactical (Silver) Incident Controller and start a log
2. Appoint and coordinate local managers
3. Establish command and control arrangements
4. Establish communication arrangements and that this is disseminated to local staff
ONGOING RECOVERY AND STAND DOWN ACTIONS
1. Conduct on-going risk assessment and management in response to the incident
2 Collate and complete Situation Report (SitRep) if required
3. Confirm the availability and location of relevant services and facilities
4. Identify any resources required and deploy them to meet the demands of the response.
5. Ensure that all calls, emails and messages are logged and allocated to senior staff for action
6. Ensure actions are carried out, taking into account the impact upon individuals
7 Ensure media enquiries are always forwarded to the Incident Communications Officer
8 Identify where circumstances require a tactical (Silver) level of management and engage with the tactical level as required
9. Maintain a chronological action log.
10. Monitor and protect the health, safety and welfare of individuals during the response.
11 Ensure that any individuals under your area of authority are fully briefed and debriefed.
IMPORTANT WELFARE INFORMATION FOR ALL RESPONDERS
A Major Incident is a stressful time, to ensure you are fully prepared for your role you should take the following key actions:
1. Notify your family, partner or significant other, that you are involved in the emergency and give them a contact number that they should be able to contact you on. If they are not available, leave a note;
2. Call the above regularly to keep them updated, and advise them not to speak to the media;
3. Ensure you take your staff and personal ID, money, cards, car, house and any work keys, mobile phone, pager (if you have one), torch and coat with you.
4. If you are called from home may also to bring want personal cosmetics / toiletries if think you will be away for a while and ensure that you bring any medications and dietary foods with you.
5. If at all possible you should not work for longer than eight hours without going off duty and please ensure that you make arrangements for meal breaks early on and take regular breaks.
REMEMBER - Staff and their families may be caught up in any emerging incident, and duty staff need to be mindful of this for two reasons 1) Its potential effects on the Organisations response 2) That affected staff need to be followed up and support services offered where necessary. If you feel that you will be unable to cope, for whatever reason, with what is expected of you for the role you are required to undertake please let someone know immediately so a replacement can be found.
IMPORTANT INFORMATION TO ALL INCIDENT COORDINATION CENTRE STAFF
Incident Log Is maintained and held by the loggist who will record all decisions cross referenced with all messages
Personal Logs It is important that all other decisions, requests within the control room to support staff etc are logged by each individual; this can be done via pocket note books.
Job Title – Senior Manager
Incident Role: COMMUNITY SERVICES COORDINATOR
ROLE DESCRIPTION
Action Card –PROV 9
With the Tactical (Silver) Incident Controller, your role is to work in conjunction with local multi agency partners, to arrange the provision of additional support and advice to acute services
MAJOR INCIDENT STANDBY ACTIONS
1. Receive initial communication from Tactical (Silver) Incident Controller and start a log if required.
2. Liaise with the Tactical (Silver) Incident Controller to determine whether you are required to attend the Incident Coordination Centre (ICC).
DECLARED MAJOR INCIDENT ACTIONS
1. Confirm with the Tactical (Silver) Incident Controller the initial level of response required
2. Assess if any PROVIDE operations will be affected by the incident. If any action is required, ensure this is fed back into the Tactical (Silver) Command Team.
3. Assess the need for additional staff, and, if appropriate, contact suitably qualified staff, and ask them to report for duty.
ONGOING RECOVERY AND STAND DOWN ACTIONS
1. Ensure you have a good overview of the tasks being carried out by other staff
2. Ensure that the Tactical (Silver) Incident Controller is kept fully briefed about the teams actions.
3. Identify bed capacity in the ALL inpatient areas, and take all action necessary to minimise occupancy levels, to allow for surge in demand
4. Mobilise community nurse workforce and healthcare facilities, working alongside PROVIDE Estates staff, if necessary
5. Ensure that service team leaders are aware of the situation and kept fully briefed.
6. Work with all agencies to ensure the continuity of services for vulnerable children and adults in the community
7. Report any issues, difficulties or problems to the Tactical (Silver) Incident Controller as appropriate for resolution
IMPORTANT WELFARE INFORMATION FOR ALL RESPONDERS
A Major Incident is a stressful time, to ensure you are fully prepared for your role you should take the following key actions:
1. Notify your family, partner or significant other, that you are involved in the emergency and give them a contact number that they should be able to contact you on. If they are not available, leave a note;
2. Call the above regularly to keep them updated, and advise them not to speak to the media;
3. Ensure you take your staff and personal ID, money, cards, car, house and any work keys, mobile phone, pager (if you have one), torch and coat with you.
4. If you are called from home may also to bring want personal cosmetics / toiletries if think you will be away for a while and ensure that you bring any medications and dietary foods with you.
5. If at all possible you should not work for longer than eight hours without going off duty and please ensure that you make arrangements for meal breaks early on and take regular breaks.
REMEMBER - Staff and their families may be caught up in any emerging incident, and duty staff need to be mindful of this for two reasons 1) Its potential effects on the Organisations response 2) That affected staff need to be followed up and support services offered where necessary. If you feel that you will be unable to cope, for whatever reason, with what is expected of you for the role you are required to undertake please let someone know immediately so a replacement can be found.
IMPORTANT INFORMATION TO ALL INCIDENT COORDINATION CENTRE STAFF
Incident Log Is maintained and held by the loggist who will record all decisions cross referenced with all messages
Personal Logs It is important that all other decisions, requests within the control room to support staff etc are logged by each individual; this can be done via pocket note books.
Job Title Clinical Lead/Director of Nursing
Incident Role
ROLE DESCRIPTION
Clinical Director
Your role is to give appropriate clinical advice as requested by the Provide Incident Director (Gold) and/or Tactical (Silver) Incident Controller
MAJOR INCIDENT STANDBY ACTIONS
1. Liaise with the Incident Controller; determine whether you are required to attend the Incident Coordination Centre (ICC)
DECLARED MAJOR INCIDENT ACTIONS
1. Confirm with the PROVIDE Incident Controller the initial level of response required
2. If the Major Incident has a clinical aspect, provide relevant clinical advice as required at the designated location.
3. Agree and mobilise any specialist medical resources as appropriate/required.
4. Liaise with medical, musing and pharmacy leads as required
5. Provide advice and support to staff involved in a major incident as appropriate
6. Provide information on access to emergency services and supplies in liaison with other members of the response team(s).
ONGOING RECOVERY AND STAND DOWN ACTIONS
1. Ensure arrangements have been made for your replacement if possible within 6-8 Hours
2. Ensure you attend any debriefs.
IMPORTANT WELFARE INFORMATION FOR ALL RESPONDERS
A Major Incident is a stressful time, to ensure you are fully prepared for your role you should take the following key actions:
1. Notify your family, partner or significant other, that you are involved in the emergency and give them a contact number that they should be able to contact you on. If they are not available, leave a note;
2. Call the above regularly to keep them updated, and advise them not to speak to the media;
3. Ensure you take your staff and personal ID, money, cards, car, house and any work keys, mobile phone, pager (if you have one), torch and coat with you.
4. If you are called from home you may also to bring want personal cosmetics / toiletries if you think you will be away for a while and ensure that you bring any medications and dietary foods with you.
5. If at all possible you should not work for longer than eight hours without going off duty and please ensure that you make arrangements for meal breaks early on and take regular breaks REMEMBER - If you feel that you will be unable to cope, for whatever reason, with what is expected of you for the role you are required to undertake please let someone know immediately so a replacement can be found.
IMPORTANT INFORMATION TO ALL INCIDENT COORDINATION CENTRE STAFF
Incident Log Is maintained and held by the loggist who will record all decisions cross referenced with all messages
Personal Logs It is important that all other decisions, requests within the control room to support staff etc are logged by each individual; this can be done via pocket note books.
Job Title – Pharmacist
Incident Role: PHARMACY COORDINATOR
ROLE DESCRIPTION
Your role is to provide appropriate pharmaceutical advice as necessary
MAJOR INCIDENT STANDBY ACTIONS
Action Card –PROV 11
1. Receive initial communication from Tactical (Silver) Incident Controller and start a log if required.
2. Liaise with the Tactical (Silver) Incident Controller to determine whether you are required to attend the Incident Coordination Centre (ICC).
DECLARED MAJOR INCIDENT ACTIONS
1. Confirm with the Tactical (Silver) Incident Controller the initial level of response required
2. Advise key staff of potential involvement in an emergency situation.
ONGOING RECOVERY AND STAND DOWN ACTIONS
1. If the Major Incident has a pharmaceutical aspect, provide relevant pharmaceutical advice as required at the designated location
2 Provide advice and support to staff involved in a major incident as appropriate
3 Ensure sufficient stock is available, if required, due to demand.
4 Report any issues, difficulties or problems to the Tactical (Silver) Incident Controller as appropriate for resolution
IMPORTANT WELFARE INFORMATION FOR ALL RESPONDERS
A Major Incident is a stressful time, to ensure you are fully prepared for your role you should take the following key actions:
1. Notify your family, partner or significant other, that you are involved in the emergency and give them a contact number that they should be able to contact you on. If they are not available, leave a note;
2. Call the above regularly to keep them updated, and advise them not to speak to the media;
3. Ensure you take your staff and personal ID, money, cards, car, house and any work keys, mobile phone, pager (if you have one), torch and coat with you.
4. If you are called from home may also to bring want personal cosmetics / toiletries if think you will be away for a while and ensure that you bring any medications and dietary foods with you.
5. If at all possible you should not work for longer than eight hours without going off duty and please ensure that you make arrangements for meal breaks early on and take regular breaks.
REMEMBER - Staff and their families may be caught up in any emerging incident, and duty staff need to be mindful of this for two reasons 1) Its potential effects on the Organisations response 2) That affected staff need to be followed up and support services offered where necessary. If you feel that you will be unable to cope, for whatever reason, with what is expected of you for the role you are required to undertake please let someone know immediately so a replacement can be found.
IMPORTANT INFORMATION TO ALL INCIDENT COORDINATION CENTRE STAFF
Incident Log Is maintained and held by the loggist who will record all decisions cross referenced with all messages
Personal Logs It is important that all other decisions, requests within the control room to support staff etc are logged by each individual; this can be done via pocket note books.
Job Title – Senior HR Manager
Incident Role: STAFF WELFARE COORDINATOR
ROLE DESCRIPTION
Action Card –PROV 12
Should an incident become protracted Strategic (Gold) Command may instruct the Human Resources Team to form a central Staff Welfare Team to provide a core information service for all Provide staff. The team will provide a focal point for staff during the incident
MAJOR INCIDENT STANDBY ACTIONS
1. Receive initial communication from Tactical (Silver) Incident Controller and start a log if required.
2. Liaise with the Tactical (Silver) Incident Controller to determine whether you are required to attend the Incident Coordination Centre (ICC).
DECLARED MAJOR INCIDENT ACTIONS
1. Confirm with the Tactical (Silver) Incident Controller the initial level of response required
2. Assess if any PROVIDE operations will be affected by the incident. If any action is required, ensure this is fed back into the Tactical (Silver) Command Team.
ONGOING RECOVERY AND STAND DOWN ACTIONS
1. Monitoring and report real-time absence rates
2. Enable staff to work by agreeing alternative duties or assisting them to find services (e.g. transport or childcare)
3. Managing the redeployment of staff, including voluntary and recently retired
4. Confirm leave and special leave arrangements
5. Direct staff to appropriate psychological support services if required
6. Enable staff to resolve concerns or disputes involving working requirements
7. Coordinate additional training required to aid response or suspend any training if it impacts upon the provision of the response.
8. Report any issues, difficulties or problems to the Tactical (Silver) Incident Controller as appropriate for resolution
IMPORTANT WELFARE INFORMATION FOR ALL RESPONDERS
A Major Incident is a stressful time, to ensure you are fully prepared for your role you should take the following key actions:
1. Notify your family, partner or significant other, that you are involved in the emergency and give them a contact number that they should be able to contact you on. If they are not available, leave a note;
2. Call the above regularly to keep them updated, and advise them not to speak to the media;
3. Ensure you take your staff and personal ID, money, cards, car, house and any work keys, mobile phone, pager (if you have one), torch and coat with you.
4. If you are called from home may also to bring want personal cosmetics / toiletries if think you will be away for a while and ensure that you bring any medications and dietary foods with you.
5. If at all possible you should not work for longer than eight hours without going off duty and please ensure that you make arrangements for meal breaks early on and take regular breaks.
REMEMBER - Staff and their families may be caught up in any emerging incident, and duty staff need to be mindful of this for two reasons 1) Its potential effects on the Organisations response 2) That affected staff need to be followed up and support services offered where necessary. If you feel that you will be unable to cope, for whatever reason, with what is expected of you for the role you are required to undertake please let someone know immediately so a replacement can be found.
IMPORTANT INFORMATION TO ALL INCIDENT COORDINATION CENTRE STAFF
Incident Log Is maintained and held by the loggist who will record all decisions cross referenced with all messages
Personal Logs It is important that all other decisions, requests within the control room to support staff etc are logged by each individual; this can be done via pocket note books.
ACTION CARD 13 – PROCUREMENT COORDINATOR
Job Title – Head Of Procurement/ Procurement Specialist
Incident Role: PROCUREMENT COORDINATOR
ROLE DESCRIPTION
Action Card –PROV 13
Should an incident become protracted strategic (Gold) Command may instruct the Procurement Team to provide a core information service for obtaining the relevant goods and services. The team will provide a focal point for staff during the incident
MAJOR INCIDENT STANDBY ACTIONS
1. Receive initial communication from Tactical (Silver) incident Controller and start a log if required.
2. Liaise with the Tactical (Silver) Incident Controller to determine whether you are required to attend the Incident Coordination Centre (ICC).
DECLARED MAJOR INCIDENT ACTIONS
1. Confirm with the Tactical (Silver) Incident Controller the initial level of response required
2. Assess if any PROVIDE operations will be affected by the incident. If any action is required, ensure this is fed back into the Tactical (Silver) Command Team.
ONGOING RECOVERY AND STAND DOWN ACTIONS
1. Monitoring and report any supply of services or goods affected by the major incident.
2. Ensure that the supply chain is maintained and redesigned as necessary.
3. Ensure that the Procurement Business Continuity plan is invoked where necessary.
4. Ensure that there is no single point of failure within the supply chain.
IMPORTANT WELFARE INFORMATION FOR ALL RESPONDERS
A Major Incident is a stressful time, to ensure you are fully prepared for your role you should take the following key actions all staff should take before responding:
1. Notify your family, partner or significant other, that you are involved in the emergency and give them a contact number that they should be able to contact you on. If they are not available, leave a note;
2. Call the above regularly to keep them updated, and advise them not to speak to the media;
3. Ensure you take your staff and personal ID, money, cards, car, house and any work keys, mobile phone, pager (if you have one), torch and coat with you.
4. If you are called from home may also to bring want personal cosmetics / toiletries if think you will be away for a while and ensure that you bring any medications and dietary foods with you.
5. If at all possible you should not work for longer than eight hours without going off duty and please ensure that you make arrangements for meal breaks early on and take regular breaks.
REMEMBER - Staff and their families may be caught up in any emerging incident, and duty staff need to be mindful of this for two reasons 1) Its potential effects on the Organisations response 2) That affected staff need to be followed up and support services offered where necessary. If you feel that you will be unable to cope, for whatever reason, with what is expected of you for the role you are required to undertake please let someone know immediately so a replacement can be found.
IMPORTANT INFORMATION TO ALL INCIDENT COORDINATION CENTRE STAFF
Incident Log Is maintained and held by the loggist who will record all decisions cross referenced with all messages
Personal Logs
It is important that all other decisions, requests within the control room to support staff etc are logged by each individual; this can be done via pocket note books.
Job Title – Finance Lead
Incident Role: FINANCE LEAD
ROLE DESCRIPTION
Action Card –PROV 14
The Finance Lead should monitor the overall resilience of the organisations financial position throughout the incident. It is acknowledged that during the response to or recovery from an incident additional cost may be incurred either through the procurement of additional supplies and services or through the alteration of existing contracts. Any finance problems, either real or anticipated, should be communicated to the PROVIDE Incident Director (Gold) as quickly as possible for resolution.
MAJOR INCIDENT STANDBY ACTIONS
1. Receive initial communication from Strategic (Gold) incident Controller and start a log if required.
2. Liaise with the Tactical (Silver) Incident Controller to determine whether you are required to attend the Incident Coordination Centre (ICC).
DECLARED MAJOR INCIDENT ACTIONS
1. Confirm with the Strategic (Gold) Incident Controller the initial level of response required
2. Assess if any PROVIDE operations will be affected by the incident. If any action is required, ensure this is fed back into the Strategic (Gold) Command Team.
3. Set up a unique cost centre and budget codes to ensure that all costs are tracked
4. Maintain a financial log for activity undertaken that has financial implications, it is essential that the records are adequate to identify:
• The expenditure that has been incurred and for what item or service
• When and where the item or service is to be provided
• To whom the expenditure is payable – the company or organisations name and address, and a named individual as contact
• On whose behalf the expenditure was incurred, particularly if acting as an agent for a organisation
• The relevant terms and conditions of sale
• When the bill is payable
• The name of the individual approving the expenditure at the time
• The date of the transaction
ONGOING RECOVERY AND STAND DOWN ACTIONS
1. Monitoring and report any supply of services or goods affected by the major incident.
2 Ensure that the Finance Business Continuity plan is invoked where necessary.
3 Ensure that the incident response is financially sustainable.
IMPORTANT WELFARE INFORMATION FOR ALL RESPONDERS
A Major Incident is a stressful time, to ensure you are fully prepared for your role you should take the following key actions all staff should take before responding:
1. Notify your family, partner or significant other, that you are involved in the emergency and give them a contact number that they should be able to contact you on. If they are not available, leave a note;
2. Call the above regularly to keep them updated, and advise them not to speak to the media;
3. Ensure you take your staff and personal ID, money, cards, car, house and any work keys, mobile phone, pager (if you have one), torch and coat with you.
4. If you are called from home may also to bring want personal cosmetics / toiletries if think you will be away for a while and ensure that you bring any medications and dietary foods with you.
5. If at all possible you should not work for longer than eight hours without going off duty and please ensure that you make arrangements for meal breaks early on and take regular breaks.
REMEMBER - Staff and their families may be caught up in any emerging incident, and duty staff need to be mindful of this for two reasons 1) Its potential effects on the Organisations response 2) That affected staff need to be followed up and support services offered where necessary. If you feel that you will be unable to cope, for whatever reason, with what is expected of you for the role you are required to undertake please let someone know immediately so a replacement can be found.
IMPORTANT INFORMATION TO ALL INCIDENT COORDINATION CENTRE STAFF
Incident Log Is maintained and held by the loggist who will record all decisions cross referenced with all messages
Personal Logs It is important that all other decisions, requests within the control room to support staff etc are logged by each individual; this can be done via pocket note books.
APPENDIX A – EMERGENCY PREPAREDNESS CONTACTS DIRECTORY
Due to size, this is a separate document and is included within on-call packs
