Hazardous Materials (HAZMAT) and Chemical, Biological, Radiological and Nuclear (CBRN)

Information last updated: 11 January 2019

On this page you will find information about:

Chemical incidents: planning for the management of self-presenters in healthcare settings

The Chemical incidents: planning for the management of self-presenters in healthcare settings gives guidance to National Health Service (NHS) funded organisations in planning, preparing and responding to chemical emergencies and managing people who may have been exposed to chemicals as a result of an accident or deliberate release. It highlights and addresses the particular features of an incident involving chemicals over and above the generic planning and response arrangements that need to be in place for all other major incidents and emergencies.

This guidance provides specific updated information and guidance on changes to aspects of the decontamination process for certain chemical incidents. It does NOT change any aspects of the decontamination process for biological or radiological contamination.

NHS funded organisations need to ensure that they have in place appropriate plans to respond to all hazards.

The national programme to replace existing PRPS across the NHS in England is currently underway.  Below is the latest correspondence on this programme:

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Initial Operational Response (IOR)

The Initial Operational Response (IOR) programme has been introduced by the Home Office across all blue light emergency services and to key first responders including the NHS, to improve patient outcomes following contamination with hazardous materials (HAZMAT) or a chemical, biological, radiological or nuclear (CBRN) incident.

The IOR programme has been introduced following extensive research. Principles of the IOR are applicable to NHS settings that may expect to receive ambulant self-presenting patients following an incident – for example emergency departments, walk in centres, urgent care centres or general practices. It is now being rolled out across the NHS in England, with an expectation that full implementation will occur by the beginning of April 2015.

An IOR training DVD has recently been produced and circulated to all hospitals to support the roll out of the IOR programme, and to highlight the changes that acute NHS trusts will need to make to existing decontamination processes.

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Preparation for incidents involving hazardous materials: Guidance for primary and community care facilities

This resource pack and training material are for those working in primary and community care services operating within a community based setting, where there may be a risk of secondary contamination as a result of a hazardous material (HAZMAT) or chemical, biological, radiological, nuclear (CBRN) incident.

The resource pack provides practical guidance for:

  • General practice (GP), pharmacies, dentists and opticians
  • Health clinics, walk-in-centres (WICs), minor injury units (MIUs)
  • Community hospitals without emergency departments
  • Mental health service providers operating in the community

All of these are settings where people may self-present in search of treatment, advice and reassurance, having left the scene of an incident without first coming into contact with the responding emergency services; as a consequence of developing symptoms or concern generated by widespread media coverage.

This pack provides staff with a resource to support them with:

  • assessment of the potential hazards, means of contamination, and identification of the needs of the self-presenters
  • limiting the spread of contamination, especially the risk of secondary contamination of staff and patients
  • incident management and team coordination
  • effective communication

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UK Reserve National Stock for Major Incidents – Countermeasures access guidance

NHS England has produced guidance for accessing countermeasures in England, this has been placed on Resilience Direct on the NHS England guidance page, through your RD login.

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Patient Group Directions (PGDs)

A specific set of PGDs have been developed by Public Health England (PHE) in partnership with NHS England, the Department of Health (DH) and other specialist advice to enable the NHS in England to respond to a CBRN event.

The PGDs are provided to ensure a national capability to respond appropriately as required and will be updated in line with any changes to legislation or clinical evidence on efficacy of use and dosage requirements.


Initial supply

Further supply


Initial supply

Further supply

Potassium iodate and potassium iodide protocols

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