MAJOR INCIDENT
RESPONSE PLAN
Contents
Paragraph Page
Forward from the Chief Executive 3
Part 1 The plan
1 Introduction 4
2 Major Incident definitions 7
3 The role of the Acute hospitals 8
4 Executive responsibilities for development, adoption and
review of the plan 8
5 Interface with external parties 9
6 Major Incident evaluation and debrief 12
7 Guidelines for Major Incident exercise 14
8 Hospital Site Plans 15
9 Key Locations and telephone numbers 17
10 Key Personnel quick reference guide 19
Part 2 Action cards 20
Part 3 A scheme for the support of staff following a Major
Incident 72
Appendices
Appendix
A Guidance for Staff Call-Out 74
Appendix
B CBRN Plan
75
Appendix
C Burns Major Incident Plan 103
Appendix
The PRIMARY Command and Control
Centre is situated in Seminar Room 17,
Education Centre, Level 1, Queen
Elizabeth Hospital Birmingham
Should this area become out of action then
:
The SECONDARY Command and Control
Centre will be situated in Trust
Headquarters, Mendelsohn Way,
Queen Elizabeth Medical Centre.
BBW Security will allow access to Trust Headquarters via
the side entrance
FORWARD FROM THE CHIEF EXECUTIVE
This Major Incident response plan has been developed for University Hospitals Birmingham NHS Trust (UHB), to meet current legislation and forms part of the Trust Emergency Preparedness Plans. It provides a clear action plan to be undertaken in the event of a Major Incident and should be used with Local Action Cards specific to your areas of work.
It is the responsibility of this Trust to ensure that this plan is shared with our staff, tested and updated to reflect the evolving requirements of safety and welfare for our patients, staff and the maintenance of our services.
Each and every one of us has the responsibility to familiarise ourselves with the plan and our specific roles during a Major Incident. As an individual working for UHB it is essential that you take time to read this plan, to think about your individual responsibilities during its activation and to share it with others in your area of responsibility.
Remember: If you are reading this plan because a Major Incident has been declared, then it is too late.
Julie Moore Chief Executive October 2011
Part 1
The plan
1.
INTRODUCTION
THIS PLAN aims to set out the structure and organisation of Queen Elizabeth Hospital Birmingham (QEHB) during the period of a Major Incident.
Under the Civil Contingencies Act 2004, University Hospital Birmingham NHS Foundation Trust is classed as a Category 1 Responder. As a Category 1 Responder, the Trust is required to maintain plans which ensure that in the event of an emergency, (MAJOR INCIDENT), it can deliver a co-ordinated and effective response to the Incident.
The Plan details the framework for the Trust’s response to a MAJOR INCIDENT. The Plan has been written with reference to the NHS Emergency Planning Guidance 2005.
1.1 AIMS OF THE PLAN.
To ensure a level of quality response for the needs of the patients, their relatives, the Trusts’ staff and the media.
To ensure effective arrangements for the command, control and co-ordination of services within the Trust.
To ensure effective communications between the Trust and the Incident Site. To ensure effective communications between various agencies within the
Health Service, other agencies (category 2 responders) and the media.
To ensure awareness training of the Plan. To ensure training and education of relevant staff members is maintained in line with national guidance. To ensure that Plans are tested and updated regularly, in line with national guidance.
To ensure a response to the needs and welfare of all staff during and after a MAJOR INCIDENT.
Therefore, ALL staff MUST endeavor to familiarise themselves with the overall plan so that they will have greater understanding of the entire situation.
Realistically it is expected that QEHB, as the receiving hospital, could deal with major (immediate / urgent) and minor cases.
PLEASE NOTE that it is imperative that each Division/Group/Department organises its own Staff Call-Out procedure (this applies to medical and non-medical Staff) in line with the guidelines in this policy for calling out staff and the action taken by Switchboard.
THE CALL OUT PROCEDURE MUST NOT INVOLVE SWITCHBOARD, MUST ALWAYS BE KEPT UP TO DATE AND ALL STAFF WITHIN THE DIVISION / GROUP / DEPARTMENT MUST BE FAMILIAR WITH IT.
It is also imperative that all Staff are aware of their arrival/registration point. Key Managers/Heads of Department (HOD) must ensure that all staff called out report to the Human Resource Manager in the Main Library Level 1 (Education Centre QEHB) to be registered before going to their work area. Medical staff will also report to the Library Level 1(QEHB)
As well as the Action Cards set out in this Policy, which offer guidelines for all Key Personnel, it is vitally important that Key Managers/HOD ensure their Division/Group/Department has its own up-to-date Local Action Cards which fully detail any action required. Staff must be familiar with their own Local Action Cards
ONE COPY OF ALL LOCAL ACTION CARDS AND CALL OUT PROCEDURES MUST BE
HELD IN THE HOSPITAL COMMAND AND CONTROL CENTRE
(SITUATED IN EDUCATION CENTRE LEVEL 1, SEMINAR ROOM 17 QEHB)
1.2 REQUIREMENTS OF THE CIVIL CONTINGENCIES ACT 2004
Risk Assessment and Emergency Plans.
As a Category 1 responder, this Trust must assess the risk of an emergency within, or affecting the geographical area for which they have a responsibility, and prepare plans to mitigate these risks, where possible.
Business Continuity
The Civil Contingencies Act 2004 places a statutory duty on this Trust to ensure that it can:-
Respond to an emergency;
Continue to support emergency response partners;
Continue to provide critical services to the public, as is reasonably practicable in the event of an emergency.
The implementation of Business Continuity Management allows these requirements to be met. This process helps an organisation to continue to deliver its services in the event of a disruption, either internally such as a building flood / fire or externally such as a Major Incident, adverse weather conditions or loss of a service or supplies from an external service provider or contractor.
This Trust has a prepared Business Continuity Plan to ensure that the Trust can meet these requirements. Ref UHB Business Continuity plan
Warning and Informing
The Civil Contingencies Act 2004 requires all Category 1 responders to maintain arrangements to warn the public if an emergency is likely to occur or has occurred, including the provision of information and advice to the public.
A formal system for the West Midlands to warn and inform the public is established by the activities of the Local Resilience Forum Communication Group.
Co-operation and Sharing Information
The Civil Contingencies Act 2004 states there is a legal duty on all Category 1 responders to co-operate in the execution of their emergency planning duties. Within the West Midlands, the principal mechanism for co-operation between the responders is through the county’s Local Resilience Forum (LRF) and structured “role specific” subgroups.
The Trust recognises that at the local level of it working in collaboration with partner agencies, including the sharing of relevant information, it is important to ensure that any response to a MAJOR INCIDENT is effective and well coordinated.
2.
MAJOR INCIDENT DEFINITIONS
A MAJOR INCIDENT is defined as an occurrence arising with little or no warning, that presents a serious threat to the health of the community, disruption to the service, or causes (or is likely to cause) such numbers of casualties as to require special arrangements to be made within this Trust.
Major incident standby is the term used when there has been a report that a Major Incident has occurred but cannot be confirmed, or where the capabilities/capacities of other hospitals already alerted are filled. The Ambulance service will issue a Major Incident standby message.
Major Incident declared is when the call-out procedures are activated.
Stand-down is actioned by the Command and Control centre when the pressure on services is reduced after a declared incident or when stand-by is no longer deemed necessary.
Major incident exercise is when the Trust initiates an exercise.
3.
THE ROLE OF THE ACUTE HOSPITALS
University Hospitals Birmingham operates on 2 sites:
3.1 The Queen Elizabeth Hospital Birmingham
The Queen Elizabeth Hospital Birmingham is designated as a category 1 responder in the event of a Major Incident.
3.1.2 The old Queen Elizabeth
The old Queen Elizabeth will provide support to the QEHB to enable resources to be used flexibly across both sites in order to respond to the increased activity.
3.1.3 Paediatric services
In the event of UHB being designated as the receiving hospital for a major incident it will provide care to all ages. As UHB has no in-patient Paediatric facility however,
children will be managed in the following way:
Children with minor injuries will be received, treated and discharged from the Trust.
Children with major injuries will be received, emergency treatment will be initiated and after stabilization they will be transferred to the Birmingham Children’s Hospital or another appropriate facility.
3.2 The Command and Control centre
The Command and Control centre will be based in the Education Centre Level 1 seminar room 17 at QEHB. The responsibility of the Command and Control centre team is to:
Lead and direct a coordinated approach to the management and deployment of Trust resources during the incident.
To maintain an accurate record of actions undertaken during the incident to ensure detailed feedback and debrief.
To provide a single focus for operational decisions likely to affect the whole hospital.
Ensure clear lines of communication are maintained within and outwith the Trust.
To brief call-in list responders and initiate a response by the provision of action cards and departmental plans.
3.3 The role of Divisions
To develop an appropriate response on receiving directions from the Command and Control centre
To activate call out procedures as per ‘guidelines for calling out staff’ (appendix A)
To develop and maintain a departmental specific plan and action cards for key roles in the event of a Major Incident.
4.
EXECUTIVE RESPONSIBILITIES FOR DEVELOPMENT,
ADOPTION AND REVIEW OF THE PLAN
4.1 Chief Executive
It is the Chief Executive’s responsibility to ensure that the Trust has a Major Incident plan that complies with national guidance and that the plan is regularly tested and updated as necessary.
4.2 Chief Nurse
Ensure the Major Incident procedure is updated and that all services and staff are aware of their responsibility.
Arrange exercise of the key elements of the plan within the Trust in line with legislation.
Evaluate the hospital’s response and ensure modification to the plan as necessary.
Ensure that the hospital’s response plan is included in the staff induction programme and that staff are aware of their role in the event of there being a Major Incident.
Delegate on-going training and awareness.
4.3 Director of Human Resources – staff support
The Director of Human resources will be responsible for the development and review of plans designed to provide support for staff during the response to the incident and for ensuring arrangements are in place to allow for an appropriate level of de-briefing and on-going support for staff.
The Director of Human Resources will assist in the identification of training needs and the coordination and delivery of appropriate training.
The Trust will participate with other agencies in the development and delivery of a county wide welfare plan.
4.4 Executive Directors, Directors of Operations
Ensure all their staff are aware of their departmental responsibilities.
Ensure that action cards are written, maintained and kept up to date for their department.
Ensure that call out systems for off duty staff exists.
Ensure that the departmental action plan is included in local induction programmes for all staff.
Ensure amendments to the plan are notified to the Chief Nurse. Ensure changes to the Trust call in list are notified to the switchboard. Ensure on-going training and awareness.
5.
INTERFACE WITH EXTERNAL PARTIES
Dependant on the nature and scale of the Major Incident the Trust will liaise with partner agencies e.g. Police, Ambulance service, Birmingham cluster (formerly the Primary Care Trust) to ensure that it is delivering an effective response which is coordinated with multi-agency partners.
The Trust will inform the Strategic Health Authority of the occurrence and nature of any Major Incident.
5.1 The Police
In most instances the Police have overall responsibility for coordinating the strategic response to a Major Incident of all the emergency services and other organisations involved. They will coordinate the provision of information to the public and the media and will send a Documentation team to the receiving hospital.
The role of the documentation team is to collate demographic information of the arrivals at Emergency department(ED) for the purposes of populating the Casualty Bureau systems of the deceased or injured.
The team will consist of a team leader and Police officers trained in the role of hospital documentation. The team leader will, upon arrival, liaise with the Senior Nurse controller in ED.
The team will arrive with standard documentation used for casualty collation and will establish an operating centre within the designated hospital documentation room in ED.
5.2 The Public
Following a Major incident the Police will establish a casualty enquiry bureau to collate information from the public, mortuaries etc on people who may or may not have been involved in the incident. The information would be passed onto another unit to be checked and processed to determine whether further action is required. Once the bureau has been established the Police will issue a telephone number to the public via the media.
In advance of the casualty enquiry bureau being established, enquiries from the public should be referred to the hospital information room until numbers are released by Police authorities.
The documentation team will be responsible for forwarding information on all casualties and fatalities at the Trust to the casualty enquiry bureau. However, the Trust is free, as would be under normal circumstances to contact patient
relatives if they feel it is appropriate.
Relatives arriving at the hospital for information will be accompanied by volunteers to the relative reception area situated in the Level 1 Therapies Services, South Suite Treatment 7.
5.3 The Media
The Trust communications manager will continually brief the Chief Executive to enable effective communication with the public and the press.
The Trust communications manager will liaise with the Police and other partner agencies in handling press activity for the Major Incident to ensure that briefings released to the media are consistent. Reference should be made to Local Resilience Forum (LRF) communications plan where an incident involves a multi agency response.
NOTE: The Trust’s communications manager must only brief the media on the Trust’s response to an incident and not on the incident(s) itself.
5.4 The role of the Ambulance service
The role of the Ambulance service is to:
Alert the most appropriate receiving hospitals, based on local circumstances at the time.
Dispatch an Ambulance Liaison Officer to each receiving hospital to supervise ambulance activity and liaison at the receiving hospital and provide mobile radio communication links between the hospital and the Ambulance service Ensure the Ambulance Incident officer will work closely with the Medical
Incident Officer at the site of the emergency
The Ambulance Liaison Officer will be based in the Emergency department and West Midlands Ambulance service will provide a Silver Commander to the hospital Command and Control room.
5.5 The role of the Birmingham Cluster (formerly the Primary care Trust)
The role of the Cluster is to:
Coordinate the local NHS response to an incident
Mobilise primary and community care resources in support of the ambulance service
Provide support to acute and non acute hospital Trust’s in their response to an incident
5.6 The role of Birmingham City Council Emergency planning division
The role of the Birmingham City Council is to:
Coordinate the City response to an emergency
In the event of a mass fatality situation consult with the Police and appropriate Coroner to select the most suitable pre designated emergency mortuary option
Arrange for rest centres/survivors reception centres/emergency
accommodation to be provided or those who have been evacuated during an emergency
Facilitate the provision of City council and other resources to assist the emergency services
Co-ordinate the recovery from the emergency together with other agencies
6.
MAJOR INCIDENT EVALUATION AND DEBRIEF
6.1 Evaluation
Following any Major Incident practice or incident the relevant Executive Director will be responsible for ensuring the evaluation and debrief of the effectiveness of the Trust response takes place. In order to assist this process, every division and department must:
Evaluate the effectiveness of their call out procedures.
Ensure mechanisms are in place to evaluate the level of response
Record any problems related to poor communication or unavailability of resources
Record variations to normal service delivery
The Command and Control centre will ensure monitoring arrangements are in place to record all information received by the centre and all actions that generate from within the Command and Control centre.
6.2 Debrief
A formal Trust wide debrief will be completed within 6 weeks of the incident and may involve external agencies.
Individual departmental debriefs will be completed at a time deemed appropriate by the departmental lead clinician.
The Trust will participate in an inter-agency debrief as initiated by the regional City Emergency planning officers.
6.3 Review of the Major Incident plan
It is the responsibility of the Chief Nurse in conjunction with the Major Incident planning team to review the plan as required by legislation.
This review will take into consideration any action arising from the evaluation of any incident or exercise, changes within the Trust, and of any new guidelines that may have been issued.
Account will also be taken of any changes to Major Incident plans of partner organisations.
6.4 Training and awareness
The Trust will provide mandatory training for all Trust staff in Major Incident awareness. The level of training will depend on the level of responsibility of staff. Staff who undertake key roles in the event of a Major Incident will be given role specific training.
7.
GUIDELINES FOR MAJOR INCIDENT EXERCISE
In the event of a major incident ambulance control will notify Queen Elizabeth Hospital Birmingham Switchboard using the following code words:-
7.1. If the Hospital is to be alerted only of a possible Major Incident (yet to be confirmed), or where the capabilities / capacities of other hospitals already alerted are filled then the message passed will be:-
"MAJOR INCIDENT - STANDBY"
If, having initiated "STANDBY", it is found not to be required Ambulance Control will pass on the following message to Switchboard:-
"MAJOR INCIDENT - CANCELLED"
The Hospital Switchboard will then immediately notify those individuals originally informed of the Standby
7.1.1 If the Hospital is required to initiate the Major Incident Plan then the message passed will be:-
"MAJOR INCIDENT DECLARED - ACTIVATE PLAN"
The Hospital should be informed whether it is a RECEIVING or
SUPPORTING Hospital.
7.1.2 When the site of the incident is cleared and all casualties have been moved Ambulance Control will pass on the following message to Switchboard:-
“MAJOR INCIDENT – STAND DOWN”
The hospital switchboard will then immediately notify the Command and Control Centre manager, who will then decide the point at which to call the
Hospital Stand Down, i.e. when Hospital activity has fallen to near normal levels.
7.1.3 MAJOR INCIDENT EXERCISE
This is when the Trust initiates an exercise of one or more of its components. All test messages will be prefixed with EXERCISE, EXERCISE, EXERCISE.
Mindelsohn Cr escent Vincent Drive Harbor ne Lane Harbor ne Park Rd Mindelsohn W a y Mindelsohn W a y Mindelsohn Way Vincent Drive Mindelsohn Way New Fosse W ay Hospital W a y Metchley Park Road Metchley Lane Oak T ree lane Raddlebar n Road Raddlebar n Road Oak T ree lane
Bristol Road A38
Bristol Road A38
Raddlebar n Road Harbor ne Lane Aston W ebb Boulevar d New Fosse W ay
Aston Webb Boulevard
Busy Bees Nursery
Old Queen Elizabeth Hospital Birmingham Women’s Hospital Medical School The Oleaster (BSMHFT) The Barberry (BSMHFT) Harborne Birmingham S elly Oak
Nuffield House CentreClub
THQ Cancer Centre Post Graduate Centre
Vincent Drive closed to vehicles
Access for residents only
Sainsbur y’s
(one way only)
Selly Oak
Main Entrance Patient / Visitor/ Outpatients (non - A&E, CDU)
e Eli Eli A&E A&E entrance and drop-off (15 mins waiting only) Clinical Decision Unit (CDU) entrance CDU Queen Elizabeth Hospital Birmingham University Station
Queen Elizabeth Hospitals
B15 2WB
Shuttle 448/a/b 647 64 99 Shuttle Shuttle Shuttle Shuttle Shuttle Shuttle 11 448/a/b 11 448/a/b 64, 99 448/a/b 64, 76, 84 98, 99 448/a/b 98, 99 448/a/b 98, 99 448/a/b 64, 99 448/a/b 647 64, 76 84, 98 64, 76 84, 98 647 Shuttle 11 61, 62, 63, 64 61, 62, 63, 64 61, 62, 63, 64 11 0 – 1hr £2.60 1 – 2hrs £3.80 2 – 3hrs £3.90 3 – 4hrs £4.50 4 – 5hrs £5.20 5 – 6hrs £5.80 6 – 8 hrs £6.40 Over 8hrs £12.90 Weekly Pass £18.00 Car Parking Charges
When visiting our
hospitals we recommend the following Car Parks as the most convenient: For the new
Queen Elizabeth
Hospital Birmingham use Car Park A
(sat nav postcode B15 2WB)
For the old Queen Elizabeth Hospital use Car Park D
(sat nav postcode B15 2TH)
For the Emergency Department (A&E) or CDU use Car Park D
(sat nav postcode B15 2TH)
Parking on the Queen Elizabeth
Hospitals site
When visting Outpatients Departments at Selly Oak Hospital choose the parking area closest to the location of your appointment. This is identified on your appointment letter. Parking on the Selly Oak Hospital site H.A.R.C Centre
The service runs from 07:00-19:00 Monday-Friday (excluding Bank Holidays).
Entrance
Entrance and info desk Disabled Entrance Disabled Parking Parking
Bus Stop Centro / WM Walk Route
Disabled drop-off / Taxi drop-off / non- emergency transport Shuttle bus
E E
Key
Visitor and Patient (non - A&E & CDU) Ambulances &
Buses only
New QEHB Parking – Car Park A Staff Car Park F Staff Car Park B1 Visitor / Patient / A&E / CDU Staff Car Park E Old QE Parking – Car Park D
9. Key locations and telephone numbers
KEY LOCATIONS AND TELEPHONE NUMBERS Internal DDI HOSPITAL CONTROL CENTRE Seminar room 17 Level 1 Education centre QEHB
Phone for receiving external calls only Fax
13500 0121 3713500
0121 3712900 0121 3712901 Breakout room 1 Seminar room 16
Level 1
Education centre QEHB
13501 0121 3713501
Breakout room 2 Seminar room 18 Level 1
Education centre QEHB
13502 0121 3713502
TRIAGE POINT Ambulance Entrance Emergency
Department
Runners
MAJOR INJURIES AREA
(immediate & urgent cases) Main Emergency Department Resuscitation area 12609 12607 0121 3712609 0121 3712607 MINOR INJURIES AREA
See and treat area 12621 0121 3712621 BODY HOLDING AREA Quiet room (rear of
resus) Emergency Department MAIN ADMISSIONS AREA Ward 410 QEHB 14131 14136 0121 3714131 0121 3714136 DISCHARGE AREA
Those patients in A&E at the time of the emergency and other hospital in-patients
Ward West 4 old QE
RELATIVES’ AREA Therapy services south suite
Level 1 QEHB
INFORMATION CENTRE Sister’s office, Emergency Department 12624 12625 12626 12627 0121 3712624
PRESS AREA Old QEH Post
graduate centre 6385 POLICE AREA (DOCUMENTATION TEAM) Emergency Department Seminar Room 12640 0121 3712640 STAFF REPORTING AREA QEHB Main library Level1 Education centre QEHB 12486 12485 0121 3712486 0121 3712485 Education Reception 12480 RCDM CONTACT OFFICER RCDM 07810636849 TEMPORARY MORTUARY Furniture and Equipment store Level -1 MEDICAL STAFF REPORTING AREA Main library Level 1 Education centre QEHB 12486 12485 0121 3712486 0121 3712485 BBW SECURITY 119 0121 4156336 0121 4156337 BBW HELPDESK + CAR PARKING 777 0121 4156300
10. Key personnel quick reference guide
KEY PERSONNEL – QUICK REFERENCE
The following list defines the roles to be undertaken by personnel in the event of a Major Incident:-
1. MEDICAL CONTROLLER Medical Director of UHB Trust, or nominated deputy
2. NURSING CONTROLLER Chief Nurse or Deputy
Initially Site Senior Nurse/site on-call sister until relieved by above
3. CONTROL CENTRE MANAGER
Overall responsibility for the management of the incident within the Trust
Exec on call
Initially site manager until relieved by above.
4. TRIAGE OFFICER Duty Emergency Department SpR
Until relieved by 2nd available ED Consultant
5. EMERGENCY DEPARTMENT - CLINICAL CONTROLLER
Duty Emergency Department SpR
Until relieved by Duty ED Consultant
6. CRITICAL CARE UNIT – CLINICAL CONTROLLER
ITU registrar
Until relieved by Duty ITU Consultant
7. THEATRES –
CLINICAL CONTROLLER
1st on call Anaesthetist
Until relieved by Duty Anaesthetic Consultant
8. TRAUMA WARDS – CLINICAL CONTROLLER
Duty Trauma Consultant 9. CLINICAL STAFF
CONTROLLER
Duty Medical Consultant 10 STAFF VOLUNTEER
RECEPTION MANAGER
Human resource manager 11 CAPACITY LEAD MANAGER ADN or Available site manager. 12 EMERGENCY DEPARTMENT
SUPPORT
On call manager
13 BBW SECURITY (119) Ensure doors are deactivated and signage erected
14 BBW HELPDESK (777) Ensure Consort On Call Manager has been contacted
15 CONSORT ON CALL MANAGER
Ensures, BBW, Q-Park and Kcom ( if applicable) are continuously updated
PART II
ACTION CARDS
THE SPECIFIC ACTION CARDS and notes that follow act as guide to key personnel in the organisation of the hospital during the emergency
ONLY key personnel responsible for organisation of key tasks or whose role will change dramatically are included in the document.
One Copy of the Action Cards forming part of this policy will also be held separately in the Command and Control Centre in the Education Centre, Level 1, Seminar Room 17 QEHB. A second set of action cards are held in the SECONDARY Command and Control Centre, Trust Headquarters.
Key personnel must have their own, and their Division/Group/Department Action Cards available and copies of all local Actions Cards will be kept in the Hospital Control Centre.
All key personnel must collect their card from the Control Centre and sign for it as soon as possible after "Call Out". This will enable the Control Centre Manager to monitor staff in position.
All key personnel and Heads of Department must ensure that all their staff are issued with local Action Cards immediately. It is also the responsibility of key personnel and/or Heads of Department that staff under their control are fully aware of their responsibilities set out on the Local Action Cards.
ACTION CARD
SWITCHBOARD OPERATORS
Major Incident calls should come from Ambulance control; however they may sometimes be made from the Emergency Department.
On receipt of a call that states:
MAJOR INCIDENT – STANDBY OR
MAJOR INCIDENT DECLARED – ACTIVATE PLAN
Switchboard operator will take details of the incident using the MAJOR INCIDENT METHANE PROFORMA
“
M
” identity of caller ( WMAS or ED or other) confirm major incident “standby” or “declared” or “internal response plan”“
E
” exact location of the incident“
T
” type of incident (e.g. rail crash)“
H
” Ask if any particular hazards present at the scene (e.g. Fire/chemical/explosion)“
A
” assessment of the situation from the caller – any further information relevant to the Trust“
N
” number and type of casualties / injuries – ask for estimated number of casualties involved.“
E
” emergency / internal services present on scene or required to the scene. – if internal response plan, then ask if emergency services have been contacted.- if not – ask caller what is required and then make 999 call on behalf of the trust.A copy of this report (blank proformas kept in switchboard) must be taken to hospital control room after call-out procedure completed.
For
STANDBY
The following will be informed:
Medical Director Switchboard Manager
Duty Emergency Department Consultant Duty Surgical Consultant (Vascular) & General Surgery
Duty Anaesthetic Consultant – QEHB Critical Care unit
Duty Trauma Consultant
Duty Medical Consultant Lead/on call Radiologist QEHB
Site managers QEHB Emergency Department – alert phone ext
12608
Senior Manager on call On call manager / DIV C Support
manager Haematology Technician
For
ACTIVATE PLAN
Switchboard Staff:
Will be informed that a Major Incident has been declared and that they should activate their plan giving brief details of the type of incident.
Switchboard should inform all staff of the Incident via ‘Mass Bleep’ giving very brief details, (eg plane crash, chemical spillage, etc) and location, stating:
‘MAJOR INCIDENT DECLARED – details – location – ACTIVATE PLAN Inform Switchboard manager who will activate call-out of other
Switchboard staff.
Contact staff according to Operator Priority List.
Inform or Fax Control room with response from call out.
Once the Command and Control room confirms that the Casualty Bureau has been set up by the Police, Switchboard will be issued with the number to give out to all incoming enquiries.
OPERATOR ONE LIST
In support of the Mass Bleep, Switchboard will contact staff according to the priority list as follows. All listed should implement their own internal call-out plans.
A list should be maintained for reference of any staff that are not contactable.
Area Contact
1 Emergency Department (staff base)
2 Emergency Department Consultant on call
3 On-Call Manager (Division C support manager in hours)
4 Chief Nurse
5 Medical Director
6 Chief Executive
7 2nd on call manager
8 Management Executive on call
9 Medical Consultant on call QEHB
10 BBW Helpdesk
11 Trauma Consultant on call
12 Anaesthetics Consultant on call ( Critical care)
13 Anaesthetics Consultant on call (Theatres)
14 Burns and Plastics Consultant on call
15 Surgical Consultant on call - Vascular
16 Surgical Consultant (Liver Consultant on call if not available)
17 On call Chaplain
18 Trust Head of Communications
19 Trust Estates & Contracts On Call
20 Facilities Manager on call
21 Medical Records Manager
22 On call Haematologist
23 On Call Radiographer
OPERATOR TWO LIST
In support of the Mass Bleep, Switchboard will contact staff according to the priority list as follows:-
A list should be maintained for reference of any staff who are not contactable. .
1 Director of Human Resources.
2 Loggist (see Loggist Rota)
3 Consultant Maxillofacial Surgeon on call.
4 Biochemistry on call
5 Neurosurgical Consultant on call
6 Pharmacist on call
7 Cardiothoracic Consultant on call
8 Anaesthetics Consultant on call (Neuro Critical Care)
9 Cardiology Consultant on call
10 Neurology Consultant on call
11 Renal Medical Consultant on call
12 RCDM – Duty Officer 13 Physiotherapist on call
14 Oncology Consultant on call
15 Medical Illustration
ACTION CARD
CHIEF EXECUTIVE
The Chief Executive will be primarily responsible for managing external affairs during the incident including:-
1. Liaise with other Local Provider Chief Executives. 2. Attend ERMA 2 Control Room if requested/on-call
3. Liaise with communications officers to oversee any Press releases on behalf of the Trust.
4. Be prepared to give Press briefings as required.
5. Strategically oversee the control room(s) and advise with regard to UHB service provision
ACTION CARD
CONTROL CENTRE MANAGER
Tabard from Command and Control Centre – Control Centre Manager
The first available On-Call Manager will assume the role of Control Centre Manager and proceed as the controller undertaking the listed duties unless/until relieved by a Senior Manager / Executive on-call.
The Control Centre manager will be responsible for the overall management and control of the incident within the Trust.
The Control Centre Manager will liaise with the Medical and Nursing Controller throughout the Incident
On receipt of the instruction:-
“MAJOR INCIDENT DECLARED – ACTIVATE PLAN”.
1. Initiate Major Incident Call-Out procedure. Including Chief Operating Officer or Deputy Chief Operating Officer and Directors of Operations
2. Proceed to Hospital Control Centre (QEHB), refer to Action Card and don Tabard. Take out command and control centre managers box from major incident cupboard.
3. Ensure that the Emergency Incident log book 101 is used and that all decisions, actions and messages are being logged. Until Loggist is present, commence Log book 101, documenting time, reason and person who has opened the Command and Control centre.
4. Liaise with Medical and Nursing Controller and ascertain nature of incident 5. Designate manager to undertake Emergency Department support
6. Designate Manager to undertake duties of Press Officer and Information Officer until relieved by appropriate personnel
7. Discuss with Loggist how key decisions will be maintained and recorded 8. Send available Manager to Main Library Level 1 (staff reporting) to act as
9. Ensure “Action Cards” available together with record sheet of staff roles. Check that all Action Cards are taken by appropriate personnel
10. Ensure that Division / Department Call-Out procedures have been implemented if required.
11. Liaise with RCDM of Major Incident via the RCDM Duty officer
12. Coordinate the set up of the temporary mortuary in furniture and equipment store, level -1.
13. Ensure all priority areas are made ready to receive patients.
14. Ensure staff are allocated to the Information Room where Staff will receive calls from the general public and press initially until press room established. Ensure staff are allocated to the Press Area until relieved by the Communications team.
15. Liaise with Police, Ambulance and Fire Services as necessary
16. Liaise with Capacity Lead Manager, who will be working from the breakout room near to the control centre.
17. Liaise with Information Room Officer and Press Officer
18. Liaise with Medical and Nursing Controllers to manage bed state effectively 19. Where this is an external incident, receive Stand Down from West Midlands
Ambulance Service and make executive decision, in collaboration with Medical and Nursing Controllers, to stand down the Trust.
Emergency Response and Management Arrangements
(ERMA)
Activation Procedure
To contact the ERMA Level 2 Commanders (PCT and Acute Chief Executives on call) for the West Midlands Conurbation please telephone
First Response on
01384 215684
First Response will then contact the appropriate on-call person. This telephone number is a 24/7 priority line.
ACTION CARD
NURSING CONTROLLER
Tabard in Command and Control Centre – Nursing Controller
This role will be undertaken by the Site Manager for the Hospital (24/7 Team or Hospital at Night) until relieved by the Chief Nurse / Deputy Chief Nurse. In the absence of both the Chief Nurse and the deputy Chief Nurse this role will be undertaken by an Associate Director of Nursing. The Nursing Controller will be based in the Hospital Control Centre and will be responsible to the Control Centre manager who has overall responsibility for managing the incident.
On receipt of the instruction:-
"MAJOR INCIDENT DECLARED - ACTIVATE PLAN".
1. Proceed to Hospital Control Centre and set up room from Major Incident Cupboard. (See guidance notes in major incident cupboard) Start a log book of all actions and times. If available, task untrained member of staff to assist you in initial set-up.
2. Liaise with Medical Controller and ascertain the nature of the incident. Proforma will be sent from switchboard with initial METHANE message.
3. Call all Senior Nurses available and instruct them to inform all ward and Nursing departmental areas to be ready to activate their plan.
Advise staff to await instruction from control centre before activating call out staff procedure (guidance at appendix A). Only ED will activate their call out at this stage.
Advise ward staff to remain on duty until senior nurse for their area decides otherwise. Please bear early consideration to other key areas that may need staff to be called in. e.g. Critical care, Theatres, Burns.
4. Implement Nursing Directorate staff call out procedure as decided from within the Control centre.
5. Assess present bed state, liaise with Medical Controller and continue to monitor throughout the incident. Notify Admission Areas.
6. Give instruction to begin transfer / discharge of current patients from Ward 410 .
7. Give instruction to begin transfer/discharge of current patients from Therapies Services Level 1 South Suite Treatment 7 to accommodate the relatives’ area.
8. Liaise with Key Admission Areas (below) regarding patient flow and staffing. Emergency Department and Minors area (see & treat)
WARD 410 Critical Care Unit Theatres
Ward West 4 old QE
Therapies Services Level 1 Ambulatory Care level 0
9. Delegate Trained Staff from Staff Reporting, Main Library, Education Centre Level 1, to areas being prepared for patients. Consider staffing Education Centre Level 1 early until controlled by The H.R Dept. Assign ADN to this area.
10. Liaise with Human Resource Manager with regard to deployment of Nursing Staff under the supervision of the assigned ADN.
11. Liaise with Medical Consultants and Senior Nurses to manage bed state 12. Liaise with Nursing, Management and Clinical Controllers to agree the
point at which stand down is called.
ACTION CARD
MEDICAL CONTROLLER
Tabard in Command and Control Centre – Medical Controller
This role will be undertaken by the Medical Director of the Trust or a nominated Deputy
The Medical Controller will be based in the Hospital Command and Control Centre and should be the medical point of contact for Senior Hospital Management in co-ordinating the hospital response to the incident.
On receipt of the instruction:-
"MAJOR INCIDENT DECLARED - ACTIVATE PLAN".
1. Contact Ambulance Control (Duty Officer) to obtain detailed information of the incident (Tel: 01384-215520).
2. Work with Nursing Controller and ascertain present bed state via Capacity Manager.
3. Inform Clinical Controllers of bed state and details of the incident. 4. Ensure adequate medical staffing of:-
Emergency Department Ward 410 – Admissions Ward Critical Care Unit
Theatres
Ambulatory Care level 0 CDU
Wards
5. Authorise cancellations of Theatre lists, TCI's, Outpatient Clinics as discussed and agreed by Control Centre Manager.
6. Liaise with Nursing, Management and Clinical Controllers to agree the point at which stand down is called.
ACTION CARD
LOGGIST
Tabard in Command and Control Centre – Loggist This role will be undertaken by designated personnel
The role of the Loggist is to record all key decisions taken or not taken by the decision maker
On receipt of the instruction:-
“MAJOR INCIDENT DECLARED- ACTIVATE PLAN”
1 Report to the Major Incident command and control room (Education Centre Level
1 seminar room 17)
2. Meet with control centre manager to ensure that clear guidance is given on what
they want you to log during the incident
3 Take out the Loggist box from the Major Incident cupboard
4 Commence Emergency Log book 101 (this may have initially been commenced
by whoever has opened the Command and Control centre, but will not be in any official format)
5. Refer to Loggist training manual for best practice
6. Use abbreviation list provided in Loggist box as required
7. After the incident or change of Loggist enter into a debrief with decision maker
and go through the log carefully ensuring this is signed off at the end
8. Following the debrief at the end of the incident ensure that all logs are locked
ACTION CARD
CLINICAL STAFF CONTROLLER)
(DUTY MEDICAL CONSULTANT.)
Tabard in Command and Control Centre – Clinical staff controller
This role will be undertaken by the Duty Medical Registrar until relieved
by the Duty Medical Consultant.
On receipt of the instruction:-
“MAJOR INCIDENT DECLARED- ACTIVATE PLAN”
1. Receive details of the incident from Command and Control centre. 2. Report to the Main Library Level 1, swipe access will be opened.
3. Co-ordinate all Medical staff to appropriate/priority areas during the incident. 4. Contact off duty Consultants in specialties relevant to the type of suspected
injuries from information pertaining to the incident, to ascertain their availability and request their attendance to the Main Library Level 1.
5. Designate and support the call out of all off-duty specialty Doctors to an assistant supplied to you.
6. Co-ordinate all Medical staff as they attend from outside the Trust.
7. Liaise with the clinical controller, Emergency Department, for staffing requirement.(ext 21609 /21607 )
8. Advise HR rep to check Trust ID and GMC numbers.
# SEND A TRAUMA TEAM TO THE EMERGENCY DEPARTMENT AS A MATTER OF PRIORITY #
Note:
Doctors Call out numbers will be kept up to date (by the Data Management Team) in the Command and Control room, Major Incident cupboard.
.Be aware that all Doctors on duty in the Hospital at the time of a Major Incident will automatically attend the Main Library Level 1, other than registrars who will have consultant tasks to perform until relieved by consultants.
ACTION CARD
CLINICAL CONTROLLER EMERGENCY
DEPARTMENT
Tabard in Command and Control Centre – Clinical Controller Emergency Department
This role will initially be undertaken by the Duty Emergency Department Specialist Registrar (SpR)/Middle Grade until relieved by the Duty Emergency Department Consultant.
The Clinical Controller Emergency Department will be based in the Emergency Department
On receipt of the instruction:-
"MAJOR INCIDENT DECLARED - ACTIVATE PLAN"
1. Ensure Emergency Department call out procedure is actioned for Doctors. Collect action card and tabard from Command and Control Centre (level 1 seminar room 17 education centre) and return to Emergency Department. 2. Commence or continue clearance of Emergency Department by admitting,
discharging or transferring existing patients as appropriate. 3. Allocate available medical staff:
To deal with immediate/urgent cases on a 1:1 basis where possible To Minor Injuries area (see and treat)
To body holding area (as a consideration) Triage Officer
4. Give advice on individual patient management in the Emergency department in conjunction with the Triage Officer.
5. Liaise with Medical Controller to obtain updated details of the incident. 6. Liaise with Clinical Controllers Critical Care, Theatres and Wards
7. Attend the ‘Bunker style’ meetings in conjunction with Trauma, Critical Care and Theatre Clinical Controllers. The initial meetings will be held within the Emergency Department, subsequent meetings will take place in the coordination centre, Theatres.
8. Liaise with Clinical staff controller (library) regarding Medical staffing requirements.
9. Receive the order to stand down from the Control Centre Manager and communicate this to other Emergency Department staff.
ACTION CARD
SENIOR NURSE EMERGENCY
DEPARTMENT
Tabard in Emergency Department – Senior Nurse Emergency Department
This role will be undertaken by the Senior Nurse on duty in the Emergency Department until relieved by the Emergency Department Nurse Manager. This Manager should not become involved with individual cases and will not co-ordinate the Emergency Department.
On receipt of the instruction:-
“MAJOR INCIDENT DECLARED – ACTIVATE PLAN”.
1. Initiate Emergency Department Staff Call-Out procedure if not already done so by ED Nurse Coordinator
2. Support the clearing of the Department as follows:-
Where admission or transfer has been arranged, admit or transfer.
Admit or transfer urgent cases requiring medical intervention. Discharge non-urgent cases home or to Ward West 4 to await
transport
Support ED Nurse Co-coordinator in allocating/making announcement to ED waiting room patients (see script card) 3. Activate the lock-down of ‘walking wounded’ entrance to Emergency
Department ( BBW helpdesk 777)
4. Liaise with Lead Nurse Minor Injuries (See and Treat). Prepare to clear clinic / area if necessary.
5. Support the allocation of Senior Emergency DepartmentNursing Staff to:- Triage point (Ambulance entrance)
Resuscitation Room Cubicles
Holding Area (ED VIEWING ROOM) Minor Injuries Area ( See and Treat)
6. Issue log sheets to staff when allocated to a patient / area
7. Liaise with Nursing Controller and assess extra staffing requirements 8. Supply immediate bed requirements and work in conjunction with ED
support manager
9. Liaise with Clinical Controller Emergency Department. Arrange for nursing staff to work on a 1 to 1 basis with medical staff/ patients.
10. Liaise with Emergency Department Reception Staff and establish patient log / ledger. Assist in collating the information on the log sheets held by the ED Lead Nurses for all areas, onto the main ED Coordinators patient log.
11. Oversee staffing requirements for the ED during and post incident
12. The Police Documentation Team will be based in the ED Seminar room. They will require access to patients and any accompanying persons, from the incident. The Police Documentation Team will require Identity information to be released to them from the Department, in addition to the copy of the Patient registration document from ED Reception. Support staff during this process.
ACTION CARD
CLINICAL CONTROLLER
CRITICAL CARE
Tabard in Control Room – Clinical Controller Critical Care
This role will be undertaken by the Critical Care Unit (CCU) registrar, until relieved by the duty CCU Consultant.
On receipt of the instruction:-
‘MAJOR INCIDENT DECLARED - ACTIVATE PLAN’
1. Go to Command and Control Room to collect Action Card and Tabard 2. Receive details of the incident and current bed state.
3. Report to Critical Care and oversee all areas. 4. Assess patients, identify those suitable for transfer.
5. Liaise with Clinical Controller in the Emergency Department to estimate number of critical care beds required and assistance required and Clinical Controller of theatres to deploy staff between Critical Care, Emergency Department and operating theatres as requested. Discuss staffing requirements with the Clinical Staff Controller in Staff Reporting Centre.
6. Liaise with Medical Controller regularly.
7. Liaise with Clinical Controller of wards to estimate number of beds available for Critical Care transfers.
8. Arrange discharge and preferred destination for existing Critical Care patients to be transferred to general wards, other Critical Cares or other hospitals as appropriate.
9. Attend the “BUNKER” style meetings in conjunction with Emergency Department, Trauma and Theatre Clinical controllers, the initial meetings will be held within the Emergency Department, subsequent meetings will take place in the Co-ordination Centre, Theatres
10. Co-ordinate and participate in medical management of admissions to Critical care
11. Receive stand down from Control Centre Manager and communicate to other staff.
ACTION CARD
CLINICAL CONTROLLER THEATRES
Tabard in Command and Control centre – Clinical Controller Theatres
This role will be undertaken by the first on-call anaesthetist for theatres until the duty anaesthetic consultant arrives or during the day by a senior anaesthetist present in the theatre suite.
On receipt of the instruction:-
‘MAJOR INCIDENT DECLARED - ACTIVATE PLAN’.
1. Go to Control Room to collect Action Card and tabard. 2. Receive details of the incident and current bed state.
3. Report to theatres. – Activate Local Action Cards in conjunction with Theatre Supervisor / Team Leader
4. Set up Theatre Co-Ordination centre in Office 15.
5. Consider suspending all operating except for previously booked
life-threatening emergencies following discussion with the Medical Controller in the Command and Control centre.
6. BBW will ensure that the Access Control will be De-activated in the event of a Major Incident.
7. Set up the Theatre Co-Ordination Point at Theatre / Recovery junction to allocate patients through to Theatres as they become available and staffed. 8. Clear recovery and liaise with Ward Controller who will allocate beds via
Capacity Manager.
9. In liaison with Clinical Controller Critical Care (level 2), deploy the available anaesthetic staff between operating theatres, and Emergency Department. 10. Arrange for the anaesthetic staffing of further operating theatres as they are
required, the Clinical Staff Controller will contact medical staffing as required. 11. Liaise with the Theatre Manager for Theatre suites regarding the call out of
additional theatre and recovery staff (The initial command for doing this will come from the Command and Control Centre Manager)
13. Attend the “BUNKER” style meetings in conjunction with Emergency Department, Trauma and Critical Care Clinical controllers, the initial meetings will be held within the Emergency Department, subsequent meetings will take place in the Co-ordination Centre, Theatres.
ACTION CARD
CLINICAL CONTROLLER MEDICAL
Wards
Tabard in Command and Control centre – Clinical Controller Medical Wards.
This role will be undertaken by the Duty Medicine Registrar until relieved by an available Medicine Consultant (NOT DUTY CONSULTANT)
On receipt of the instruction:-
"MAJOR INCIDENT DECLARED - ACTIVATE PLAN".
1. Report readiness to Clinical Staff Controller in Main library Level 1 and receive details of the incident and current bed state.
2. Initially have teams of medical staff assess for potential discharges/transfers. Once actioned by Medical Controller, Ensure discharge / transfer of patients is activated on all Wards using the teams of medical staff allocated to you by the Clinical Staff Controller.
Command and Control centre will advise of the discharge facilities available for patients awaiting discharge medicines and transport.
3. Liaise with The Clinical Staff Controller regularly for staff deployment. 4. Liaise with Clinical Controllers Emergency Department, Critical Care Unit 5. Liaise with Hospital Command and Control Centre to manage bed state
effectively.
6. Receive the order to stand down from the Control Centre Manager and cascade to staff
ACTION CARD
All CONSULTANT STAFF EXCEPT
CLINICAL CONTROLLERS
On receipt of the instruction:-
"MAJOR INCIDENT DECLARED - ACTIVATE PLAN".
1. Report to the Main Library Level 1, Education centre, QEHB.
2. Report to and liaise with the Staff Clinical Controller (Duty Medical Consultant) at all times
3. Areas which will require Consultant attention:-
- Clinical Decisions Unit
- Theatres
- Main Wards
- Secondary triage - Emergency Department
- Imaging Department Level 1 - Admission ward 410
- Critical Care Unit - Theatre reception - Minor Injuries Area – Emergency Department - Relief and support of colleagues
ACTION CARD
ALL JUNIOR DOCTORS AND MEDICAL
STUDENTS ALL SPECIALITIES
On receipt of the instruction:-
"MAJOR INCIDENT DECLARED - ACTIVATE PLAN".
IF OFF DUTY– You will be contacted to attend the Trust and report to the Main
Library Level 1 to await tasking/allocation. IF ON DUTY -
1. Report to Clinical Staff Controller in the Main Library Level 1 Education centre QEHB
.
2. You will be allocated to one of the four areas:-
- Main Emergency Department (immediate / urgent injuries) - See and Treat Area ED (minor injuries)
- Holding area in Emergency Department
- The main hospital under the direction of the Clinical Controllers.
3. Assist on management of patients in ED:-
- Ideally there will be at least one Doctor and one Nurse for
each patient. You may be required to act as a scribe for each of the ED teams.
- Unless otherwise instructed, stay with the patient you have been allocated.
- It is essential that ALL DRUGS AND FLUIDS administered to a patient are recorded on the appropriate charts.
- Advice on patient management should be sought from the Triage Officer or the Clinical Controller, Emergency Department.
ENSURE ALL DOCUMENTATION IS COMPLETED BEFORE LEAVING THE PATIENT. MEDICAL STUDENTS MAY BE ASKED TO ACT AS SCRIBES OR RUNNERS DURING THE INCIDENT
4. Please inform the Clinical Controller in your area should you need to leave your area before stand down is called.
5. The Clinical Controller in your area will inform you when the stand down is called.
ACTION CARD
EMERGENCY DEPARTMENT
RADIOLOGY CO-ORDINATOR
Tabard in Command and Control centre – ED Radiology Co-Ordinator
This role will be undertaken by the Group Manager or the most Senior/ Superintendent Radiographer available.
On receipt of the instruction:-
"MAJOR INCIDENT DECLARED - ACTIVATE PLAN".
1. Report to Medical Controller in Hospital Control Centre and then proceed to Emergency Department Imaging Department.
2. Make contact and identify a Lead Radiographer (ideally the Superintendent lead, alternatively the most Senior Radiographer available) in:
Emergency Department Imaging level 1 Main Imaging Department level 0
3. Ensure that Departmental Major incident procedure has been implemented and that all Superintendents are aware.
4. Confirm staffing levels in each Department are adequate and able to be flexed according to demand including across site.Out of hours, one or more of these roles may have to be combined according to numbers available and nature of the incident
5. Return to the Emergency Department and make contact with the Duty Consultant and Senior Nurse, Emergency Department. Agree a method of contact and establish a mechanism of regular communication.
6. As patients are triaged, continuously assess nature of injuries and therefore likely imaging requirements and by liaising with the Supt Leads, organise the flow of patients to and from Emergency Department to the Emergency Department Imaging, Main Imaging department as appropriate, as follows:
Emergency Department Imaging – major injuries/ highly dependant patients requiring plain film examinations
Emergency Department CT scanner – All major injuries requiring CT Main Imaging Dept. Level 0 – all walking wounded, some agreed low
dependency trolleys
Imaging Main Dept CT scanner ( level 0) – low dependency patients requiring CT
Control numbers according to patient dependency
7. In liaison with Superintendents, assess ongoing staffing requirements for night and following day shifts. As necessary, send staff off duty in order to ensure
continuity of cover.
ACTION CARD
CLINICAL CONTROLLER – TRAUMA
Tabard in Command and Control centre – Clinical Controller Trauma
This role will be undertaken by the duty Trauma Registrar until they are relieved by the duty Trauma Consultant.
On receipt of the instruction:-
"MAJOR INCIDENT DECLARED - ACTIVATE PLAN".
1. Record attendance in the Main Library Level 1, to the Clinical Staff Controller. Give an indication of the level and numbers of Trauma staffing you feel will be required initially to be called in. Report readiness to Medical Controller in Hospital Control Centre and receive details of the incident and current bed state.
2. Prepare to open the first emergency theatre by communicating with the Clinical Controller Theatres.
3. Ensure maximum discharge of patients from wards to the emergency discharge facility (ward west 4) by allocated SHO/ST1/ST2. Ward 410 will require early medical assistance to discharge or transfer patients to other bed capacity. The Capacity Manager will oversee Hospital capacity and the bed management team will liaise regarding capacity moves.
4. Report to Clinical Controller Emergency Department and assist with resuscitation until required in theatre.
5. Attend the “BUNKER” style meetings in conjunction with Emergency Department, Theatre and Critical Care Clinical controllers, the initial meetings will be held within the Emergency Department, subsequent meetings will take place in the Co-ordination Centre, Theatres.
5. Ensure supply and support of Trauma doctors to the Emergency Department team.
ACTION CARD
CLINICAL CONTROLLER BURNS AND
PLASTICS
Tabard in Command and Control centre – Clinical Controller Burns and Plastics
This role will be undertaken by the duty burns and plastics registrar until relieved by the duty burns and plastics consultant.
On receipt of the instruction:-
“MAJOR INCIDENT DECLARED – ACTIVATE PLAN”.
1. Report attendance in the Main Library Level 1 to the Clinical Staff Controller and then report readiness to Medical Controller in Hospital Control Centre and receive details of the incident and current bed state.
2. In the event of a burns incident, report to Burns Unit
3. The Duty Burns Consultant will liaise with the Command and Control Centre and instigate the Burns Major Incident Plan as appropriate. ( see Appendix C) 4. Prioritise patients for potential transfer to other wards or discharge where
appropriate
5. Remain on Burns Unit until relieved by Duty Burns & Plastic Consultant, then report to Clinical Staff Controller in the Main Library, Level 1 Education Centre for appropriate tasking.
6. For non- Burns related incidents, The Burns and Plastics teams will work under the direction of the Trauma Clinical Controller.
ACTION CARD
VASCULAR CONSULTANT ON CALL
This role will be undertaken by the Duty Registrar until relieved by the Vascular Consultant on call.
On receipt of the instruction:-
“MAJOR INCIDENT DECLARED – ACTIVATE PLAN”
1. Report to Clinical staff controller located in the Main Library Level 1 to register attendance.
.
2. Receive details of the incident and current bed state
3. Proceed to ED and report to ED Clinical Controller
4. Work as part of the multidisciplinary Resuscitation teams in ED, offering specialist assessment / advice.
ACTION CARD
CAPACITY MANAGER
THE ROLE OF CAPACITY MANAGER WILL BE ALLOCATED TO AN AVAILABLE ADN OR ON CALL MANAGER.
Tabard from Command and Control centre – Capacity Lead Manager
This role will be established as staffing becomes available. This manager will be based in the breakout room within the control centre structure.
1. Co-ordinate the capacity across both hospital sites in liaison with the bed managers / Senior Nurses / Hospital At Night Teams.
2. Maintain up to date records / flow board of patient admissions and movements within the Hospital.
3. Liaise with the Control Centre Manager and update on capacity issues. 4. Liaise with the Nursing and Medical Controller in the Control Room and
identify potential capacity needs (actual or potential) and staffing requirements.
5. Set up communication links with the bed managers to maintain up to date information on capacity within the Trust.
6. Await instructions to stand down from the Nurse controller in the Command and Control centre
ACTION CARD
BED MANAGER
The role of the Bed Manager will be undertaken by the Site CoOrdinator (QEHB) or (at night) by one of the Hospital at Night Team.
On receipt of the instruction:-
“MAJOR INCIDENT DECLARED – ACTIVATE PLAN”
1. Phone wards to obtain current bed situation, at the same time, notify wards of Major Incident.
2. Liaise with the CAPACITY MANAGER based in the Control Centre breakout rooms. (seminar rooms 16 & 18, Education Centre, Level 1)
3. By liaising with medical and nursing staff, obtain the following information: How many patients may be transferred to other Hospitals/Nursing
Homes
Availability of beds following discharges, making full use of discharge lounge
4. Inform the CAPACITY MANAGER in the Control Centre Break Out Rooms of any actual and potential issues regarding bed management.
5. Continue to work with Nurses In charge of wards to free beds and accommodate admissions.
6. Assess potential transfers from ward 410, and allocate beds accordingly ( as discussed with the Capacity Manager).
ACTION CARD
EMERGENCY DEPARTMENT SUPPORT
MANAGER.
Tabard from Command and Control centre – ED Support Manager.
This role will be undertaken by the on-call manager once allocated by the Control Centre Manager.
This Manager will be based in the Emergency Department and will respond to the requirements of the Emergency Department regarding capacity and patient flow issues.
1. Liaise with the Senior Nurse Controller ED and the ED Nurse Coordinator regarding issues of capacity and admissions of existing patients in the department.
2. Establish communications with the Capacity Manager regarding ED capacity for the incident.
3. Communicate the ED admission requirements to WARD 410, Critical Care, and Theatres etc directly to the Capacity Manager, who will update the Bed Managers and Control Centre Manager.
4. Collect copies of the ED Patient Registration Document from the ED
