Emergency preparedness, resilience and response communication policy

Rotherham, Doncaster and South Humber NHS Foundation Trust policy for emergency preparedness, resilience and response communication.

The NHS England core standards for emergency preparedness, resilience and response EPRR (NHS England, 2015) requires organisations, including NHS Foundation Trusts, to have arrangements in place that include a process to inform and advise the public.

This policy provides detail on what communication arrangements the trust will put in place to prepare for, respond to and recover from a critical or major incident.

1 Introduction

2 Purpose

This policy provides detail on what communication arrangements the trust will put in place to prepare for, respond to and recover from a critical or major incident.

2.1 Definitions and explanation of terms used

Definitions
Definition	Explanation
Category 1 and 2 responders	Under the Civil Contingencies Act (2004) the agencies that may be required to respond to an emergency are categorised and given statutory legal duties. The trust is a category 1 responder
AEO	Accountable emergency officer, The strategic leader within the trust with responsibility for EPRR (chief operating officer)
CCG	Clinical commissioning group
EA	Environment agency
ICS	Integrated care system. During an incident the ICS may decide to form a coordination group made up of health provider partners during an incident. This may be on a local place based footprint or on an ICS wide footprint
LA	Local authority
LHRP	Local health resilience partnership. The strategic planning group made up of trust accountable emergency officers with responsibility for emergency preparedness, resilience and response
LRF	Local resilience forum, the strategic planning group made up of emergency responding agencies. The trust is represented on this group by NHS England
PHE	Public Health England
SCG	strategic coordinating group. Provides multi agency strategic leadership within an LRF area during response to a major incident. The trust is usually represented on this group by NHS England
Sit reps	Situation reports
TCG,	Tactical coordination group. A placed based multi agency tactical leadership group that reports to the SCG. The trust may need to provide representation at this group

3 Scope

This policy explains how the trust will adhere to its responsibilities for warning and informing staff, patients, public, partners and stakeholders.

It sets out how the provision of relevant timely information about the nature of an unfolding event will be communicated. The policy is split into preparedness, response and recovery in order to show how communications would differ between each phase of an incident.

The policy provides guidance on:

managing the media
the process of communication with all staff
sharing information about the different phases of an incident, for example, response and recovery
the warning and informing arrangements of other category 1 and 2 responders and other organisations

4 Responsibilities, accountabilities and duties

Responsibilities, accountabilities and duties may vary depending on whether the trust is preparing for, responding to or recovering from a critical or major incident. These are described in detail below. Definitions of a critical or major incident can be found in the trust major incident plan.

5 Procedure and implementation

5.1 Preparedness

Some types of incident are predictable such as severe weather. In such cases the trust will ensure that staff, patients, public, partners and stakeholders are given appropriate messages in order to prepare for and mitigate the risk in order to ensure disruption to services is kept to a minimum.

The nature of the message must be tailored to the type of risk presented. The trust severe weather and winter plan gives comprehensive guidance on actions to take in the event that the trust receives notifications such as cold weather alerts, weather warnings and flood guidance statements.
Similar guidance is provided in the trust heatwave plan.

In the event of a pandemic the trust pandemic Influenza plan provides guidance on actions to take in the event that the trust receives notifications from PHE or NHSE to prepare for a pandemic.

Other events that may be predicted could be the effect of a planned event on the transport network or a disruption to utilities provision. In such cases information may be received from the LHRP, LRF or specific partner such as a local authority or utilities company.

For predicted events, once received, information may be disseminated in the following ways depending on the nature of the risk and the time of day since some ways of communicating may be less appropriate out of hours.

Some events can occur without warning such as cyber attack, loss of utilities or a mass casualty incident. In such cases the following options should be considered. Some may be unavailable due to the nature of the event.

5.1.1 Trust staff

Via daily communications all staff email sent by the trust Communications team or via immediate all staff email sent by the trust Communications team or business continuity and EPRR manager depending on the urgency of the warning. A decision on who sends an all staff email will be agreed between the Communications team and the business continuity and EPRR manager. This is only available in normal office hours.
Intranet message placed by the trust Communications team that takes appropriate precedence on the intranet home page. This is only available in normal office hours.
Via targeted email, for example, email sent to specific Managers or Directors tailored to a specific geographical area that may be affected. Out of hours staff can identify all other on call staff via the rotas stored on L:\Corporate\Trust OnCall Rotas.
Via ‘PageOne’ communications’ system. This can be used in the event of the loss of the primary communications system, for example, switchboard or email. This system is separate from the trust landline telecoms and IT system and so will not be affected by any failure of these systems. After consultation with the AEO (or deputy within EMT) text messages may be sent to appropriate staff mobiles by the business continuity and EPRR manager, estates manager, care group director or out of hours equivalent. The PageOne communications SOP provides detail on how this system is used. This system is a useful way to contact staff that are away from their base and may be more suitable for out of hours communications. All silver on call staff have PageOne login details and a copy of the SOP in the L:\Corporate\Trust OnCall Rotas\Duty director gold and silver OnCall rota pack.
Via desktop pop-up alert message. On screen messages to be displayed on a large number of IT devices simultaneously, for example, to all trust staff who are logged in to a desktop or laptop. For use in normal weekday hours only but messages can be set to deliver at set times. Further information contained in the desktop alerts popup messages communication system SOP.
Via trust social media accounts. Out of hours login details are contained in L:\Corporate\Trust OnCall Rotas\Duty director gold and silver OnCall rota pack.

Content within emails and messages will usually be provided by the business continuity and EPRR manager or deputy. However the trust Communications team also receive weather warnings and will communicate appropriate content to all staff in the absence of the business continuity and EPRR manager or deputy as per the guidance contained in the trust severe weather and winter plan. In some cases content will be dictated centrally. For example during the covid-19 pandemic content was provided centrally by NHSE for local dissemination.

All communications to staff will be agreed with the trust Communications team before sending and be consistent with guidance given in warnings received from the agencies providing them.

For flooding related risks some template messages are contained on page 16 of the trust severe weather and winter plan. Wherever possible all messages should link to relevant guidance provided at the time on websites such as the EA, met office, NHSE and Public Health England.

Where staff do not have access to email it is the responsibility of their manager to ensure that information is provided in a suitable format.

5.1.2 Patients

The communication of information to patients about a potential disruptive incident, for example,. severe weather will be made by staff that are familiar with communicating with specific patient groups. This will ensure information is provided that will not cause undue concern or alarm. Staff communicating with patients will ensure the information they provide is consistent with that provided by the Communications team.

It is the responsibility of managers to ensure that they inform patients of any disruption to services that may be likely such as postponement of appointments and to provide guidance on what actions are being put in place to mitigate the effects of any disruption, for example, re-prioritisation of services.

Managers may use information provided by partner agencies as described above to ensure patients are kept fully aware of how a developing incident may affect the trust’s ability to deliver services.

5.1.3 Public

The trust Communication team is responsible for placing content on the trust website and social media feeds. Where an incident affects trust services the Communications team may place statements on the trust website or via social media. The content of such statements will be consistent with information provided by external agencies where appropriate and be agreed by the trust accountable emergency officer (chief operating officer) or deputy (for example, director on call) before publication.

Some statements may include links to relevant appropriate advice based on the risks posed by the incident.

Some statements may be pre-written for adapting later to serve these needs:

for example, “As you may be aware parts of Doncaster, Rotherham, North Lincs have been affected by flooding and heavy snow. This has disrupted some trust services. Please note that if your appointment has been affected you will be contacted.”

Alternatively, the trust may play a collaborative role with partners in publicising messages to the public about preparing for winter or heatwave. This would include links to resources agreed by all partners.

5.1.4 Partners and stakeholders

Partner agencies such as commissioners and NHS England often request assurance that communication of potential risks to patients, staff and partners has occurred and that business continuity plans are in place. This request is usually made to the accountable emergency officer or business continuity and EPRR manager via email. In such circumstances the business continuity and EPRR manager or deputy will seek assurance this has been done and provide a response.

It is the responsibility of managers at team level to communicate with suppliers, contractors or voluntary agencies to check if they are liable to be affected by a potential incident, for example, severe weather so they can put in place appropriate contingencies.

The trust major incident plan provides guidance on the classification of incidents within the trust and which partners should be informed. Final agreement of communications will be provided by the AEO or deputy.

5.1.5 Media

It is possible that the trust may receive enquiries from the media on its level of preparations in the run up to a potential incident. In such a situation all enquiries will be referred to the Communications team who will issue statements on behalf of the trust.

The Communications team may also consider putting information about preparations for a potential incident on the trust website and social media feeds to “head off” potential media contact. In the event that media request a spokesperson the Communications team will respond.

5.2 Response

The trust may respond to an incident in one of two ways:

by continuing to deliver services in a normal manner managing response from within its own resources
by calling upon or assistance from external agencies to deliver services which may trigger the trust major incident plan

During the response phase of an incident the demand for information and the requirement for effective communication increases.

The trust major incident plan describes the triggers and actions that take place in the lead up to the declaration of a critical or major incident. This includes the various communication channels between gold, silver and bronze levels of command and control within the trust. It also describes the communication and reporting arrangements with external agencies.

During the response phase the following considerations should be taken when communicating with staff, patients, public, partners and other stakeholders.

5.2.1 Trust Staff

The business continuity and EPRR manager or deputy and the Communications team will ensure that information is disseminated to staff about the response to the incident. For example they will continue to issue information about alerts and warnings about severe weather as these are received from partner agencies. In such instances LRF partners may decide to from an SCG to coordinate response and this may have communications cell. In such instances NHSE usually provide representation on behalf of all trusts but local place based TCGs may be formed. The trust may be required to provide representation to TCGs. Further information can be found in the trust major incident plan.

Information passed to staff must be consistent with that provided in alerts and warnings. This will be provided in the same format and using the same medium as during preparation for an incident.

Should an incident develop that may at a later stage intensify and become a critical or major incident a trust director will activate the major incident plan.

In such scenarios the trust accountable emergency officer (chief operating officer) or deputy (for example, director on call) would agree messages to disseminate to staff with the Communications team and business continuity and EPRR manager or deputy. If a “critical incident” or “major incident standby” or “major incident declared” occurs this information should be disseminated to staff using some of the suggested options below:

via an immediate all staff email sent by the trust Communications team
prominent intranet message placed by the trust Communications team that takes precedence on the intranet home page
via an immediate targeted email, for example, email sent to specific managers or directors tailored to a specific geographical area that may be affected
via a PageOne text message to all trust mobile phones
via on screen desktop alert popup messaging

All communications must be agreed between the trust accountable emergency officer (chief operating officer) or deputy (for example, director on call) and the trust Communications team before sending.

Care group directors will be required to acknowledge receipt of information and confirm that this has been passed onto managers to ensure all staff are aware. In such cases follow up may be made by the business continuity and EPRR manager, Communications team or other staff delegated by directors.

The trust Communications team will also be responsible for disseminating information on the overall trust response to all staff. Where staff do not have access to email or intranet it is the responsibility of their manager to ensure that information is provided in a suitable format.

It should be noted that the Communications team and business continuity and EPRR manager is not available out of hours. On call directors (gold) and care group directors (silver) have access to trust social media account passwords within L:\Corporate\Trust OnCall Rotas\Duty director gold and silver OnCall rota pack.

5.2.2 Patients

The communication of information to patients about a potential disruptive incident, for example, severe weather will be made by staff that are familiar with communicating with specific patient groups. This will ensure information is provided that will not cause undue concern or alarm. Staff communicating with patients will ensure the information they provide is consistent with that provided by the Communications team.

Managers may use resources provided by partner agencies as described above to ensure patients are kept fully aware of how a developing incident may affect the trust’s ability to deliver services.

5.2.3 Public

The trust Communication team is responsible for placing content on the trust website and social media feeds. Where an incident affects trust services the Communications team may place statements on the trust website or via social media, specifically Facebook and X. The content of such statements will be consistent with information provided by external agencies where appropriate and be agreed by the trust accountable emergency officer (chief operating officer) or deputy (for example, director on call) before publication.

This may be done by providing links to other organisation’s websites where appropriate so as to not risk misinterpretation. Additionally the trust may issue information about any immediate action it has taken, for example impacts and possible changes to services caused by an incident.

5.2.4 Partners and stakeholders

Partner agencies such as commissioners and NHS England often request assurance that communication of potential risks to patients, staff and partners continues as response to an incident occurs and that business continuity plans are being used. This request is usually made to the accountable emergency officer or business continuity and EPRR manager via email. In such circumstances the business continuity and EPRR manager or deputy will seek assurance this has been done and provide a response.

It is the responsibility of managers at team level to communicate with suppliers, contractors or voluntary agencies to check if they are affected by the incident, for example, severe weather so as not to be taken by surprise if services or deliveries are disrupted.

5.2.5 Situation reports

The trust major incident plan contains guidance about how situation reports (sit-reps) are requested and submitted to agencies such as commissioners or NHS England.

For the avoidance of doubt any request for information regarding response to an incident that is received from any external partner should be shared with trust gold command, the trust accountable emergency officer and the trust business continuity and EPRR manager before a response is sent.

It is often advisable to share the contents of trust situation reports to ensure all staff have an awareness of how the trust is responding. In a critical or major incident, the Communications team will seek guidance from gold command before sharing situation reports with staff.

In a critical or major incident, the trust will track information requests or information and guidance received by keeping a record at gold and silver commands. This may be included in official logs or minutes of meetings.

The trust major incident plan contains further information about incident logging at strategic (gold) and tactical (silver) levels. Details of trained loggists can be obtained from the business continuity and EPRR manager.

At operational (bronze) level each team’s business continuity plan contains a blank log sheet. This can be used by teams to log information requests from gold or silver and record actions. This sheet should be commonly available to all team members to consult and update if required.

5.2.6 Coordination

Situation reports are also produced by partner agencies. These are often placed online using the resilience direct system. This is a secure web-based system where all emergency responders share information to ensure they are coordinated in response.

Resilience direct is only available to category 1 and category 2 responders as described in the 2004 Civil Contingencies Act. The trust has an account and can request additional accounts. Access should be restricted to trust gold command staff. Currently the head of communications and business continuity and EPRR manager hold accounts.

In the event of a multi-agency incident resilience direct will be monitored by the business continuity and EPRR manager or deputy for information to inform trust response and enable close coordination with other agencies.

5.2.7 Incident email account

In a long running incident, the trust may decide or be requested to set up a new email account for all communications related to the incident. This ensures that monitoring of email can be performed by a team of people to ensure out of hours coverage. Any request for such an account will include proposed monitoring arrangements including user access and hours of working. Gold command (or AEO or deputy) will be responsible for consideration and approval of any request to set up such an account to ensure it can be established as soon as possible.

Once operational emails to an incident email account should be red flagged if they require attention and be “ticked” only when action has been concluded.

5.2.8 Media

It is possible that the trust may receive enquiries from the media on its response to an incident and impact on services. In such a situation all enquiries will be referred to the Communications team who will issue statements on behalf of the trust.

In the event that the trust is required to conduct a press conference the Communications team will respond.

The Communications team may also consider putting information about a response to an incident on the trust website and social media feeds to “head off” potential media contact. The trust Communications team will also if required brief a trust spokesperson who will address the media if required.

5.3 Stand down and recovery

Following a critical or major incident the return to normal services may potentially take weeks or months depending on the severity and impact of the incident on the trust.

The end of the response period is signified via communication from trust gold command via the communication channels mentioned above.

The trust major incident plan requires a recovery coordination group to be set up during the response period which is responsible for the overall recovery of the trust from the incident.

During the recovery phase the following considerations should be taken when communicating with different stakeholders.

5.3.1 Trust staff

Internally it will be important for the recovery coordination group to keep all staff informed as to the progress of recovery via regular updates. This will be facilitated by the trust Communications team.

5.3.2 Patients

The trust will continue to communicate with patients to ensure they are aware of any further disruptions to service or to inform them of the resumption of normal business.

5.3.3 Public

The trust Communication team is responsible for placing content for public consumption on the trust website and social media feeds regarding information about recovery.

5.3.4 Media

During the recovery, media attention will be high, and journalists may contact the trust regarding local stories, particularly during periods of lull. The Communications team are the team to which all media enquiries must be routed.

It is also possible that the trust may receive enquiries from the media on significant anniversaries. The Communications team have access to statements on file and can write statements for the media promptly, seeking sign off from the relevant director.

5.3.5 Partners and stakeholders

Externally NHS England and CCGs are likely to require regular situation reports on the status of the trust recovery to any incident.

The nature and severity of the incident will dictate the type and number of requests for information.

During recovery the recovery coordination group should ensure that all communications with outside agencies are coordinated via the business continuity and EPRR manager, accountable emergency officer and trust Communications team.

The emergency preparedness, resilience and response communications policy should be read in conjunction with the trust major incident plan and trust major incident recovery plan.

6 Training implications

It is required by NHS England that the trust exercise its communications arrangements annually in the form of a desktop exercise. Should the trust activate these arrangements for an incident the desktop exercise is not required.

Directors on call should be aware of this policy and be familiar with its contents. Details of this policy will be included in director on call packs and reference made in the trust major incident plan.

6.1 On call directors, care group directors, care group nurse directors, directors

How often should this be undertaken: Every 2 years.
Length of training: Up to 30 minutes.
Delivery method: Page one system one to one.
Training delivered by whom: Business continuity and EPRR manager.
Where are the records of attendance held: Emergency planning training record.

6.2 Appropriate gold, silver and bronze levels of command and control as defined by the business continuity and EPRR manager

How often should this be undertaken: Annually.
Length of training: Up to 1 Hour.
Delivery method: Desktop exercise.
Training delivered by whom: Business continuity and EPRR manager.
Where are the records of attendance held: Emergency planning training record.

A training needs analysis (TNA) is not required for this policy as training for this policy is not mandatory or statutory.

7 Monitoring arrangements

7.1 Annual training exercise

How: Exercise report to be produced.
Who by: Business continuity and EPRR manager.
Reported to: Operational management group.
Frequency: Annually.

8 Equality impact assessment screening

This policy was provided in line with the equality impact assessment associated with the EPRR policy. In order to ensure this policy overcomes and exclusion issues the business continuity and EPRR manager, Communications team, or on call member of staff will state in any EPRR related message they put on the Web, all staff email, or other notification that it is the responsibility of managers to ensure, within reasonable adjustments, that information is communicated to staff and patients with access issues.

8.1 Privacy, dignity and respect

The NHS Constitution states that all patients should feel that their privacy and dignity are respected while they are in hospital. High Quality Care for All (2008), Lord Darzi’s review of the NHS, identifies the need to organise care around the individual, ‘not just clinically but in terms of dignity and respect’.

As a consequence, the trust is required to articulate its intent to deliver care with privacy and dignity that treats all service users with respect. Therefore, all procedural documents will be considered, if relevant, to reflect the requirement to treat everyone with privacy, dignity and respect, (when appropriate this should also include how same sex accommodation is provided).

8.1.1 How this will be met

No issues have been identified in relation to this policy.

8.2 Mental Capacity Act 2005

Central to any aspect of care delivered to adults and young people aged 16 years or over will be the consideration of the individual’s capacity to participate in the decision-making process. Consequently, no intervention should be carried out without either the individuals informed consent, or the powers included in a legal framework, or by order of the court.

Therefore, the trust is required to make sure that all staff working with individuals who use our service are familiar with the provisions within the Mental Capacity Act (2005). For this reason, all procedural documents will be considered, if relevant to reflect the provisions of the Mental Capacity Act (2005) to ensure that the interests of an individual whose capacity is in question can continue to make as many decisions for themselves as possible.

8.2.1 How this will be met

All individuals involved in the implementation of this policy should do so in accordance with the guiding principles of the Mental Capacity Act (2005) (section 1).

9 Associated documents

Document control

Version: 3.1.
Unique Reference Number: 435.
Date ratified: 21 December 2023.
Ratified by: Corporate policy approval group.
Name of originator or author: Emergency planning officer.
Name of responsible individual: Emergency planning officer.
Date issued: 29 December 2023.
Review date: June 2024.
Target audience: Trust Communication team, business continuity and EPRR manager, on call directors and managers.

Page last reviewed: April 09, 2024
Next review due: April 09, 2025

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