Post on 14-Jun-2015
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Role and responsibilities of the NHS in emergency response
Dominic MellonSpecialty Registrar – Public Health
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Role and responsibilities of the NHS in emergency response
NHS command, control and coordination The structure of the NHS Organisational roles and responsibilities NHS role in a chemical, biological, radiological
or nuclear response (HART) Hazardous Area Response Teams (HART) Scientific and Technical Advice Cell (STAC) NHS reorganisation
SUBJECT TO CHANGE
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Department of HealthCabinet Office
Civil Contingencies Committee
NHS South West(Strategic Health Authority)
Regional Coordinating Group
Primary Care Trust
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SHA representative
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Local Health responseLocal Strategic Coordinating
Centre
(‘Gold’)
Ambulance Executive
representative
PCT Executive representative
Operational Level management (Bronze Commanders)
Command and Control
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Strategic Health Authorities
Role of NHS South West:
Strategic leadership of the NHS
Ensuring the local NHS operates effectively and delivers improved health and healthcare performance
Development of NHS organisations and staff
Delivery assurance, e.g. Civil Contingencies A compliance
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Role and Responsibilities
Source: Information about the NHS in the Southwest, NHS Southwest, 2006
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Role and Responsibilities
Strategic Health Authorities: Strategic command and control for widespread
major incidents Support coordination of local NHS response Coordinate mutual aid/military assistance Liaise with the Department of Health Assure command of a local response if required Asses ongoing situation and identify emerging
issues
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Primary Care Trusts
Role of Primary Care Trusts: 14 Primary Care Trusts in the South West Primary Care health services:
General Practitioners; Public Health of the local population; walk-in centres/ minor injuries units; Community hospitals Community nurses;
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Role and ResponsibilitiesPrimary Care Trusts Represent the local NHS at Strategic
Coordinating Group Coordinate the implementation of the local
NHS response Implement arrangements for mass
prophylaxis Health monitoring and surveillance Manage local health media messages
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Role and ResponsibilitiesAcute Trusts Activate Major Incident Plans when alerted
by the Ambulance Service Establish a control room Provide a Medical Emergency Response
incident Team to the scene Lockdown hospital Decontaminate patients
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Ambulance Service Trust
Ambulance Service Trusts: Two ambulance services in the South West
Great Western Ambulance Service NHS Trust (GWAS)
South Western Ambulance Services NHS Trust (SWAST)
The saving of life …by instigate a triage process when required …by treat casualties …by transport casualties to hospital
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Role and Responsibilities
Ambulance Service Trusts
To instigate a command and control structure
To protect the health, safety and welfare of all health service personnel on site
To co-ordinate the NHS communications on site and to alert the main 'receiving' hospitals for the receipt of the injured
To carry out a health service assessment for the incident
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Specialist incident response
Special Incident Response Teams (SORT) provide clinical decontamination and support mass decontamination
Specialist equipment: National capabilities mass casualty equipment Multi-patient oxygen delivery
Ambulance service chemical, biological, radiological and nuclear incident response:
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NHS Zones
IncidentIncidentSiteSite
Hot ZoneHot Zone
MobileMobileDecon.Decon.
UnitUnit
De-De-robbingrobbing
areaarea
Modesty Modesty areaarea
Warm ZoneWarm Zone
Casualty Casualty ClearingClearing
Amb. Amb. Loading Loading
PointPoint
Cold ZoneCold Zone
HospitalsHospitals
Inner Inner CordonCordon
Outer Outer CordonCordon
Fire & RescueFire & Rescue Ambulance ServiceAmbulance Service
Triage Triage OfficerOfficer
Decon. Decon. operatorsoperators
Decon. Officer
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Hazardous Area Response Teams
The Hazardous Area Response Team (HART) is a new capability to Great Western Ambulance Service
Hazardous Area Response Teams are national assets
Provides a capability for ambulance services to save lives in CBRN or hazardous incidents
Improve the care provided by ambulance services inside the inner cordon of major incidents
Teams of six provide 24 hour cover
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HART provides an incident support capability to extend paramedic care into a range of challenging situations:
Complex/protracted incidents Urban Search and Rescue Incident Response Unit Incidents involving hazardous materials Working at height Inland water operations CBRN decontamination
Hazardous Area Response Teams
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NHS Blood & Transplant
Role of NHS Blood & Transplant Hold reserve national stockpile for Major
Emergencies on behalf of Department of Health Stockpile includes nerve agent antidotes and
other counter measures Activated by ambulance control to NHS Blood &
Transplant Only delivered to hospitals with a transfusion lab
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Scientific and Technical Advice Cell
Multi-agency expert group Provide advice to Strategic Coordinating
Group (SCG) on health, scientific and technical matters
Activated by SCG chair Commonly chaired by Director of Public
Health Ensures advice is consistence Liaison with national specialist advisors
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Scientific & Technical Advice Cell
Regional Civil Contingencies
Committee
Strategic Coordinating
Group
Tactical
Operational
Regional STAC
STAC
Scientific Advice for Government in Emergencies
Cabinet Office Briefing Room
(COBR)
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Scientific and Technical Advice Cell Members of the Scientific and Advice Cell may
include: Director of Public Health Health Protection Unit Environmental Health (Local Authority) Utility companies (water/gas/electric) Environment Agency Met Office Health & Safety Executive Site Operator Port Health
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NHS reorganisation April 2011 – provider services must be
independent from the Primary Care Trust March 2012 Abolition of Strategic Health
Authorities March 2013 Abolition of Primary Care
Trusts Creation of GP consortia Creation of Public Health Service Abolition of Health Protection Agency Implications for resilience?
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Department of HealthCabinet Office
Civil Contingencies Committee
NHS South West(Strategic Health Authority)
Regional Coordinating Group
Primary Care Trust
Acu
te T
rust
s
SHA representative
Pri
mar
y C
are
Am
bu
lan
ce
Ser
vice
Oth
er h
ealt
h
serv
ices
Local Health responseLocal Strategic Coordinating
Centre
(‘Gold’)
Ambulance Executive
representative
PCT Executive representative
Operational Level management (Bronze Commanders)
Command and Control
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NHS reorganisationDepartment of
Health
?
X GP consortia
17 Acute Trusts
2 Ambulance Service Trusts
6 Mental Health Trusts
National
Regional
Local
x Primary Care Provider Services
NHS Commissioning Board
(Including Public Health Service)
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Questions?
Jody James
Associate Director Regional Resilience
NHS South West
jody.james@southwest.nhs.uk