EMERGENCY PLANNING ANNUAL REPORT 2013-14
EMERGENCY PLANNING
NHS SHETLAND ANNUAL REPORT
2013-14
EMERGENCY PLANNING ANNUAL REPORT 2013-14
Contents: Page no.
Introduction 2
National, regional and local Inter-agency arrangements 3
Local Planning 4
Events 6
Incidents 7
Other Issues 7
Training 8
Exercises 9
Partner Exercises 9
Risk Management 9
Audit and Self-assessment 10
Abbreviations 11
Acknowledgements
Thanks for help in the local response and preparedness within Public Health goes to Dr Susan Laidlaw, Consultant in Public Health Medicine, and in preparation of this Annual Report goes to Ingrid Gall, Emergency Planning & Resilience Officer, Shetland Islands Council.
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Introduction
This Emergency Planning Annual Report written for NHS Shetland reports on emergency planning activity in Shetland for the year 2013 – 2014. Reporting also happens locally across agencies and to the local service via the Shetland Emergency Planning Forum.
Emergency planning for health services is part of the core public health responsibilities carried out by the public health department and led by the Director of Public Health, supported by the Shetland Islands Council (SIC) Emergency Planning and Resilience team which provides a service to both NHS Shetland and SIC through a Service Level Agreement. However, it is the responsibility of all staff and managers within the service to be prepared for emergencies, and therefore to plan, train and exercise their preparedness appropriately.
This Annual Report describes the activities undertaken in the last year to support and deliver the function of emergency planning for NHS Shetland.
The Civil Contingencies Act 2004 (Contingency Planning) (Scotland) Regulations 2005 create responsibilities on a number of organisations in the event of an „emergency‟. Under the 2004 Act an „emergency‟ is defined as an event or situation which threatens serious damage to human welfare in a place in the United Kingdom, the environment of a place in the UK, or war or terrorism which threatens serious damage to the security of the UK.
An event or situation threatens damage to human welfare if it involves, causes or may cause:
. loss of human life . human illness or injury . homelessness . damage to property . disruption of a supply of money, food, water, energy or fuel . disruption of a system of communication . disruption of facilities for transport, or . disruption of services relating to health.
An event or situation threatens damage to the environment if it involves, causes or may cause:
. contamination of land, water or air with biological, chemical or radioactive matter, or . disruption or destruction of plant life or animal life.
Each statutory emergency service and other agencies have a responsibility to serve and protect the public. In practice, in Shetland, the local emergency plans prepare us for situations which call on responses beyond the usual capacity of our organisations. These cover the range of threats outlined in the Civil Contingencies legislation, including those posed by our remote and rural
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situation, and the island and maritime context (the DPH role includes responsibility for Port Health). The Public Health response is also governed by the Public Health etc. (Scotland) Act 2008.
NHS Shetland is a Category One responder (organisations that provide vital services in an emergency), along with local authorities, police, fire service, ambulance, coastguard, environment protection and weather services.
National, regional and local Inter-agency arrangements
The local service has historically worked within the Highlands and Islands Strategic Coordinating Group (HISCG) to underpin our local and regional preparedness, and to link into the national structures on resilience.
The formation of the Police Service of Scotland (PSoS) and the Scottish Fire and Rescue Service (SFRS) as single national agencies, required a change to national emergency planning, response and recovery arrangements to align boundaries with the areas established by Police and Fire to support strategic management of their local activity. From 1 November 2013 three Regional Resilience Partnerships (RRP) were created in Scotland.
Each RRP is comprised of Local Resilience Partnerships (LRP) which are aligned with Police, Fire and Rescue and Local Authority boundaries. Shetland is part of the Highlands and Islands LRP, (mirroring the previous Strategic Coordinating Group arrangement) which comes together with Grampian and Tayside to form the North of Scotland Regional Resilience Partnership (NSRRP).
Amendments to the Civil Contingencies Act regulations to support the new arrangements were included in the Police & Fire Reform process.
On island, the emergency services and other relevant partners come together within Shetland in a formal inter-agency group, the Shetland Emergency Planning Forum (SEPF) that takes collaborative responsibility for local action and the preparing and testing of local plans. This group is responsible for the local Multi-Agency Initial Response Plan (MAIRP).
In 2013 it was agreed that the previous annual meeting of the group held to update stakeholders in local emergency planning activity would be held biannually. The meeting in November 2013 dealt with: Severe Weather preparedness; The debrief on the Helicopter Incident and actions / lessons learnt; Planned training and exercising; The National and Regional changes in structure and arrangements through Regional and Local Resilience Partnerships; Community Safety & Resilience Board reporting Scottish Government – guidance on:
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o Ready for Winter o Community Resilience – local work is underway with Police and Fires service visiting rural communities and engaging with Community Councils on community resilience issues o Business Resilience
Shetland Emergency Planning Forum Executive meets regularly throughout the year, and in 2013-14 dealt with a range of topics including: Agreeing the training and exercising programme for the year, and planning / supporting its delivery; Review and update of emergency plans and procedures including: Updating the Board‟s Major Emergency Procedure and adding an Annex on Counter Terrorism; Planning for and de-briefing from events and incidents throughout the year including those affecting the wider Highlands and Islands Strategic Co- ordinating Group where local lessons may be learnt; Updating the Community Risk Register; Business continuity planning; Roads and winter maintenance; Government policy on Community Resilience; Emergency Helicopter Landing Site – planning for relocation with the new Anderson High School planned build; Airwave communications; Introducing the Mobile Telecommunications Privileged Access Scheme (MTPAS) locally, whereby the Police give priority to those phones when making calls during a major emergency in which the police have invoked powers to commandeer the mobile phone network; Contingency planning for the increased personnel working on the gas and oil expansion programme at Sullom Voe, including the accommodation barges; Considering the options for multi-agency accommodation across the emergency services – a piece of work still underway; A piece of work undertaken to map the coastline with regard to pollution which identified several areas of interest relating to flora, fauna, livestock etc
Local Planning
The Shetland Emergency Planning Forum‟s mission statement is to provide the communities of the Shetland Islands with fully integrated, cohesive, efficient, and quality civil contingencies planning, management and response services.
Within NHS Shetland, resilience and civil contingencies is managed by the Director of Public Health (DPH) as Executive Lead, reporting to the Board’s Senior Management Team chaired by the Chief Executive, responsible ultimately to the Board.
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As well as the multi-agency arrangements through the Shetland Emergency Planning Forum, NHS Shetland has specific surge capacity arrangements in place across the north of Scotland for Public Health functions via the North of Scotland Public Health Network, and arrangements between the north of Scotland NHS Boards for clinical and support services. These are designed to ensure co-operation and collaboration between Shetland and the other northern NHS Boards in emergency situations where local demands outstrip local capacity, and are formalised through a Mutual Aid Agreement.
Key local plans for dealing with major emergencies in Shetland are listed below. These comply with national Scottish arrangements for the management of emergencies which are set out in: Preparing Scotland: Scottish Guidance on Resilience 20121, and NHS Scotland Resilience Preparing For Emergencies: Guidance for Health Boards in Scotland August 20132.
Other relevant national guidance is detailed in the Shetland Joint Health Protection Plan, updated 2012 and includes:
Management of Public Health Incidents Guidance on the Roles and Responsibilities of NHS led Incident Management Teams - Published October 20113
Local Plans
Shetland’s Emergency Planning Forum’s Multi-Agency Initial Response Plan;
NHS Shetland’s Major Emergency Procedures (updated 2014);
NHS Shetland Business Continuity Plans;
Shetland Public Health Incident / Outbreak Plan and the Shetland Hospital Outbreak Plan;
Shetland Islands Council’s Emergency Plan.
In addition, specific plans are in place to deal with specific hazards including:
NHS Shetland’s Winter Plan;
1 http://www.scotland.gov.uk/Publications/2012/03/2940/0
2 http://www.scotland.gov.uk/Resource/0043/00434687.pdf
3 Management of Public Health Incidents Guidance on the Roles and Responsibilities of NHS led Incident Management Teams 2011
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Shetland’s Contingency Plan for Pandemic Influenza (updated 2013);
Plan for the Investigation and Control of Foodborne Disease Outbreaks;
Scottish Waterborne Hazard Plan; Shetland Blue/Green Algae Monitoring and Action Plan; Public Health Plan for cryptosporidium in public drinking water supplies;
Procedures for the management of Legionnaire’s Disease; Viral Haemorrhagic Fever; prevention and control of TB; Meningococcal Disease.
Shetland Islands Council Offsite Control of Major Accident Hazards (COMAH) Plans for specific local sites including Sullom Voe Oil Terminal, and Shetland Gas Plant;
Shetland Islands Council Pipeline Safety Plans (Brent, Ninian and Clair Pipelines, Total E&P Shetland Islands Regional Gas Export Line (SIRGE);
CBRN (Chemical, Biological, Radiological and Nuclear) Joint Initial Response Plan (Highlands & Islands Emergencies Co-ordinating Group); and various supporting guidance detailed in the Shetland Joint Health Protection Plan.
During 2012 / 13 further progress was made in developing and updating the Board‟s Business Continuity Plans (BCPs). All service areas (priority and non-priority, clinical and non-clinical) now have a BCP in place to prompt responses to the major potential impacts against timescales for recovery, and plans are now updated regularly in a standard format. Increasingly the plans are tested and revised through both incidents and near misses, and training / exercising experience (see also section on audit and self-assessment).
Events
A number of events were planned and prepared for during the last year:
Possible Industrial Action by Scottish Fire & Rescue Service and separately by Petrofac were planned for though did not have effect locally;
Preparation was undertaken in liaison with the national planning for the Commonwealth Games and the Queens Baton Relay visit to Shetland.
A number of severe weather events occurred over winter disrupting power and transport services particularly.
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Incidents
A helicopter incident on the evening of Friday 23rd August 2013 had a significant impact on NHS Shetland with a major emergency response from all agencies, and the Gilbert Bain Hospital used as the receiving hospital for casualties. There were 18 people on board and 18 people were recovered with 4 fatalities. The rescue phase went well though there were a number of learning points both single and multi-agency.
A small number of incidents occurred where the emergency services call out system had not worked as well as it might, particularly in relation to the lines of communication to different services and standing down services when a potential incident did not materialise. These incidents were the subjects of de- briefs with actions taken to review procedures.
In September 2013 a communications failure occurred when the broadband services to over 2,000 end-users in Shetland including emergency services were impacted by a transmission radio link failure on the Orkney network. The services were remotely re-routed and restored while the original damage was repaired.
A positive Legionella water testing result on an accommodation barge moored in Shetland raised an alert about potential risks to human health. No human health impact was identified though testing of a small number of exposed individuals who presented with flu like illnesses happened via primary care.
Other issues to report
Preparation and planning has been undertaken for the increase in numbers of workers with the development of the Shetland gas plant and refurbishment of the Sullom Voe oil terminal. Liaison has taken place between primary care and the hospital with colleagues from the industry to negotiate appropriate use of local services, on a continuing basis to tackle operational issues, and to make sure that the increasing demand on local services is managed appropriately. There are now six accommodation vessels and one accommodation village housing over 3,000 temporary workers. Meetings were held early on in the planning of the additional accommodation to ensure that evacuation and emergency plans are adequate and to tie in with local resources and facilities. The additional workforce will be at its maximum during 2014/15 and then gradually reduce in size.
A familiarisation visit to the Gas Plant site at Sullom was undertaken by local agencies and discussion held about emergency response planning. Further work is being done on Emergency Response Plans for the site with a commitment to coordinate with the Shetland Multi-Agency Initial Response Plan.
The local Community Safety & Resilience Board with representation of all Category 1 Responders continues to meet. Its business fulfils the Local
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Authority requirement to oversee local Police and Fire plans, and in addition it oversees Community Safety and Resilience issues for Shetland. The Board has been meeting on a regular basis and has considered a range of resilience issues.
Shetland‟s Single Outcome Agreement includes a priority outcome on community safety and resilience: Shetland stays a safe place to live, and we have strong, resilient and supportive communities. To achieve this we had local actions for 2013/14 on developing Community Resilience (working with the Shetland Association of Community Councils) and particularly on ensuring that the new National Contingency Plan for Marine Pollution from Shipping and Offshore Installations is fit for purpose. Shetland submitted a robust response to the consultation on the draft of this plan.
During 2013/14 NHS Shetland‟s Business Continuity Plans were reviewed and updated with a particular focus on IT resilience.
The CBRN decontamination suits held by the A&E Department at GBH were reconditioned to extend the life of the suits, in line with the national quality assurance process.
Updates from Government on Utilities Resilience have been received and actioned.
Training
Relevant training is delivered locally both within NHS Shetland and in conjunction with partner agencies. Training in 2013 / 14 has included:
Participation in a national workshop on Critical Infrastructure in April 2013 which looked at local infrastructure and plans in place for preparedness and resilience. A Scottish Waterborne Hazard Plan & Waste Water Pollution Incidents Training Workshop held in May 2013 which was attended by a range of local agencies including public health. This rehearsed a number of scenarios including wastewater pollution and familiarised participants with the Scottish Water Risk Management guidance, risk management and control, and local response capability. Business Continuity Workshops run for SIC staff (including joint services staff) in January 2013
Individual Continuing Professional Development (CPD) by members of the Public Health team took place on aspects of emergency planning including the role of public health in leading the local strategic response and in chairing a STAC, and strategic resilience.
In addition, specific training issues for individuals and departments have been identified from local exercising of plans, recorded in de-briefs and actioned within the service.
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Exercises
A number of local exercises had direct involvement of NHS staff and services:
“Scarf One” – Sumburgh Airport Tabletop Care for People April 2013: an exercise to test care for people - handling information and aftercare for casualties and families, looking at contingency plans and checking that support mechanisms are in place. This had limited success because of difficulties in participation on the day, but there was participation with similar aims in the live exercise held in 2014. A tabletop exercise was held in September 2013 with Scatsta Airport to test the management of the Casualty Reception Centre and Care for People issues. This used the recently updated Care for People Plan and highlighted some issues to be dealt with before testing in a live Care for People exercise.
Exercise “Safe Hand”: a national NHSScotland exercise in which a wide range of Shetland staff participated in October 2013, which explored the arrangements for responding to a mass casualty incident beyond the capability of a single Board. A number of lessons were learnt by local services, including liaison for supplies, and some training needs.
All of these exercises resulted in learning for health staff. Specific actions were identified and followed through, with resulting changes to local plans documented in the exercise de-briefs which are now reported to the Board‟s Senior Management Team.
Partner exercises
A number of exercises were also undertaken by the local Emergency Planning partnership which did not have direct NHS involvement, but which tested aspects of partner agencies emergency preparedness. These included
“Orinocco” – Sullom Voe Terminal – Live – 22nd May 2013 “Rio Grande” – Sullom Voe Terminal – Live – 11th September 2013
Because of the small scale and isolated context of Shetland services, it also continues to be important for local agencies to use national exercises and reports to inform local plans, and this is done via the local Emergency Planning Forum Executive.
Risk Management
Local risks are assessed and along with remedial actions, used to inform emergency planning via Shetland‟s Community Risk Register in line with the responsibilities outlined in the Civil Contingencies Act 2004 for category 1 and 2 responders. The Community Risk Register is updated annually or whenever
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an incident occurs, to ensure the risks contained therein are correctly assessed. This correlates with the risks identified within Shetland NHS Board‟s Corporate Risk Register (which has been regularly updated through 2013/14 with respect to emergency planning risks), and the process for risk management within the Board. The Public Health Department Risk Register continues to be updated with more detailed risks (and their management) recorded in relation to the public health team‟s role in emergency planning and resilience.
In early 2014 the Community Risk Register was specifically updated from the work done to prepare for the Commonwealth Games Queens Baton Relay.
Audit and self-assessment
Following the Audit of Preparedness undertaken by the Board‟s public health team in December 2010 in response to the 2009 Audit Scotland Civil Contingencies Report, responses within the local Action and Improvement Plan were completed and this was signed off by the Board‟s Senior Management Team in May 2013.
A follow up review of the Board‟s resilience and business continuity planning was planned by the Internal Audit Team in the 2013 audit cycle, but postponed because of other priorities into the 2014/15 programme.
Dr Sarah Taylor Director of Public Health August 2014
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Abbreviations
BCP Business Continuity Plan CBRN Chemical, Biological, Radiological and Nuclear COMAH Control of Major Accident Hazards CPD Continuing Professional Development DPH Director of Public Health H&I Highlands and Islands HISCG Highlands and Islands Strategic Coordinating Group HPS Health Protection Scotland LRP Local Resilience Partnerships MAIRP Multi-Agency Initial Response Plan MTPAS Mobile Telecommunications Privileged Access Scheme NCP National Contingency Plan NSRRP North of Scotland Regional Resilience Partnership PSoS Police Service of Scotland RRP Regional Resilience Partnerships SEPF Shetland Emergency Planning Forum SFRS Scottish Fire and Rescue Service SIC Shetland Islands Council STAC Scientific and Technical Advice Cell ScoRDS Scottish Government, Scottish Resilience and Development Service
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