Emergency Preparedness, Resilience and Response (EPRR)

The NHS needs to plan for, and respond to, a wide range of incidents and emergencies that could affect health or patient care. These could be anything from extreme weather conditions to an outbreak of an infectious disease or a major transport accident. The Civil Contingencies Act (2004) requires NHS organisations, and providers of NHS-funded care, to show that they can deal with such incidents while maintaining services.

This programme of work is referred to in the health community as emergency preparedness, resilience and response (EPRR). New arrangements for local health EPRR form some of the changes the Health and Social Care Act 2012 is making to the health system in England. If you would like more information or have any queries, please email england.eprr@nhs.net

Flooding: advice for the public

Public Health England has re published useful advice to help people who may be affected by the flooding due to the current severe weather conditions.

Further advice can be found on the Environment Agency website and updated weather warnings are available on the Met Office web site.

People are urged not to use items such as BBQs and generators indoors or in enclosed spaces due to the risk of carbon monoxide poisoning.

Pandemic Influenza remains the top risk for England and the UK.

To support planning by commissioners and providers NHS England has produced the following guidance document on the overview of the current status of the work around Pandemic Influenza preparedness. The powerpoint will be updated at least every quarter.

Roles and Responsibilities of CCGs in pandemic influenza: This document provides guidance to CCGs on their role in pandemic preparedness and response, and supports CCGs in identifying the high level priorities during a pandemic.

Infectious Respiratory Viruses – the use of facemasks and respirators

NHS England in partnership with the Department of Health, Public Health England and the Health and Safety Executive have reissued guidance on the use of surgical facemasks and FFP3 respirators, to be used when caring for patients with a suspected or confirmed infectious respiratory virus. These are in the form of posters and leaflet.

Updates (since 1 March 2013)

  • 25 March: The NHS England Core Standards Matrix has been slightly amended to ensure clarity in respect of some of the standards. A control sheet within the matrix, highlighting these changes, has been provided. The NHS England Core Standards for EPRR document has been re-issued with the matrix detached.
  • 25 March: The NHS England FAQ for EPRR has been updated with a link to the Public Health Regulations 2012 (in the answer section to question 12).
  • 22 March: Ian Dalton wrote to colleagues regarding the transition of EPRR.
  • The requirements for EPRR are set out in the NHS England planning framework, Everyone Counts: Planning for Patients 2013/14 (section 1.45 on page 13).
  • The requirements for EPRR are set out in the near final draft of the 2013/14 NHS standard contract (Service Condition 30, page 25).
  • 20 March: The published NHS CB Emergency Preparedness Framework 2013 describes a set of general principles to guide all NHS organisations in developing their ability to respond to incidents and emergencies and to manage recovery locally, regionally or nationally under the Civil Contingencies Act 2004. It replaces the NHS Emergency Planning Guidance 2005.
  • 20 March: The publishing of the NHS England incident response plans at national, regional and area team level.
  • 20 March: The publishing of the NHS England Emergency Planning Officer Competencies and JD Template.
  • The Summary of published key strategic guidance for health EPRR has been updated (25 March) to identify those documents which transferred to NHS England to include additional Cabinet Office information and to reflect the publication of the NHS England emergency preparedness framework (2013).

NHS Emergency Preparedness Framework

NHS England Emergency Preparedness Framework 2013: This is a strategic national framework containing principles for health emergency planning for all NHS England at all levels including NHS provider organisations, providers of NHS-funded care, clinical commissioning groups (CCGs), GPs and other primary and community care organisations. All NHS-funded organisations must meet the requirements of the Civil Contingencies Act (2004), the Health and Social Care Act (2012), the NHS standard contracts, the NHS England EPRR core standards, the NHS England command and control framework (2013) and NHS England business continuity management framework (2013). This framework supersedes both the “The NHS Emergency Planning Guidance 2005″ and the “Arrangements for Health Emergency Preparedness, Resilience and Response.

NHS England incident response plans: These set out the arrangements for the command, control and co-ordination of an NHS England health response in the event of periods of pressure, significant incidents or emergencies at either national, regional or area team-level. The plans should be read in conjunction with the Civil Contingencies Act (2004), the NHS planning framework for 2013/14, the NHS standard contracts, the NHS England emergency preparedness framework (2013) and the NHS England command and control framework (2013). These documents collectively supersede the Department of Health’s NHS Operations team’s national incident response plan (NIRP).

NHS England Command and Control Framework for the NHS during significant incidents and emergencies (2013): This document sets out the nationally recognised NHS command and control structure. It explains the framework for responding to local, regional and national periods of pressure, significant incidents and emergencies. This document supersedes the Strategic Command Arrangements for the NHS during a Major Incident guidance published in December 2007.

NHS England Business Continuity Management Framework (service resilience) (2013): This document highlights the need for business continuity management in NHS organisations so that they can maintain continuity of key services in the face of disruption from identified local risks. This document replaces the ‘NHS Resilience and Business Continuity Management Guidance 2008 (Interim Strategic Guidance for NHS organisations)’.

NHS England Core Standards for Emergency Preparedness, Resilience and Response (EPRR): The core standards are the minimum EPRR standards which NHS Organisations and providers of NHS-funded care must meet in accordance with NHS England planning framework, the terms and conditions of their contracts and in compliance with the Civil Contingencies Act 2004. The core standards matrix is available in Excel format. For NHS- funded providers, these standards clarify the existing EPRR requirements – they are not additional. It is expected that the level of preparedness will be proportionate to the role of each organisation and the services they provide.

Supporting materials

NHS England Emergency Planning Officers & JD Template This document contains suggested minimum competencies and skills required for all emergency planning officer (EPO) post holders within all NHS-funded organisations and providers of NHS-funded care. EPOs have responsibility for leading the development and implementation of policies, procedures and practices relating to their organisation’s preparedness for, and resilience to, disruptive events including emergencies (as defined in the Civil Contingencies Act 2004) as well as business continuity and other resilience planning arrangements. The act requires NHS organisations, and providers of NHS-funded care, to show that they can respond to such incidents while maintaining services to patients.

Maps of England displaying geographical boundaries for NHS England regions, area teams, Public Health England (PHE) Centres, local health resilience partnerships and local resilience fora.

Model competencies for members of NHS England emergency on-call rotas A list of competencies for area team emergency on-call directors is available. These should be referred to when selecting members of the rotas and to identify any training needs.

NHS England Model Job Description and Competencies for Emergency Preparedness Officers in NHS Provider Organisations: A list of competencies for emergency preparedness officers is available.

The Role of Accountable Emergency Officers: Each provider of NHS-funded care is required to identify an accountable emergency officer to assume executive responsibility and leadership at service level for EPRR. The definition of an accountable emergency officer is provided.

Frequently asked questions (FAQs) on the future arrangements for health EPRR: Answers to frequently asked questions have been provided. These will be updated as new queries are raised.

Template health EPRR presentation and speaking notes: A template health EPRR Powerpoint presentation, complete with speaking notes, is provided for local adaptation and use. The speaking notes are embedded in the first slide of the presentation.

Summary of published key strategic guidance for health EPRR: A map of DH and Cabinet Office EPRR guidance documents is provided for ease of reference. Please Note: As part of the migration of the Department of Health’s website to the gov.uk domain, a number of links to previously published DH guidance have become broken. The NHS England (Corporate) EPRR Team are aware of this issue and are working to re-issue a corrected PPT guidance chart as soon as possible. In the interim, please contact england.eprr@nhs.net for further information.

Off-the-shelf exercise and testing: Information on the series of off-the-shelf exercise packages, which have been developed to support organisations in testing their own EPRR capabilities.

NHS England transitional assurance process for EPRR: The NHS England transitional assurance process sets out the procedure by which NHS England, through the regional directors, gains assurance that the revised model of EPRR is in place and that NHS England is able to maintain a safe and resilient system of patient care. The document includes a pro-forma template and ‘statements of readiness’ which NHS England regional and area team directors will complete.

NHS England area team director implementation checklist for the future health arrangements for EPRR: A checklist is provided to assist area team directors in implementing the new EPRR arrangements. The checklist is for local determination and is also available in Word format to facilitate completion.

Memoranda of understanding: Template MOUs are provided to facilitate the safe transfer of EPRR responsibilities between SHA/PCT clusters and NHS England and to enable area teams to call upon such relevant provider resources as may be necessary in response to a significant incident or emergency.

NHS Business Continuity Management Toolkit

(These documents have been published under Gateway ref: 00999)

Previously published information

Information regarding the post-April 2013 arrangements for health EPRR was published on 3 April 2012. A key feature of the new arrangements is the formation of local health resilience partnerships (LHRPs) and a resource pack to support the roll out of LHRPs was published on 26 July 2012. Supporting that Dear colleague letter were the following materials:

On 2 August 2012, further information was published on the establishment of LHRPs whilst maintaining resilience arrangements. Supporting that Dear colleague letter, were the following materials:

The letter from Ian Dalton, dated 31 October 2012, gave extra detail on:

  • The assurance process for implementation of the new EPRR arrangements;
  • Maintaining resilience throughout transition and the process for operational handover to NHS England;
  • Competencies and training for members of emergency on-call rotas;
  • Establishing the NHS England command and control arrangements.

Clinical Commissioning Groups (CCG) have been informed of this letter and the EPRR supporting materials via issue 23 of the CCG bulletin published on the 9 November 2012. CCGs were reminded of their out of hours arrangements via issue 29 of the CCG bulletin published on 21 February 2013.

The NHS leadership community has been made aware of the changes to EPRR through issue 61 of “The Month”  published on 13 December 2012.

Contact us

If you have any queries, or if you would like further information, please send an email to the address below: england.eprr@nhs.net

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