Guidance and framework

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Summary of published key strategic guidance for health emergency preparedness, resilience and response (EPRR)

This document gives an overview of the key strategic EPRR guidance documents currently published.

NHS EPRR Framework

This is a strategic national framework containing principles for health emergency preparedness, resilience and response for NHS-funded organisations in England including but not limited to NHS Trusts, Foundation Trusts, Care Trusts, providers of NHS-funded primary care, NHS commissioning organisations including NHS England and integrated care boards.

All NHS-funded organisations must meet the requirements of the Civil Contingencies Act 2004, the NHS Act 2006, the Health and Care Act 2022, the NHS standard contract, the NHS Core Standards for EPRR and NHS England business continuity management framework.

NHS England Incident Response Plan (National)

The NHS England Incident Response Plan (National) is the overarching generic plan that details how NHS England responds to any health related incident or emergency at the national level.

Regional and Director of Commissioning Operations teams’, at a local level, incident response plans will be modelled on the national plan to ensure consistency and standardisation of NHS England’s response plans and functions.

The key objective is to provide confidence through effective oversight, direction and co-ordination of the NHS to enable it to provide a resilient response to incidents and emergencies that could have a national impact upon the NHS.

Concept of operations for the management of mass casualties

This Concept of Operations sets out the way NHS England will establish command and control for a mass casualty incident, and the arrangements which will be put in place beyond normal incident arrangements. It also confirms how, if required, we will make use of powers under section 252A of the NHS Act 2006, as amended by the Health and Social Care Act 2022, to direct the health service to respond.

In addition to this, the roles of Ambulance, Acute, Community and Mental Health and Primary Care providers have been set out and, where necessary, identify anticipated requirements for response.

NHS England asks all organisations to work with partners, to ensure their own Mass Casualty response arrangements meet any specific requirements of the Concept of Operations, and these work within the wider health and social care economy.

NHS England EPRR annual assurance process

The purpose of the EPRR annual assurance process is to assess the preparedness of the NHS, both commissioners and providers, against common NHS EPRR core standards.

Following  the establishment of Integrated Care Boards as Category 1 responder organisations in the CCA (2004) and as local health system leaders, it is hoped that the 2023 process will build on these experiences by developing robust local processes for undertaking organisational self-assessments against the core standards and agree the processes to gain confidence with organisational ratings.

NHS England has written to commissioners and providers of NHS funded services confirming the process for the 2023/24 EPRR annual assurance, which includes EPRR annual assurance guidance and core standards self-assessment tool.

NHS Core Standards for EPRR

As part of the NHS England EPRR framework, providers and commissioners of NHS funded services must show they can effectively respond to major, critical and business continuity incidents whilst maintaining services to patients.

NHS England has written to commissioners and providers of NHS funded services, sharing the NHS core standards for EPRR which sets out the minimum requirements expected of providers of NHS Funded services in respect of EPRR. This is supported by the core standards for EPRR guidance.

In addition to this, core standard 59 requires acute hospitals to assure themselves against the Decontamination checklist.

Minimum occupational standards for EPPR

This document sets out the minimum national occupational standards that health commanders, managers and staff responding to incidents as part of an incident management team and other staff involved in EPRR must achieve in order to be competent and effectively undertake their roles.

Evacuation and shelter guidance for the NHS in England

This guidance is intended to provide a framework for all Health and Social Care providers in the planning, preparation and response to the evacuation and shelter of patients, staff and others from, or within, health care settings, including whole site evacuation.

While this guidance concentrates on the shelter and evacuation of hospital sites, the principles are sufficiently flexible to be adapted for use in respect of other buildings or facilities on healthcare provider sites or to wider primary, social and community care and independent sector facilities.

This guidance supports the use of commercially available hospital evacuation tools which should be interoperable with partner organisations and promote system wide triage and tracking of patients within and across sites.

The guidance replaces the 2014 NHS England guidance ‘Planning for the evacuation and sheltering of people in health sector settings’ and is complemented by the 2014 Cabinet Office ‘Evacuation and shelter guidance’.

Resilient Telecommunications Guidance for NHS England and the NHS in England

Good communication is at the heart of an effective response to and recovery from, an emergency and responders should plan for disruption to its communications.

Resilient communications planning is part of broader emergency planning and preparedness and should take account of:

  • Community Risk Registers which provide insight into the types of local situations that might cause disruption.
  • The National Risk Register (NRR) which identifies a number of situations that could potentially disrupt telecommunications.

This guide sets out the minimum operational communications functions, equipment and networks to enable NHS England and NHS-funded organisations in England to discharge their statutory responsibilities. This document sets out maintaining critical functions of patient safety during a major incident or significant service disruption.