NHS Emergency planning has to plan for, and respond to, a wide range of incidents that could impact on health or patient care.
Emergency planning could be anything from prolonged period of severe pressure, extreme weather conditions, an outbreak of an infectious disease, or a major transport accident. A significant incident or emergency is any event that cannot be managed within routine service arrangements. It requires the implementation of special procedures and involves one or more of the emergency services, the NHS or a local authority.
NHS funded organisations must also be able to maintain continuous levels in key services when faced with disruption from identified local risks such as severe weather, fuel or supply shortages or industrial action. This is known as business continuity management.
NHS organisations must use the Integrated Emergency Management (IEM) cycle to anticipate, assess, prevent, prepare, respond and recover from disruptive challenges. The IEM cycle ensures a constant review of activity and therefore robust preparedness arrangements.
Significant Incident and Emergency
A significant incident or emergency can be described as any event that cannot be managed within routine service arrangements. Each require the implementation of special procedures and may involve one or more of the emergency services, the wider NHS or a local authority, a significant or emergency may include:
Times of severe pressure, such as winter periods, a sustained increase in demand for services such as surge or an infectious disease outbreak that would necessitate the declaration of a significant incident however not a major incident;
Any occurrence where the NHS funded organisations are required to implement special arrangements to ensure the effectiveness of the organisations internal response. This is to ensure that incidents above routine work but not meeting the definition of a major incident are managed effectively.
An event or situation that threatens serious damage to human welfare in a place in the UK or to the environment of a place in the UK, or war or terrorism which threatens serious damage to the security of the UK. The term ‘‘major incident’’ is commonly used to describe such emergencies. These may include multiple casualty incidents, terrorism or national emergencies such as pandemic influenza.
An emergency is sometimes referred to by organisations as a major incident. Within NHS funded organisations an emergency is defined as the above for which robust management arrangements must be in place.
What is a heatwave and how is it declared?
An average temperature of 30°C by day and 15°C overnight for at least two consecutive days would trigger a heat-health watch alert (this figure varies slightly around the UK). These temperatures can have a significant effect on people's health if they last for at least two days and the night in between.
The Met Office has a warning system that issues alerts if a heatwave is likely. See here for more information.
Level one is the minimum alert and is in place from 1 June until 15 September (which is the period that heatwave alerts are likely to be raised):
- the minimum alert simply means that people should be aware of what to do if the alert level is raised
- if a level two alert is issued, there is a high chance that a heatwave will occur within the next few days
- the level three alert is when a heatwave is happening
- the level four alert is when a heatwave is severe
Advice during a heatwave
- stay out of the heat
- keep out of the sun between 11am and 3pm
- if you have to go out in the heat, wear UV sunglasses, preferably wraparound, to reduce UV exposure to the eyes, walk in the shade, apply sunscreen of at least SPF15 with UVA protection, wear a hat. Wear light, loose-fitting cotton clothes. This should minimise the risk of sunburn
- avoid extreme physical exertion
- have plenty of cold drinks, and avoid excess alcohol, caffeine or drinks high in sugar. If drinking fruit juice, dilute it with water. Eat cold foods, particularly salads and fruit with a high water content and when travelling ensure you take water with you
- look out for others: Keep an eye on isolated, older people, ill or very young people and make sure they are able to keep cool. Ensure that babies, children or older people are not left alone in stationary cars. Check on older people or sick neighbours, family or friends every day during a heatwave. Be alert and call a doctor or social services if someone is unwell or further help is needed
- keep your environment cool: Keeping your living space cool is especially important for infants, older people or those with long-term health conditions or who can’t look after themselves
- shade or cover windows exposed to direct sunlight and keep windows that are exposed to the sun closed during the day external shutters or shades are very effective, while internal blinds or curtains are less effective but cheaper and easier to install However, care should be taken with metal blinds and dark curtains, as these can absorb heat – consider placing reflective material between them and the window space
- open windows at night if it feels cooler outside, although be aware of security issues especially in ground floor rooms. Close curtains that receive morning or afternoon sun.
- turn off non-essential lights and electrical equipment – they generate heat
- keep indoor plants and bowls of water in the house as evaporation helps cool the air
- electric fans may provide some relief, if temperatures are below 35°C
- seek medical advice if you are suffering from a long-term medical condition or taking multiple medications
- if you or others feel unwell seek medical advice
- if you feel dizzy, weak, anxious or have intense thirst and headache, move to a cool place as soon as possible. Drink some water or diluted fruit juice to rehydrate, avoid alcohol and caffeinated drinks like tea or coffee
- if you have painful muscular spasms (particularly in the legs, arms or abdomen, for example after sustained exercise during very hot weather), rest immediately in a cool place and drink electrolyte drinks. We say that most people should start to recover within 30 mins and if not, they should seek medical help. Consult your doctor if you feel unusual symptoms or if symptoms persist
NHS England have produced advice guides to help during a heatwave. The guides are available in a number of formats and are available to download here.
Business Continuity is often described as ‘just common sense’. It is about taking responsibility for your business and enabling it to stay on course whatever storms it is forced to weather. It is about “keeping calm and carrying on”! Business Continuity is about building and improving resilience in your business; it’s about identifying your key products and services and the most urgent activities that underpin them and then, once that ‘analysis’ is complete, it is about devising plans and strategies that will enable you to continue your business operations and enable you to recover quickly and effectively from any type disruption whatever its size or cause. It gives you a solid framework to lean on in times of crisis and provides stability and security. In fact, embedding BC into your business is proven to bring business benefits.
Business Continuity (BC) is defined as the capability of the organisation to continue delivery of products or services at acceptable predefined levels following a disruptive incident. (Source ISO 22301, 2012)
Business Continuity Management (BCM) is defined as a holistic management process that identifies potential threats to an organization and the impacts to business operations those threats, if realised, might cause, and which provides a framework for building organisational resilience with the capability of an effective response that safeguards the interests of its key stakeholders, reputation, brand and value-creating activities. (Source: ISO 22301:2012)
The NHS is required to have robust BC Plans in place to ensure that effective levels of service provision are maintained during major service disruption caused by such things as:
- Severe weather
- Mass casualties
- Pandemic Influenza