Severe weather plan

1 Authorisation and agreement of plan

This plan is agreed at the trust emergency preparedness, resilience and response group.

1.1 Distribution list

1.1.1 Copy number 1

Accountable emergency officer (chief operating officer).

1.1.2 Copy number 2

Business Continuity and EPRR manager.

1.1.3 Copy number 3

Copy available via trust internet site.

1.1.4 Copy number 4

L:\Corporate\Operational Business Support\Emergency Planning\Emergency Planning Resilience and Response\Severe Weather Plan\Severe Weather Plan

1.1.5 Copy number 5

Copy available in emergency cupboard, Boardroom 2, Woodfield House, Tickhill Rd, Doncaster.

1.1.6 Copy number 6

Copy available in emergency cupboard, Boardroom 2, Swallownest Court, Rotherham.

1.1.7 Copy number 7

Head of communications.

1.2 Plans to be used in conjunction with this plan

1.3 Aim and scope of plan

This plan provides guidance and information to enable Rotherham, Doncaster and South Humber NHS Foundation Trust to provide a response to a period of severe weather.

This plan explains the met office cold weather alert system and severe weather warning system. It also covers the environment agency’s (EA) flood warning system. The plan sets out the trust response for each of the warnings received.

This plan is covered by the overarching trust emergency preparedness, resilience and response (EPRR) policy.

1.4 Introduction

Severe weather can impact the trust directly through physical damage (e.g. flooding of premises) or indirectly via disruption to the road network, school closures and disruption to other services which all may have an effect on the Trust’s staffing levels and its ability to provide both clinical and corporate services.

The impact of severe weather may mean damage to buildings or the disruption or cancellation of clinics or other community-based services. In other health providers (acute trusts or ambulance services) the impact may be due to an increase in casualties from injuries, exacerbation of long-term conditions and conditions such as hypothermia all of which may require hospital admission and have a subsequent impact on Trust services.

Delays to discharge may also occur during periods of severe weather since vulnerable people cannot be discharged into potential hazardous conditions and potential isolation if health and social care services have been reduced or suspended on a temporary basis.

1.5 Risk assessment

Local community risk registers have risk assessed the likelihood and impact that severe weather incidents would have on the delivery of critical services that the trust provides.

The following risks have been identified from the latest community risk registers for South Yorkshire and the Humber and included in the trust EPRR risk assessment.

1.5.1 Storms and gales

Storm force winds affecting most of the region for at least 6 hours. Most lowland areas experience mean speeds in excess of 55 mph (50 knots) with gusts in excess of 85 mph (70 knots).

A localised windstorm (e.g. “tornado”) could also occur affecting a very limited area. Winds in such a storm often reach speeds well in excess of 120 mph.

Likelihood: Medium high (4).
Impact: Moderate (2).
Overall risk: Medium.

1.5.2 Low temperatures and heavy snow

Snow falling and lying over most of the area for at least one week and after an initial fall of snow, there is further snowfall on and off for at least 7 days. Most lowland areas experience some falls in excess of 10cm, a depth of snow in excess of 30cm and a period of at least 7 consecutive days with daily mean temperature below negative 3C. Up to 1000 fatalities and thousands of casualties, mainly amongst the elderly and there is likely to be some disruption to transport networks, businesses, power supply and water supply, and also school closures.

Likelihood: Medium high (4).
Impact: Very high (4).
Overall risk: Very high.

1.5.3 Flooding, river and surface water flooding

A sustained period of heavy rainfall extending over two weeks, or similar quantities falling over a shorter time, perhaps combined with snow melt, resulting in steadily rising river levels across the region and adjoining areas.

River or surface water flooding of commercial and residential properties. 20k plus properties at risk in the Doncaster and 1500 plus in Rotherham.

The major risk area is in the flood corridors, washlands, and drainage systems in the Don Valley from Sheffield City centre downstream through Rotherham to Doncaster and beyond.

Sudden onset (“flash”) flooding of 100 to 1,000 properties caused by very heavy localised rainfall leading to either local watercourses or surface water drainage systems (or both) being overwhelmed. Sometimes referred to as “pluvial” flooding.

Likelihood: Medium (3).
Impact: Very high (4).
Overall risk: Very high.

1.5.4 Major coastal and tidal flooding

Serious flooding affecting parts of more than two UK regions with coastal flooding impacting up to 300,000 properties for 14 days causing widespread damage, evacuation and loss of lives.

Likelihood: Medium (3).
Impact: High (3).
Overall risk: High.

2 Activation of plan

Often severe weather can be forecasted, and this allows us to take suitable pre-emptive actions to mitigate the impacts. This plan is activated when certain triggers are reached. These relate to the following alert systems through which severe weather is measured by the met office and environment agency.

Cold weather alerts.
Severe weather warnings.
Environment agency flood and severe flood warnings.

In the sections below this plan sets out the response when the alerts above are received. Often one may receive several of these alerts at once. Depending on the severity of the alert the appropriate response may be to activate the trust major incident plan which may be used in conjunction with the severe weather plan.

2.1 Cold weather alert

The following staff receive cold weather alerts from the met office via email:

business continuity and EPRR manager
accountable emergency officer (AEO)
on call silver members of staff
head of estates and facilities
trust Communications team
Doncaster Single Point of Access team
on call bronze members of staff
Patient Flow team

Cold weather alerts provide brief information about upcoming cold weather. The diagram below shows how they are disseminated to all health providers.

2.2 Cold weather alert reporting diagram

Met office and heatwave alert are responsible for alerting:

public via media, TV, radio, newspapers
Public Health England centres
department of health or civil contingencies secretariat, other government departments
local authority emergency planners and directors of public health including local resilience forums and local health resilience partnerships
NHS England

Department of health or civil contingencies secretariat, other government departments are responsible for alerting:

summer resilience network

Local authority emergency planners and directors of public health including local resilience forums and local health resilience partnerships are responsible for alerting:

social services
schools
residential homes
nurseries
voluntary organisations
day care centres
health and wellbeing boards

NHS England, corporate team, national, regional teams and regional are responsible for alerting:

clinical commissioning group ICSs
RDaSH
GPs and district nurses
pharmacies
ambulance Trust
NHS choices

Clinical commissioning group ICSs are responsible for alerting:

RDaSH

RDaSH are responsible for alerting:

GPs and district nurses

The cold weather alert service now includes five alert levels, as outlined below. Cold weather alerts are issued by the met office on the basis of either of two measures: low temperatures; or widespread ice and or heavy snow. Often low temperature criteria are met at the same time as the ice and snow. However, sometimes one may occur without the other. The thresholds for what constitutes severe winter weather have been developed in consultation between the met office, DH, cabinet office and other experts.

Level 0, winter preparedness, long-term planning emphasises that to build resilience for the coming winter requires long lead-in planning times. This level of alert is aiming to emphasise the need to prepare for, adapt to and mitigate climate change and develop long-term sustainable approaches which seek to ensure behaviour change across the general population, community and health care professionals. Level 0 denotes that these are actions that should be taken throughout the year, and certainly before level 1 starts for winter preparedness at the start of winter.
Level 1, winter preparedness is in force throughout the winter from 1 November to 31 March and indicates that preparations should be in place to protect health and ensure service continuity in the event of severe cold and winter weather.
Level 2, alert and readiness is declared when the Met Office forecasts a 60% risk of severe winter weather in one or more defined geographical areas in the days that follow. This usually occurs two to three days ahead of the event. A level 2 alert would be issued when a mean temperature of 2C is predicted for at least 48 hours, with 60% confidence, and or widespread ice and heavy snow are forecast, with the same confidence.
Level 3, severe weather action is issued when the weather described in level 2 actually happens. It indicates that severe winter weather is now occurring, and is expected to impact on people’s health and on health services.
Level 4, national emergency is reached when a period of cold weather is so severe and or prolonged that its effects extend outside health and social care, and may include, for example, transport or power or water shortages; and or where the integrity of health and social care systems is threatened. At this level, illness and death may occur among the fit and healthy, not just in high-risk groups, and will require a multi-sector response at national and regional levels. The decision to go to a level 4 is made at national level and will be taken in light of a cross-government assessment of the weather conditions, coordinated by the civil contingencies secretariat (cabinet office). A level 4 alert is a judgement made in light of this cross-government assessment and, depending on the severity of the conditions and impact, could be declared over any time period. The cold weather alert levels are summarised in figure 2.2.

2.3 Cold weather alert levels

2.2.3.1 Level 0 Long-term planning

All year.

2.2.3.2 Level 1 Winter preparedness programme

1 November to 31 March.

2.2.3.3 Level 2 Severe winter weather is forecast, Alert and readiness

Mean temperature of 2C and or widespread ice and heavy snow are predicted within 48 hours, with 60% confidence.

2.2.3.4 Level 3 Response to severe winter weather

Severe weather action severe winter weather is now occurring: mean temperature of 2C or less and or widespread ice and heavy snow.

2.2.3.5 Level 4 Major incident

Emergency response central government will declare a level 4 alert in the event of severe or prolonged cold weather affecting sectors other than health.

2.4 Trust action on receiving a cold weather alert

Level 1 alert, this signifies the start of the winter preparedness programme and is the trigger for the business continuity and EPRR manager to check that the winter plan and major incident plans are up to date, and that teams have their business continuity plans available and up to date.
Level 2 alert, when this is received from the met office the business continuity and EPRR manager (or in their absence a deputy chief operating office) will liaise with the accountable emergency officer or deputy to consider appropriate action and provide details of a message to be sent via all staff email and be placed on the Trust Intranet pages. This will direct staff to make appropriate preparations such as referring to their business continuity plans. It is likely that this alert will be received alongside a severe weather warning.
Level 3 alert, at this level the business continuity and EPRR manager (or in their absence a deputy chief operating officer) will liaise regularly with the accountable emergency officer or deputy and head of communications to ensure that information is disseminated to staff. Depending on the severity of the weather the accountable emergency officer or deputy (a fellow director) may decide to activate a major incident plan “standby” situation. This alert will usually be received alongside a severe weather warning.
Level 4 alert, the accountable emergency officer or deputy will consider declaring a major incident and activate the major incident plan. This alert is likely to be in conjunction with a “red” weather warning.

3 Met office sever weather warnings

The met office issue warnings and alerts for rain:

these are given a colour depending on a combination of both the likelihood of the event happening and the impact the conditions may have

Early warnings of severe or extreme weather:

these are issued when the met office has 60% or greater confidence that severe weather is expected in the next few days

Flash warnings of severe or extreme weather:

these are issued when the met office has 80% or greater confidence that severe weather is expected in the next few hours

Both use the formats below:

3.1 Example severe weather warning

3.2 Trust action on receiving a severe weather warning

In normal office hours when a weather warning or alert is received it is reviewed by the business continuity and EPRR manager who may consult with appropriate members of staff. If the business continuity and EPRR manager is absent a deputy chief operating officer will liaise with the AEO (who also receives this information) and disseminate the warning or alert as follows. In addition if a red or amber warning is received the Patient Flow team will ensure this is flagged with silver on call at daily on call handover meeting:

is there a potential impact on the trust?
- No, no action
yes, inform following:
- accountable emergency officer (COO)
- deputy chief operating officers
- head of communications
- on call gold, silver and bronze for the period covered by the warning or alert
- head of estates and facilities
issue advice to staff based upon predicted impact

Weather warnings rated amber or red will be sent immediately by the business continuity and EPRR manager or deputy to the list above. In addition the Doncaster Care Group Single Point of Access team receives weather warnings directly from the met office so that it has warning of any potential disruption to community services and can deploy staff appropriately.

Receipt of a red warning would signify a potential major incident and the accountable emergency officer (or if absent, director) will consider moving to “standby” as set out in the trust major incident plan.

Receipt of an amber warning would signify warning of a disruptive incident. In this event suitable advice to staff to encourage them to make appropriate plans to mitigate the effects of the impending weather would be issued via the Communications team. For example, will be instructed to familiarise themselves with their business continuity plans and take any actions contained therein. This may be through an all-staff email and or via the trust internet and intranet sites. Generic guidance on actions to take can be found at appendix B.

An amber weather warning often triggers the environment agency to chair a telephone conference or MS Teams call to inform emergency responders about likely impacts. The trust receives invitations to such telephone conferences via email to the business continuity and EPRR manager via the rdash.emergencyplanning@nhs.net account and AEO. These emails contain the telephone number and passcode or MS Teams link to join.

A yellow weather warning is usually of a lower likelihood or impact than a red or amber warning. As a result this does not usually trigger any response. However should there have already been a prolonged wet period it may lead to flooding impacts. The text accompanying the warning should be studied. For further advice regarding the weather the business continuity and EPRR manager or deputy can approach the met office advisor (civil contingencies). Details are included in the contacts spreadsheet in the on-call folder.

A standard operating procedure for communicating with staff during periods of winter weather and other potential emergency situations that may affect attendance at the workplace can be found on the Trust Intranet.

3.3 Out of hours

Out of Hours when a weather warning or alert is received it is reviewed by the on call silver who will review the warning or alert as follows. If a red or amber weather warning that covers South Yorkshire and or North Lincolnshire is received on a weekend or a bank holiday between 7am and 3pm the Patient Flow team will telephone the on-call silver to make sure they are aware.

The weather warning is also received by the Doncaster Care Group Single Point of Access team (24 hours a day, 7 days a week) who will be able to deploy planned and unplanned services appropriately. If informed of a weather warning that may impact on trust services on call staff should ensure the following are informed:

is there a potential impact on the trust?
- no, no action
yes, Inform following:
- accountable emergency officer (COO)
- deputy chief operating officers
- head of communications
- on call gold, silver and bronze for the period covered by the warning or alert
- head of estates and facilities
issue advice to staff based upon predicted impact

4 Environment agency flood warnings

and flood guidance statements

The environment agency works with the met office in the joint flood forecasting centre. They provide a complete picture of national flood risk, from developing weather through to the actual flood event itself.

They provide a national forecasting and alert service to all emergency responders. The centre operates 24 hours a day, 365 days a year, giving emergency responders longer lead times and targeted information to prepare for flooding.

4.1 Environment agency flood warning codes

For further information see the environment agency website (opens in new window).

4.1.1 Flood alert

Flooding is possible, be prepared.

Issued two hours to two days in advance of flooding:

be prepared to act on your flood plan (opens in new window)
prepare a flood kit of essential items
monitor local water levels (opens in new window) and the flood forecast on our website

Flood alert symbol, ref: environment agency (2008).

4.1.2 Flood warning

Flooding is expected, immediate action required.

Issued half an hour to one day in advance of flooding:

move family, pets and valuables to a safe place
turn off gas, electricity and water supplies if safe to do so
put flood protection equipment (opens in new window) in place

Flood warning symbol, ref: environment agency (2008).

4.1.3 Severe flood warning

Severe flooding, danger to life.

When flooding poses a significant threat to life:

stay in a safe place with a means of escape
be ready should you need to evacuate from your home
co-operate with the emergency services
call 999 if you are in immediate danger

Severe flood warning symbol, ref: environment agency (2008).

4.2 Environment agency flood guidance statements

The trust receives the flood guidance statement (FGS) from the Flood forecasting agency. This statement provides a flood risk assessment to assist with planning decisions. A typical flood guidance statement will be issued when flooding is forecast. An example map of what may be received is below. The FGS are received by the business continuity and EPRR manager, accountable emergency officer, trust communications and on call silvers.

4.3 Flood advisory service (FAS) teleconferences

The Trust may receive an email notification of a flood advisory Teleconference or MS Teams call in the event that flooding of significant impact is forecasted. These calls are chaired by the EA and are available to all responding agencies to dial in. Taking part is not compulsory but may be advisable if there is a significant impact forecasted. Email notifications are sent to the business continuity and EPRR manager, accountable emergency officer, trust communications, deputy chief operating officers and on call silvers.

4.4 Trust action on receiving a flood guidance statement

In normal office hours when a flood guidance statement is received it is reviewed by the business continuity and EPRR manager who may consult with appropriate members of staff. In addition if a red or amber FGS is received the Patient Flow team will ensure this is flagged with silver on call at daily on call handover meeting. If the business continuity and EPRR manager is absent a deputy chief operating officer will liaise with the AEO (who also receives this information) and disseminate the warning or alert as follows:

is there a potential impact on the trust?
- no, no action
yes, inform following:
- accountable emergency officer (COO)
- deputy chief operating officers
- head of communications
- on call gold, silver and bronze for the period covered by the warning or alert
- dead of estates and facilities
issue advice to staff based upon predicted impact, business continuity and EPRR manager or deputy will take part in flood advisory service call if held

Flood guidance statements rated yellow will be considered by the business continuity and EPRR manager or deputy and disseminated further if they represent a risk to the trust. Flood guidance statements rated amber or red will be automatically passed by the business continuity and EPRR manager or deputy to the dissemination list above.

Receipt of a red warning would signify a potential major incident and the accountable emergency officer or deputy (a director) will consider moving to “standby” as set out in the trust major incident plan.

Receipt of an amber warning would signify warning of a disruptive incident. In this event suitable advice to staff to encourage them to make appropriate plans to mitigate the effects of the impending weather would be issued via the Communications team. For example, staff will be instructed to familiarise themselves with their business continuity plans. This may be through an all-staff email, via the trust Internet and Intranet sites or by using pop-Up on screen messaging. generic guidance on actions to take can be found here at appendix B.

Out of hours when a flood guidance statement is received the on-call Silver will respond as shown below. The flood guidance statement is also received by the Doncaster Care Group Single Point of Access team (24 hours a day, 7 days a week) who will be able to deploy planned and unplanned services appropriately. If a red or amber FGS that covers South Yorkshire and or North Lincolnshire is received on a weekend or a bank holiday between 7am and 3pm the Patient Flow team will telephone the on-call silver to make sure they are aware. If informed of a flood guidance statement that may impact on trust services on call staff should ensure the following are informed:

is there a potential impact on the trust?
- no, no action
yes, Inform following:
- accountable emergency officer (COO)
- deputy chief operating officers
- head of communications
- on call gold, silver and bronze for the period covered by the warning or alert
- head of estates and facilities
issue advice to staff based upon predicted impact, on call silver or deputy will take part in flood advisory call if held out of hours

5 Business continuity

All teams in the trust have business continuity plans, which identify the actions required for the service to continue to maintain essential services. Action cards are provided in the appendix of each plan that describe actions to take in the event severe weather warnings or cold weather alerts are issued.

For trust headquarters it will be necessary to maintain essential 24 hours a day, 7 days a week telephone switchboard services and staff living close to this location may be asked to remain at work to ensure this building remains open.

Teams will be instructed to refer to their business continuity plans whenever severe weather is likely to have an effect on their team. business continuity plans are held electronically and in hard copy by each team and by the business continuity and EPRR manager. Once the alert has been disseminated local decisions can be made about service prioritisation. Teams may need to make special arrangements for vulnerable people.

6 Example staff advice

When the trust receives notification of severe weather it may be appropriate to issue advice to staff via the Communications team or the business continuity and EPRR manager using all staff email and or trust intranet.

In such circumstances some example advice is included below that may be adapted to suit the circumstances. For example reference to the Trust’s snow and ice clearing policy.

6.1 Example staff advice upon receipt of sever weather warning

In the case of receiving warnings of heavy rain the advice may include details of the weather forecast and the location and amount of predicted rainfall along with expected impacts. The trust receives emails from the met office that contain links to the met office website which contains this information. Amber and Red warnings for areas covered by the trust will trigger a warning for all staff. Yellow warnings may be dealt with according to the judgement of the business continuity and EPRR manager or deputy or out of hours the on call silver.

6.2 Example staff advice for extreme low temperatures and heavy snow

Staff need to ensure they wear appropriate warm clothing to work, check their route to work is clear before setting off on a journey and always carry additional warm clothing and blankets and food and drink in the car especially if the journey to work is long.
It is advisable to carry a spade in your car’s boot especially when snowfall is heavy or is predicted to be heavy. It is also good practice to ensure that there is ample charge on your mobile phone or carry a car adaptor phone charger.

6.3 Example staff advice for storms and gales

The main risks to the trust in these incidents would be disruption to services caused by damage to premises or disruption of the transport network. If a building is damaged as a result of severe storms or gales, the business continuity plan for that site or service must be implemented. If damage was to occur out of hours, then estates on call and the relevant on call silver should be contacted with referral to the on-call gold and accountable emergency officer if required.

If the severe weather commences during the day then directors, care group directors, or managers may need to consider the safety of their staff as driving conditions may be very difficult in severe gales and heavy storms.

If, due to inclement weather, employees are unable to get into work (or their nearest base) and are unable to work from home they will be required to take annual leave, flexitime or unpaid leave (unless otherwise directed by the Human Resource team in cases of severe weather).

Where practicable, employees may work from home with the agreement of their manager or director.

Employees not able to get to work must inform their line manager of their absence as close as possible to the beginning of their shift or day’s work.

6.4 Yorkshire 4 by 4 response

The trust has a memorandum of understanding with Yorkshire 4 by 4 response volunteers who are willing to use their own 4 by 4 vehicles to assist the trust when business continuity measures have been exhausted. The MOU is included at appendix I.

Assistance may take the form of essential transport of:

frontline medical staff to and from their place of work (whether this be at healthcare premises or a patient’s home)
key staff and decision makers to and from their place of work or home to work
medicines, food and other vital supplies or equipment
patients to and from healthcare premises, subject to medical assessment that they are fit to travel, must be transported safely in the company of a suitable carer or trust member of medical staff

Should the 4×4 response be required it may only be requested by the following:

accountable emergency officer
care group director
care group nurse director
on call silver
business continuity and EPRR manager
any member of the trust gold command in response to a critical or major incident

Yorkshire 4 by 4 response contact numbers and email may be obtained via trust switchboard or the business continuity and EPRR manager.

When contacting Yorkshire 4×4 response, staff should ensure where possible that they coordinate with other care group directors to avoid making multiple separate requests for assistance. During out of hours the on call silver is authorised to request support from Yorkshire 4 by 4 Response. A booking form for using the service is included at appendix C.

Yorkshire 4 by 4 response drivers will always have a photo identification card.

Costs for using Yorkshire 4×4 response volunteer drivers will be as per the memorandum of understanding (MOU) which may be obtained from the business continuity and EPRR manager. Costs will be charged to the budget of the service requiring assistance.

Staff should follow the current infection prevention and control guidance if using the 4 by4 service, see action card at appendix C.

If the 4 by 4 service is not available staff may request assistance via NHSE who will escalate this request via the local resilience forum partners.

7 Managing patient safety

A severe weather incident may impact directly on patient safety e.g. in the event of damage to premises or if staff levels are severely reduced. In such circumstances it is the responsibility of patient facing staff to ensure they are aware of the effects this has on patient safety and how to mitigate it. Staff should refer to individual patient records, business continuity and evacuation plans.

8 Winter planning groups, multi-agency local response and governance arrangements

The trust’s services are delivered across a large geographic area covering Rotherham, Doncaster, North and North East Lincolnshire.

Different areas contain different multi agency planning groups that deal with issues like winter planning, capacity, surge and escalation management. These groups meet throughout the year to discuss normal business but often meet more frequently during the winter period. This allows different agencies to monitor usage of all services and work together to manage any “rising tides” if necessary.

In the event of a severe weather incident these networks would likely be used to communicate to help facilitate response. In each case the CCG would chair and coordinate arrangements for meetings or telephone conferences.

9 Debrief and lessons learned

9.1 Critical and or major incident

At the conclusion of a critical or major Incident, the accountable emergency officer will make arrangements for staff to be debriefed and may request other health organisations that have worked alongside the trust in response to take part.

This process will take place within 3 months of the incident “stand down”.

The debrief may take the form of a pro-forma or a debrief meeting as appropriate to the incident. At the conclusion of the incident, the accountable emergency officer will prepare a report on the major incident, to include issues identified by the debriefing process, together with an action plan to address the issues raised. The report and action plan will then be submitted to the trust’s board of directors, NHS England and other agencies as appropriate, subject to the agreement of the Trust Board.

The report should be submitted to the board of directors within 6 months of the incident “stand down”.

9.2 Other debriefs

In the event of a period of severe weather affecting the trust but not triggering a critical or major incident the business continuity and EPRR manager will make arrangements for staff to be debriefed and will seek feedback from other organisations that have worked alongside the trust during the response.

The debrief will take the form of a meeting attended by all affected services where feedback will be sought on the trust’s response. The business continuity and EPRR manager will prepare a report containing a list of “lessons learned” with an action plan to address these issues. The report and action plan will be submitted to the emergency preparedness, resilience and response (EPRR) group.

10 Links to trust policies

11 Equality impact assessment screening

To access the equality impact assessment for this policy, please see the overarching equality impact assessment.

12 Appendices

12.1 Appendix A Generic actions for cold weather alerts

12.1.1 Level 0 Long-term planning

All year.

Work within your teams and with partner organisations to ensure that systems are developed to support the identification and sharing of information between agencies of people who may be vulnerable to cold weather and other seasonal variations.
Systematically work to improve the resilience of vulnerable people to severe cold.
Ensure that all staff have been made aware of the winter plan and the dangers of cold weather to health and know how to spot signs and symptoms

12.1.2 Level 1 Winter preparedness programme

1 November to 31 March.

Identify those at risk on your caseload and necessary changes to care plans for high-risk groups. For those with multiple agency inputs, ensure that the key worker is clearly identified. Work with individuals at risk, their families and carers to ensure that they are aware of the dangers of cold weather and cold housing and how to keep warm.
Ensure that there are clear arrangements for ‘signposting’ those at risk clients and patients to other services (e.g. home insulation schemes, benefits entitlements) when identified in ‘clinical’ situations or consultations. Work with partners to ensure that vulnerable patients and clients have access to fuel supplies.
Link to energy supplier priority service registers as required. Ensure that clients and colleagues are aware of, and take advantage of, flu and other vaccination programmes. Identify the resources available to you for raising awareness of health risks associated with winter weather and cold housing (for example, pharmacists have a key role in reminding people to have sufficient medicine and can help with preventive medicines management.

12.1.3 Level 2 Severe winter weather is forecast

Alert and readiness Mean temperature of 2C and or widespread ice and heavy snow is predicted within 48 hours, with 60% confidence.

As appropriate, contact those most at risk and implement care plans.
When making home visits, be aware of the room temperature in the household and be able to advise on recommended room temperatures.
Know how to signpost clients onto other services, especially those at high risk.
Remind clients of the actions they can take to protect themselves from the effects of severe cold.
Consider how forecast weather conditions may impact on your work and make appropriate arrangements.

12.1.4 Level 3 Response to severe winter weather

Severe weather action mean temperature of 2C or less and or widespread ice and heavy snow

Implement local plans for contacting the vulnerable.
If appropriate, consider daily visits or phone calls for high-risk individuals living on their own who have no regular contacts.
Ensure staff can help and advise clients.
Other actions as per level 2.
Maintain business continuity

12.1.5 Level 4 Major incident, emergency response

Central government will declare a level 4 alert in the event of severe or prolonged cold weather affecting sectors other than health.

Continue actions as per level 3 unless advised to the contrary.

12.2 Appendix B Generic actions for met office severe weather Warnings

12.2.1 Know what to expect and what action to take

The table below provides examples of the kind of disruption that might be experienced for each impact level (high, medium, low) and for each weather type (rain, snow, fog, ice, wind). It also provides some general advice to try and mitigate the impacts. Note that weather assessed as having a “very low” impact may still have some minor impacts.

12.2.2 Impact and advice applying to all severe weather

12.2.2.1 Very low

The weather is not expected to have any noticeable impacts but there may be some minor issues e.g. when travelling some extra care may be needed on occasions and there may be some disruption to outdoor events.

12.2.2.2 Low

BE AWARE and ensure you access the latest weather forecast for up to date weather information.
Expect some minor delays due to slower traffic.
Outdoor events may be disrupted or cancelled.

12.2.2.3 Medium

Be prepared. Take precautions where possible and ensure you access the latest weather forecast.
Be prepared. For some disruption to normal daily routines.
Travel only if well prepared and be prepared for longer journey times.

12.2.2.4 High

Take precautionary action and remain extra vigilant. Follow orders and any advice given by authorities under all circumstances.
Ensure you access the latest weather forecast.
Expect significant disruption to normal daily routines.
Avoid all non-essential journeys. If you must make a journey carry emergency food, clothing, or blanket etc.

12.2.3 Impact and advice associated with rain

12.2.3.1 Very low

Some flooding of low lying fields, recreational land and car parks but little or no disruption to travel.
Wet road surfaces and possibility of ponding water leading to difficult driving conditions.
Take extra care when driving in affected areas.

12.2.3.2 Low

Localised flooding of low lying fields, recreational land and car parks.
Flooding of a small number of homes and businesses.
Wet road surfaces and possibility of ponding water, especially in known trouble spots.
Local disruption to travel. longer journey times.
Water on roads, drive according to the conditions encountered.

12.2.3.3 Medium

Some flooding of homes, businesses and transport links possible.
Disruption to travel likely.
Disruption to gas, electricity, water supplies and telecoms.
Some evacuations may be required. Be prepared to protect yourself and your property.

12.2.3.4 High

Widespread flooding of property.
Severe disruption to travel.
Loss of gas, electricity, water supplies.
Significant disruption to communities.
Evacuation expected.
Significant risk to life.
Take action to protect yourself and follow the advice of the emergency services.

12.2.4 Impact and advice associated with wind

12.2.4.1 Very low

Debris dislodged and some branches removed.
Perhaps some very limited travel disruption.
Difficulties on some prone routes e.g. cross winds on exposed or high level roads.

12.2.4.2 Low

Some branches or trees brought down.
Localised travel disruption.
Localised problems for high-sided vehicles on prone routes.
Drive with care, especially on exposed routes.
Be aware of possible debris being blown around.

12.2.4.3 Medium

More widespread tree damage and other debris, slates etc dislodged from roofs.
Some minor structural damage possible.
Risk of injury from flying debris.
Be prepared for some travel disruption e.g. closed bridges.
Potential for some localised interruptions to power.

12.2.4.4 High

Widespread structural damage, e.g. roofs blown off, mobile homes overturned, power lines brought down.
Risk to personal safety from flying debris.
Potentially widespread and or prolonged interruptions to power.
Expect widespread transport disruption due to e.g. roads blocked by fallen trees.

12.2.5 Impact and advice associated with fog

12.2.5.1 Very low

Some localised non-persistent fog affecting limited geographical areas.
Take extra care when driving in affected areas.
There may be some very limited impact on road transport.

12.2.5.2 Low

More widespread, locally dense fog affecting significant areas of the country but not persisting beyond 1 to 2 days.
Some airports may close for short periods.
Take extra care when driving in affected areas.
Journeys through affected areas may take longer than usual.

12.2.5.3 Medium

Widespread and dense fog affecting large areas of the country including a number of major airports and or ports.
The fog is persistent and may last for many days in some areas.
Be prepared for some travel disruption.
Take great care if driving and be prepared for increased journey times.
Be prepared for delays at affected airports and or ferry ports

12.2.5.4 High

Not applicable.

12.2.6 Impact and advice associated with snow

12.2.6.1 Very low

Small amounts of snow lying on roads and pavements so some slippery road surfaces possible.
Traffic may move generally slower than normal.
Take extra care when walking, cycling or driving in affected areas.

12.2.6.2 Low

More widespread snow lying on roads and pavements but road networks generally open.
Care needed with only localised travel disruption.
Problems mostly confined to usual prone areas.
Take extra care when walking, cycling or driving in affected areas.
Journeys through affected areas may take longer than usual.

12.2.6.3 Medium

Widespread snow with a number of road closures, others passable only with care.
Be prepared for some disruption to road, rail and air transport with difficult driving conditions likely and longer journey times.

12.2.6.4 High

Widespread deep snow with many roads closed or impassable.
Roads likely to become impassable with high risk of drivers becoming stranded.
Significant disruption to road, rail and air transport.
Risk to personal safety.
Expect significant disruption to normal day to day life as a result of transport issues, school closures etc.
Avoid making unnecessary journeys.

12.2.7 Impact and advice associated with ice

12.2.7.1 Very low

Localised icy stretches on some untreated roads and pavements are possible.
Take extra care when walking, cycling or driving in affected areas.

12.2.7.2 Low

More widespread icy stretches on untreated roads and pavements but road networks generally open.
Take extra care when walking, cycling or driving in affected areas.
Journeys through affected areas may take longer than usual.

12.2.7.3 Medium

Widespread black ice, some roads passable only with care.
Possibility of road collisions and significant increase in slips and falls.

12.2.7.4 High

Not applicable.

12.3 Appendix C 4 by 4 Volunteer action card and booking form

Appendix C 4 by 4 Volunteer action card and booking form

12.4 Appendix D Record of amendments

Appendix D Record of amendments

12.5 Appendix E Glossary

Definitions
Acronym	Long form
AEO	Accountable emergency officer (chief operating officer)
BCP	Business continuity plan
CBRN	Chemical biological, radiological and nuclear
COBR	Cabinet office briefing rooms
CRIP	Commonly recognised information picture (a sitrep by another name)
DMBC	Doncaster Metropolitan Borough Council
DP	Doncaster place
EA	Environment agency
EPO	Emergency planning officer
EPRR	Emergency preparedness resilience and response
FGS	Flood guidance statement
GLO	Government liaison officer
HAZMAT	Hazardous materials
HPA	Health protection agency
ICC	Incident control centre
ICS	Integrated care system
LHRP	Local health resilience partnership
LRF	Local resilience forum
MIP	Major incident plan
PHE	Public Health England
SCG	Strategic coordinating group
SITREP	Situation report
STAC	Scientific and technical advice cell
TCG	Tactical coordinating group
TFWS	Targeted flood warning service

12.6 Appendix F MOU between RDASH and Yorkshire 4×4 Response

Appendix F MOU between RDASH and Yorkshire 4×4 Response

12.7 Appendix G Action card for patient flow team

12.7.1 Actions to be taken by Patient Flow team

Rdash.patient-flow-team.nhs.net is registered to receive met office weather warnings and environment agency flood guidance statements via email. Should a red or amber weather warning or flood guidance statement be received that covers the South Yorkshire or North Lincolnshire area the following actions should be taken:

12.7.2 Met office weather warnings

12.7.2.1 Monday to Friday

If a red or amber weather warning is received that covers South Yorkshire and or North Lincolnshire the Patient Flow team will raise this at the daily on call handover meeting to ensure staff are aware.
Actions for other staff to take are contained in the trust severe weather plan.

12.7.2.2 Weekends and bank holidays

If a red or amber weather warning is received between 7am and 3pm that covers South Yorkshire and or North Lincolnshire the Patient Flow team will telephone the on-call silver to make sure they are aware.
The actions for silver are to take are contained in the severe weather plan.

12.7.3 Environment agency flood guidance statements

12.7.3.1 Monday to Friday

If a red or amber flood guidance statement is received that covers South Yorkshire and or North Lincolnshire the Patient Flow team will raise this at the daily on call handover meeting to ensure staff are aware.
The actions for other staff to take are contained in the trust severe weather plan.

12.7.3.2 Weekends and bank holidays

If a red or amber flood guidance statement is received between 7am and 3pm that covers South Yorkshire and or North Lincolnshire the Patient Flow team will telephone the on-call silver to make sure they are aware.
The actions for silver are to take are contained in the severe weather plan.

Document control

Version: 1.1.
Unique reference number: 615.
Ratified by: Corporate policy approval group.
Date ratified: 21 December 2023.
Name of originator or author: Business continuity and EPRR manager.
Name of responsible individual: Corporate policy approval group.
Date issued: 29 December 2023.
Review date: October 2024
Target audience: All trust staff.
Amendments: It is the duty of all plan holders to inform the business continuity and EPRR manager of any information concerning changes which will consequently impact upon this plan.

Page last reviewed: May 14, 2024
Next review due: May 14, 2025

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