ADVERSE WEATHER RESPONSE PLAN - INCORPORATING FLOODING, SNOW AND HEATWAVE ARRANGEMENTS - DTGP
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Emergency Preparedness, Resilience and Response Adverse Weather Response Plan Incorporating Flooding, Snow and Heatwave Arrangements This document is uncontrolled if printed, for the latest version please see the Trust’s Intranet
Document Control and Governance
Emergency Preparedness, Resilience and Response
Executive Division Owner
Chief Executive’s Office Service Transformation Nursing Finance
People and Business
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Development
Document Control Information
Workstream Business Continuity EPRR
Document Purpose: Policy / Strategy Supporting Guidance Operational Plan
Document Name: Adverse Weather Response Plan
Author: Head of Risk and Emergency Preparedness, Resilience and Response
• All staff and contractors within CPFT,
Target Audience:
• All staff within SERCO directly involved in providing services to CPFT,
This document will be shared with the following organisations:
• NHS England (East of England) Locality Team
Additional Circulation:
• Members of the Cambridgeshire and Peterborough Local Health Resilience
Partnership (LHRP).
• The Civil Contingencies Act (2004)
• The Health and Social Care Act (2012)
• NHS Standard Contract
• NHS Commissioning Board Business Continuity Management Framework
(service resilience) (2013)
• NHS Commissioning Board Command and Control Framework for the NHS
during significant incidents and emergencies (2015)
Cross Reference
• NHS Commissioning Board Core standards for Emergency Preparedness,
Resilience and Response (EPRR)
• BSI PAS 2015-Framework for Health Resilience
• Cabinet Office National Recovery Guidance
• NHS England Planning for the Shelter and Evacuation of people in
healthcare settings
• All internal CPFT EPRR and Business Continuity published guidance
Superseded Documents: This version supersedes all previous versions of this document.
Timing / Deadlines: For immediate implementation by all Directorate and Services
Head of EPRR and Risk
Cambridge and Peterborough NHS Foundation Trust
Contact Details for
Trust Headquarters, Elizabeth House, Fulbourn Hospital
further information
Cambridge, CB21 5EF
eprr@cpft.nhs.uk
This is a controlled document. Whilst this document may be printed, the
electronic version posted on the CPFT intranet is the controlled copy. Any
Document Status printed copies of this document are not controlled. As a controlled document,
this document must not be saved onto local or network drives but should
always be accessed from the CPFT intranet.
Version Control
Authoring Department: EPRR & Risk Management Version Number: Version 1.0
Author Title: Head of EPRR & Risk Published Date: February 2019 (CP83)
Authoriser Title: Accountable Emergency Officer Review Date: February 2021
Page 1 of 25
Version Control Information
Version Date Amendments Author
0.1 24/12/18 Document creation EPRR Consultant
0.2 25/01/19 Final Draft for approval EPRR Consultant
Addition of comments by Director of Corporate Affairs
0.3 28/01/19 EPRR Consultant
(AEO)
1.0 09/02/19 Final Document EPRR Consultant
Authoring Department: EPRR & Risk Management Version Number: Version 1.0
Author Title: Head of EPRR & Risk Published Date: February 2019 (CP83)
Authoriser Title: Accountable Emergency Officer Review Date: February 2021
Page 2 of 25Contents
Introduction ..................................................................................................................................................... 4
Adverse Weather Planning ............................................................................................................................. 4
Scope of Planning ........................................................................................................................................... 4
Aims & Objectives ........................................................................................................................................... 5
Vulnerable Patients ......................................................................................................................................... 5
Roles and Responsibilities .............................................................................................................................. 6
Activation and Response ................................................................................................................................ 6
Key Groups for Prioritisation ........................................................................................................................... 8
Communicating with Staff ............................................................................................................................... 9
Maintaining Trust Activity .............................................................................................................................. 10
Communications Messages .......................................................................................................................... 10
Response Arrangements .............................................................................................................................. 12
Recovery....................................................................................................................................................... 13
Appendix A – Summary of Cold Weather Actions ......................................................................................... 14
Appendix B – Heatwave Actions ................................................................................................................... 16
Appendix C – Heatwave Actions for Community and Individuals .............................................................. 17
Appendix D – Heatwave Alert Cascade ........................................................................................................ 18
Appendix E – Heatwave Trust Actions by Alert Level .................................................................................... 19
Appendix F - Cold Weather Trust Actions by Alert Level ............................................................................... 21
Appendix G – Staff Guidance - Working in Hot Weather ............................................................................... 24
Authoring Department: EPRR & Risk Management Version Number: Version 1.0
Author Title: Head of EPRR & Risk Published Date: February 2019 (CP83)
Authoriser Title: Accountable Emergency Officer Review Date: February 2021
Page 3 of 25Introduction
This document outlines and establishes the framework for responding to Adverse Weather events and
incidents for Cambridge and Peterborough NHS Foundation Trust. These procedures aim to be a reference
to provide information, a prompt for action, and summary of priorities and responsibilities in relation to these
incidents.
Adverse Weather Planning
Heatwave Planning
Heatwave planning within CPFT is aligned to the Heatwave Plan for England 2018. This plan is intended to
protect people who use our services, patients and visitors from heat-related harm to health. It aims to prepare
for, alert people to, and prevent, the major avoidable effects on health during periods of severe heat in
England.
CPFT’s plan builds on the depth of experience within the Trust and the wider NHS around developing and
improving the ability of the Trust to deal with significant periods of hot weather. There are significant changes
that will be taken into consideration to reflect the changes in the health, care and public health landscape.
This will assist the Trust in aligning planning activity with that undertaken relating to Cold Weather Planning,
and links to the Trust’s planning for severe heat with the Public Health Outcomes Framework.
Cold Weather Planning
Cold Weather Planning for CPFT is aligned to the Cold Weather Plan for England which is issued annually
to cover the period from September through to March. This plan is a framework intended to protect people
who use our services, staff and visitors from harm to health from cold weather.
It aims to prevent the major avoidable effects on health during periods of cold weather by alerting the above
groups to the negative health effects of cold weather and enabling them to prepare and respond
appropriately.
This will also cover the Trust’s response to flooding, snow and thunderstorms by providing a framework for
the notification, response and recovery from these sudden, often unforeseen adverse weather events.
Scope of Planning
General Scope
Any Adverse Weather event or incident affecting the Trust will require the activation of a multi-agency
response via the Local Resilience Forum and health partners. These types of events are varied in both their
nature and scale; this plan is designed to give responders at all levels within the Trust advice and guidance
in the event of Adverse Weather either affecting just CPFT, or as part of a wider response.
The plan’s focus is on the arrangements for the activation and response in relation to an adverse weather
incident or event, in line with the National Guidance provided by the Met Office and other relevant
organisations.
The plan is written to supplement and work in conjunction with the CPFT Incident Response Plan (IRP) and
should not be read or used in isolation but with the IRP. The plan links to, but does not replace, the plans
developed and held by Cambridge and Peterborough Local Resilience Forum, NHS England and Clinical
Commissioning Groups
Authoring Department: EPRR & Risk Management Version Number: Version 1.0
Author Title: Head of EPRR & Risk Published Date: February 2019 (CP83)
Authoriser Title: Accountable Emergency Officer Review Date: February 2021
Page 4 of 25Specific Scope
As the Trust is the main mental health provider for the populations of Cambridge and Peterborough, we will
seek to support all other health and social care providers with the mental health needs of their patients during
adverse weather events. This will involve providing support to evacuation centers, rest centers and other
support as required.
Aims & Objectives
The aim of this plan is to detail the policies and procedures employed by CPFT in response to the presence
of contaminated persons at one of the Trust’s sites.
The objectives of this plan are to describe the Trust’s plans for the provision of the following:
• Procedures and triggers for the activation of the plan;
• Command and control structures, including key links with partner agencies;
• Procedures for the appropriate notification of the effects of an adverse weather event or incident of staff
and patients;
• The specific roles and responsibilities;
Vulnerable Patients
Management of Vulnerable Patients
Within the Civil Contingencies Act (2004) the needs of vulnerable persons are recognised. These
individuals are defined as
“people present or resident within an area known to local responders who,
because of dependency or disability, need particular attention during
incidents”.
Vulnerable persons could therefore include children and older people; BAME communities, particularly
those for whom English is a second language, and people with disabilities, including physical disabilities
and impairments, learning disabilities, mental illness and those with complex physical and/or mental health
needs.
Black and Minority Ethnic Communities
Care will be taken when producing and distributing information to ensure that it is accessible to all. This
may necessitate the production of translated materials, the use of health advocates, and the use of
interpreting services.
Children
Many major incidents involve children, and, in some cases, children are the main casualties. Children
have special needs that are different from adults in terms of their size, physiology and psychological
needs – all of which have an impact on their care.
The On-Call Managers and the Incident management Team will need to consider and take account of
the children’s needs in planning and response to a major incident. Special consideration must be given
to schools, nurseries, childcare centres and psycho-social support for children.
People with inhibited physical ability
Authoring Department: EPRR & Risk Management Version Number: Version 1.0
Author Title: Head of EPRR & Risk Published Date: February 2019 (CP83)
Authoriser Title: Accountable Emergency Officer Review Date: February 2021
Page 5 of 25This may be by reason of age, illness, disability, pregnancy or other reason. Attention should be paid to
hospitals, residential homes, care homes and day centres likely to be housing any people with inhibited
physical ability, who may be at risk of higher acuity mental health problems.
Access to the records of residents in the community who have inhibited physical ability is also important
and may be achieved in partnership with other services e.g. social and community providers.
People with learning disabilities and people with mental illness
The Trust will respond as appropriate in order to assist people with learning disabilities or mental illness
by using existing facilities and arrangements wherever possible. If there is a need for additional or
specialist assistance, then help will be sought from wider health partners as appropriate.
Specific Advice – Ramadan
Many members of the Muslim community may be fasting during the daylight hours in the month of Ramadan
(which is determined by the lunar Islamic calendar). All staff within the Trust, especially those working within
community services and on the 24/7 Crisis Support Line should familiarise themselves with the dates of
Ramadan each year, following notification from the Equality and Diversity team. The Trust will build
appropriate actions into contingency plans if it falls during the summer months or a period of sustained heat.
For the Muslim Community, it is common to have one meal just before sunrise and an evening meal after
sunset during Ramadan. During hot weather, dehydration is a common and serious risk. It’s important to
balance food and fluid intake between fasts and especially to drink enough water.
The advice for Muslim’s celebrating Ramadan, in the event of feeling unwell, disoriented or confused, or
collapse or faint, is to stop fasting and have a drink of water or other fluid. This is especially important for
older adults, those with poorly controlled medical conditions such as low/high blood pressure, diabetes and
those who are receiving dialysis treatment.
The Muslim Council of Britain has confirmed that breaking fast in such conditions is allowable under Islamic
law. Staff on community visits must make sure they check on relatives of people who use our services in the
community who may be at greater risk and keep an eye on children to ensure they are having a safe and
healthy Ramadan.
Guidance has been produced to help ensure that members of the Muslim community have a safe and healthy
Ramadan – Ramadan Health Guide: A guide to healthy fasting produced in association with the NHS.
Roles and Responsibilities
The roles and responsibilities will be as described in the Trust’s Incident Response Plan, which can be
obtained through the Risk and EPRR Team.
Activation and Response
Met Office Alerts
The Trust will monitor the Heatwave warnings issued by the National Severe Weather Warning Service
(NSWWS) alongside utilising the following services to inform activation of the plan and appropriate response:
Authoring Department: EPRR & Risk Management Version Number: Version 1.0
Author Title: Head of EPRR & Risk Published Date: February 2019 (CP83)
Authoriser Title: Accountable Emergency Officer Review Date: February 2021
Page 6 of 25Service Purpose Timing
• To provide early warning of high temperatures. The alert Alert issued as soon
levels have been set with thresholds known to cause ill as agreed threshold
health from severe hot weather. has been reached
Heatwave • They are to help ensure that healthcare staff and resources and when there is a
warning are fully prepared for hot weather periods that might impact change in alert level.
on health and; Issued between 1
• to raise awareness for those individuals who are more June
vulnerable to hot weather conditions. and 15 September
Twice a week (9am
Heatwave
To provide advice throughout the summer period relating to high each Monday and
planning
temperatures. Friday from 1 June
advice
to 15 September)
To provide warnings of severe or hazardous weather that has
the potential to cause danger to life or widespread disruption.
National
These warnings are issued to:
Severe
Weather
• the public, to prompt consideration of actions they may need When required
Warning
to take
Service
• emergency responders, to trigger their plans to protect the
(NSWWS)
public from impacts in advance of an event, and to help them
recover from any impacts after the event
General
To enable the public to make informed decisions about their day
weather Every day
to day activities
forecasts
Heatwave Threshold Temperatures for Activation
In the event that any of the threshold maximum day and night temperatures defined by the NSWWS region
are reached, the Trust will stand up the Adverse Weather Plan and the Adverse Weather Surveillance Group
(which is co-ordinated by the Risk and EPRR team in conjunction with the Director on Call):
Maximum temperatures (°C)
National Severe Weather Warning Service Region Day Night
East of England 32 18
Cold Weather Threshold Temperatures for Activation
In the event that either of the following criteria are met the Trust will stand up the Adverse Weather Plan and
the Adverse Weather Surveillance Group (which is co-ordinated by the Risk and EPRR team in conjunction
with the Director on Call):
Minimum Temperatures for Activation
Mean temperatures of 2°C and/or widespread ice and heavy snow is predicted with 60% confidence
Mean temperatures of 2°C and/or widespread ice and heavy snow has occurred
Authoring Department: EPRR & Risk Management Version Number: Version 1.0
Author Title: Head of EPRR & Risk Published Date: February 2019 (CP83)
Authoriser Title: Accountable Emergency Officer Review Date: February 2021
Page 7 of 25Adverse Weather Surveillance Group
The Trust will operate an adverse weather surveillance group all year round with responsibility for oversight
and planning for adverse weather and the Trust’s response. Core membership of the group will be as per the
list below, however this will be flexed as required dependant on the nature of the adverse weather event
forecast:
Trust Accountable Emergency Officer Director of Operations
Head of Communications Head of Risk and EPRR
Director of Estates and Facilities Cambridge and Peterborough CCG
Director of Workforce NHS England – East of England
The Group can meet either on a virtual or face to face basis for all Level 1 and 2 alerts that are issued.
In the event of a Level 3 or Level 4 alert being issued, the Group will meet face to face and will act as a
specialist sub-group of the Trust’s Tactical Coordination Group with responsibility for advising on all matters
relating to Adverse Weather response arrangements.
Key Groups for Prioritisation
Cold Weather
The following key groups have been identified for prioritisation in event of a cold weather spell and cold
weather alerts being issued. All of the identified categories are of key importance to CPFT as a mental and
physical health provider.
• older people (those over 75 years old, otherwise frail, and or socially isolated)
• people with pre-existing chronic medical conditions such as heart disease, stroke or TIA,
asthma, chronic obstructive pulmonary disease or diabetes
• people with mental ill-health that reduces individual’s ability to self-care (including dementia)
• pregnant women (in view of potential impact of cold on foetus)
• children under the age of five
• people with learning difficulties
• people assessed as being at risk of, or having had, recurrent falls
• people who are housebound or otherwise low mobility
• people living in deprived circumstances
• people living in houses with mould
• people who are fuel poor
• homeless or people sleeping rough (many of these also suffer with mental health conditions)
• other marginalised or socially isolated individuals or groups
The Trust will use the current arrangements in place to pull off and extract relevant lists from Trust patient
data systems for use when identifying patients for prioritisation.
Heatwave
Like the groups previously highlighted, the Trust will utilise a similar approach when identifying key groups of
patients for prioritisation.
Authoring Department: EPRR & Risk Management Version Number: Version 1.0
Author Title: Head of EPRR & Risk Published Date: February 2019 (CP83)
Authoriser Title: Accountable Emergency Officer Review Date: February 2021
Page 8 of 25As for the Cold Weather planning, The Trust will use the current arrangements in place to pull off and extract
relevant lists from Trust patient data systems for use when identifying patients for prioritisation.
The Trust will also provide additional support and enhanced checks on all patients referred to CPFT during
both Heatwave and Cold Weather periods in support of the wider Health and Social Care community through
the relevant Cambridge and Peterborough Local Resilience Forum plans.
Communicating with Staff
The Trust’s Communications & Engagement Team is responsible for ensuring that clear and timely messages
are made available for CPFT staff regarding the Trust’s plans and actions in response to an adverse weather
event. This includes prior communication in order to educate and prepare staff members as well as
communicating during a response.
Whilst these messages will be prepared and distributed by the Communications & Engagement Team it is
the responsibility of directorates and heads of department to ensure that they are made available to all staff
and that staff understand their responsibilities in relation to the information provided.
Staff should be encouraged to check local news websites and other official social media sources for travel
information relating to their journey to and from work and discuss concerns with line managers earlier rather
than later.
Attending Trust Locations
During an adverse weather event staff will be expected to, wherever possible, make all reasonable efforts to
safely make their own way to their place of work. As transport issues are generally confined to the ‘first
100yds’ of staff members journeys, the following actions will alleviate many of the potential reasons for non-
attendance:
• Not parking cars on sloping driveways.
• Parking on roads that are on priority gritting routes and walking to and from your car.
• Making contact with colleagues who live nearby to arrange car shares.
• Checking and using public transport services.
• Staff living within the immediate locality of the site are encouraged, where it is safe to do so, to walk to
work.
4x4 Volunteer Transport
Where staff are unable to utilise public transport or walk to site and they meet the criteria their line manager
may request that a 4x4 vehicle is sent to collect them in line with the current arrangements in place through
the Cambridge and Peterborough Local Resilience Forum. As this service is provided by a volunteer group
and is shared with other local agencies its availability cannot be guaranteed and managers should not rely
on it. It should also be noted that any abuse of this service is likely to result in its withdrawal.
Managers wishing to use the service should contact the appropriate manager with the staff member’s
location, role and reason for needing the service. The 4x4 volunteer groups will only accept requests from
the named manager or Head of Risk & EPRR.
Emergency Accommodation
In the event that staff are unable to travel home after their shift due to the situation, weather conditions, or if
their shift patterns makes travel home unrealistic, Associate Directors (in-hours) and Trust On-call Directors
Authoring Department: EPRR & Risk Management Version Number: Version 1.0
Author Title: Head of EPRR & Risk Published Date: February 2019 (CP83)
Authoriser Title: Accountable Emergency Officer Review Date: February 2021
Page 9 of 25(out of hours) may authorise the provision of trust-funded emergency accommodation or taxi services (if
appropriate).
Maintaining Trust Activity
Business Continuity
It is the responsibility of all directorates to establish and maintain business continuity plans. These should
identify and plan to maintain the directorate’s critical functions. During adverse weather events these plans
will allow the directorate to manage its activity with the potentially limited resources available. All directorates
will ensure that the Adverse Weather Meeting is kept informed as to its current ability to deliver its critical
functions.
Should one or more directorates declare an inability to maintain its functions, it is the responsibility of the
Adverse Weather Surveillance Group in conjunction with the On-Call Director to arrange Trust-wide
distribution of staff and prioritising of functions.
Cancelation of Activity
During an adverse weather event it may be necessary to cancel some clinics and activity due to:
• A significant reduction of resources and staffing
• A significant reduction in attendance
• For the safety of patients and staff
All community activity should must be reviewed, taking into account the available resources and safety of
staff and patients (for example, does cancellation increase or decrease journeys?)
Any decision to cancel or postpone planned clinics or procedures should be made by the directorate
manager, clinical director and head nurse with the support of the relevant Director and reported to the Adverse
Weather Surveillance Group at the earliest opportunity.
Communications Messages
Heatwave
Level 1: summer preparedness and long-term planning
The Trust’s Heatwave Planning Cycle commences in April and the Trust will stand-up the Adverse Weather
Surveillance Group from 1 June to 31 September. The Trust will not issue any internal warnings, unless the
situation worsens to warrant a level 2 alert being issued by the Met Office.
“If this does turn out to be a heatwave, we’ll try to give you as much warning as possible. But in the
meantime, if you are worried about what to do, either for yourself or somebody you know who you
think might be at risk, for advice go to NHS Choices at www.nhs.uk/summerhealth. Alternatively,
ring NHS 111. In the event that you require support with managing your condition, please
contact the 24/7 crisis line and a member of our team will be happy to help. “
No warning will be issued by the Trust unless there is a 60 per cent probability of the situation reaching Level 2
for the East of England within the next three days.:
Level 2: alert and readiness
Authoring Department: EPRR & Risk Management Version Number: Version 1.0
Author Title: Head of EPRR & Risk Published Date: February 2019 (CP83)
Authoriser Title: Accountable Emergency Officer Review Date: February 2021
Page 10 of 25In the event of a Level 2 alert being issued by the Met Office, the Trust will stand up the Adverse Weather
Surveillance Group to daily virtual meetings and will arrange for the following messages to be disseminated
to all staff and people who use our services.
This will be supported through additional support through our Community Teams.
“Heatwaves can be dangerous, especially for the very young or very old or those with chronic
disease. Advice on how to reduce the risk either for yourself or somebody you know can be
obtained from NHS Choices at www.nhs.uk/summerhealth, NHS 111 or from your local chemist.
In the event that you require support with managing your condition, please contact the 24/7
crisis line and a member of our team will be happy to help. “
Level 3 and 4: heatwave action/emergency
In the event of a Level 3 or 4 alert being issued by the Met Office, the Trust will stand up the Adverse Weather
Surveillance Group to daily meetings and will enact the Trust’s Major Incident arrangements. The Trust will
arrange for the following messages to be disseminated to all staff and people who use our services.
This will be supported through additional support through our Community Teams.
“Stay out of the sun. Keep your home as cool as possible – shading windows and shutting them
during the day may help. Open them when it is cooler at night. Keep drinking fluids. In the event
that you require support with managing your condition, please contact the 24/7 crisis line and a
member of our team will be happy to help. “
Cold Weather
Level 1: Winter preparedness and action
The Trust’s Cold Weather Planning Cycle commences in September and when necessary, the Trust will
stand-up a Adverse Weather Surveillance Group from 1 November to 31 March. The Trust will not issue any
internal warnings, unless the situation worsens to warrant a level 2 alert being issued by the Met Office.
In the event of the forecast predicting a spell of chilly weather the Trust will issue the following message:
“If this does turn out to be a spell of severe cold weather, we’ll try to give you as much warning
as possible. But in the meantime, if you want advice about protecting your health from the cold
go to the winter health pages at NHS Choices (www.nhs.uk). In the event that you require
support with managing your condition, please contact the 24/7 crisis line and a member of our
team will be happy to help. “
Level 2: Alert and readiness
In the event of a Level 2 alert being issued by the Met Office, the Trust will stand up the Winter Surveillance
Group to daily virtual meetings and will arrange for the following messages to be disseminated to all staff and
people who use our services. This will be supported through additional support through our Community
Teams.
Authoring Department: EPRR & Risk Management Version Number: Version 1.0
Author Title: Head of EPRR & Risk Published Date: February 2019 (CP83)
Authoriser Title: Accountable Emergency Officer Review Date: February 2021
Page 11 of 25“Severe cold weather can be dangerous, especially for the very young or very old or those with
chronic disease. Advice on how to reduce the risk either for yourself or somebody you know can
be obtained from the winter health pages at NHS Choices (www.nhs.uk) or from your local
chemist. In the event that you require support with managing your condition, please contact
the 24/7 crisis line and a member of our team will be happy to help. “
Level 3 and 4: Severe cold weather action/emergency
In the event of a Level 3 or 4 alert being issued by the Met Office, the Trust will stand up the Winter
Surveillance Group to daily meetings and will enact the Trust’s Major Incident arrangements. The Trust will
arrange for the following messages to be disseminated to all staff and people who use our services. This will
be supported through additional support through our Community Teams.
“Make sure that you stay warm. If going outside, make sure you dress appropriately. If indoors,
make sure that you keep your heating to the right temperature; heating your home to at least
18°C in winter poses minimal risk to your health when you are wearing suitable clothing. If there
is anyone you know who might be at special risk, for example, an older person living on their
own, make sure they know what to do to stay warm and are well stocked with food and
medications. In the event that you require support with managing your condition, please
contact the 24/7 crisis line and a member of our team will be happy to help. “
Response Arrangements
Command and Control
The Trust will stand up a Business Continuity Incident and the associated Command and Control Framework
in the event that a Level 3 or 4 warning is issued.
The Tactical Coordination Group chaired by the nominated Manager On-Call, who will lead the response for
CPFT with a virtual Strategic Coordination Group in operation to support the Trust as required.
The Command and Control arrangements will follow the arrangements within the Major Incident Plan.
Key Priorities - Heatwave
The key priorities for CPFT during any response to an Adverse Weather Event are:
• Reduce the risks to health to our staff, visitors and people who use our services from prolonged exposure
to severe heat.
• Raise awareness and trigger appropriate actions to support people who have mental health, or associated
circumstances that increase their vulnerability to heat.
• To providing guidance to our staff on how to prepare for and respond to a heatwave
• To provide psycho-social support to health and social care partners in managing the needs of vulnerable
patients as required.
Key Priorities – Cold Weather
Authoring Department: EPRR & Risk Management Version Number: Version 1.0
Author Title: Head of EPRR & Risk Published Date: February 2019 (CP83)
Authoriser Title: Accountable Emergency Officer Review Date: February 2021
Page 12 of 25The key priorities for CPFT during any response to an Adverse Weather Event are:
• Reduce the risks to health to our staff, visitors and people who use our services from prolonged exposure
to cold weather, snow or flooding.
• Raise awareness and trigger appropriate actions to support people who have mental health, or associated
circumstances that increase their vulnerability to heat.
• To providing guidance to our staff on how to prepare for and respond to a cold weather, snow or flooding.
• To provide psycho-social support to health and social care partners in managing the needs of vulnerable
patients as required.
Specific Actions – Heatwave
In the event of a Level 3 or 4 Heatwave alert being issued, the actions in the Action Card within the Director
and Manager On-Call Pack will be followed, in addition the following key priorities will be considered:
• Identification of additional cooling required within public, office and in-patient areas to ensure the
temperature remains at acceptable levels;
• Review of visiting times to ensure visiting can take place during the cooler part of the day;
• Review of staffing work arrangements and implement work from home where possible to avoid need for
staff to travel unnecessarily;
• Cancellation of all non-essential meetings and training;
• Review of cooling arrangements for IT Infrastructure to ensure service continuation;
• Cancellation of non-prioritised services as per Business Continuity Plans.
Specific Actions – Flooding
In the event of a Flooding Alert being issued, the actions within the Action Card within the Director and
Manager On-Call Pack will be followed, in addition the following key priorities will be considered:
• Review of all sites to ascertain the risk of flooding and take any necessary action to preserve life.
• Support to Local Authority and Health & Social Care partners in managing the impact on vulnerable
patients.
Specific Actions – Snow
• Ensuring that all sites have appropriate gritting and snow clearance arrangements to ensure continued
access to prioritised services.
• Cancellation of all non-essential community work and diversion of patients towards the 24/7 Crisis Line.
Recovery
Following from an adverse weather event, there may be a significant amount of remediation work that will
need to be carried out. Recovery arrangements to return to the new normality will be coordinated through the
Trust’s Recovery Working Group, chaired by the Strategic Commander.
Authoring Department: EPRR & Risk Management Version Number: Version 1.0
Author Title: Head of EPRR & Risk Published Date: February 2019 (CP83)
Authoriser Title: Accountable Emergency Officer Review Date: February 2021
Page 13 of 25Appendix A – Summary of Cold Weather Actions
Level 0 Level 1 Level 2 Level 3 Level 4
Severe winter weather
Winter preparedness forecast - Alert and Severe weather action
Year-round planning readiness Major incident –
All Year and action Mean temperatures of 2°C and/or
Emergency response
1 November to 31 March Mean temperatures of 2°C and/or widespread ice and heavy snow
widespread ice and heavy snow
predicted with 60% confidence
Provider organisations
1. Ensure organisation can identify
1. Ensure cold weather alerts are
and support most vulnerable. 1. Continue level 1 actions. 1. Continue level 2.
going to right staff and actions
2. Plan for joined up support with 2. Ensure carers receiving support and 2. Implement emergency and
agreed and implemented.
partner organisations. advice. business continuity plans; expect
2. Ensure staff in all settings are
3. Work with partners and staff on risk 3. Activate business continuity surge in demand in near future.
considering room temperature.
reduction awareness (eg flu arrangements as required; plan for 3. Implement local plans to ensure
3. Ensure data sharing and referral
vaccinations, signposting for winter surge in demand. vulnerable people contacted.
arrangements in place.
warmth initiatives).
1. Level 4 alert issued at national
level in light of cross-government
assessment of the weather
1. Continue level 1 actions. conditions, coordinated by the Civil
2. Consider prioritising those most Contingencies Secretariat (CCS)
Frontline staff – care facilities and
vulnerable and provide advice as based in the Cabinet Office.
appropriate.
3. Check room temperatures and 2. All level 3 responsibilities to be
1. Use patient contact to identify ensure urgent referral as maintained unless advised to the
vulnerable people and advise of 1. Identify vulnerable clients on appropriate. contrary.
cold weather actions; be aware of caseload; ensure care plans
community
1. Continue level 2 actions.
referral mechanisms for winter incorporate cold risk reduction.
2. Implement emergency and
warmth and data sharing 2. Check room temperatures and
business continuity plans; expect
procedures. ensure referral as appropriate.
surge in demand in near future.
2. Ensure awareness of health effects 3. Signpost clients to other services
3. Prioritise those most vulnerable.
of cold and how to spot symptoms. using ‘Keep Warm Keep Well’
3. Encourage colleagues/clients to booklet.
have flu vaccinations.
Authoring Department: EPRR & Risk Management Version Number: Version 1.0
Author Title: Head of EPRR & Risk Published Date: February 2019 (CP83)
Authoriser Title: Accountable Emergency Officer Review Date: February 2021
Page 14 of 25Level 0 Level 1 Level 2 Level 3 Level 4
Severe winter weather
Winter preparedness forecast - Alert and Severe weather action
Year-round planning readiness Major incident –
All Year and action Mean temperatures of 2°C and/or
Emergency response
1 November to 31 March Mean temperatures of 2°C and/or widespread ice and heavy snow
widespread ice and heavy snow
predicted with 60% confidence
1. Seek good advice about improving
1. If you are receiving social care or
the energy efficiency of your home 1. Continue to have regular contact
health services ask your GP, key
and staying warm in winter; have with vulnerable people and
worker or other contact about 1. Continue level 2 actions.
all gas, solid fuel and oil burning neighbours you know to be at risk
Individuals
staying healthy in winter and 2. Dress warmly; take warm food
appliances serviced by an in cold weather.
services available to you. drinks regularly; keep active. If you Follow key public health and
appropriately registered engineer. 2. Stay tuned into the weather forecast
1.
2. Check room temperatures – have to go out, take appropriate weather alert messages as
2. Check your entitlements and ensure you are stocked with food
especially those rooms where precautions. broadcast on the media.
benefits; seek income and medications in advance.
disabled or vulnerable people 3. Check on those you know are at
maximisation advice and other 3. Take the weather into account when
spend most of their time risk.
services. planning your activity over the
3. Look out for vulnerable neighbours
3. Get a flu jab if you are in a risk following days.
and help them prepare for winter.
group (September/October).
Community and voluntary
1. Engage with local statutory
1. Test community emergency
partners to agree how VCS can 1. Level 4 alert issued at national
plans to ensure that roles,
contribute to local community 1. Activate the community level in light of cross-government
responsibilities and actions 1. Continue level 2 actions.
resilience arrangements. emergency plan. assessment of the weather
are clear. 2. Ensure volunteers are
2. Develop a community 2. Activate the business conditions, coordinated by the
sector
2. Set up rotas of volunteers to appropriately supported. Civil Contingencies Secretariat
emergency plan to identify continuity plan.
keep the community safe in 3. Contact vulnerable people to (CCS) based in the Cabinet
and support vulnerable 3. Continue to actively engage
cold weather and check on ensure they are safe and well and Office.
neighbours. vulnerable people known to be at
vulnerable people. support them to seek help if 2. All level 3 responsibilities to be
3. Agree arrangements with other risk and check on welfare
3. Actively engage with vulnerable necessary. maintained unless advised to the
community groups to maximise regularly.
people and support them to seek contrary
service for and contact with
help.
vulnerable people.
Authoring Department: EPRR & Risk Management Version Number: Version 1.0
Author Title: Head of EPRR & Risk Published Date: February 2019 (CP83)
Authoriser Title: Accountable Emergency Officer Review Date: February 2021
Page 15 of 25Appendix B – Heatwave Actions
Level 0 Level 1 Level 2 Level 3 Level 4
Heatwave is forecast – alert and Heatwave action
Heatwave and summer preparedness
Long-term planning readiness Temperature reached in one or more Met Major incident – emergency
programme
All year 60% risk of heatwave Office National Severe Weather Warning response
1 June to 15 September
in the next 2 to 3 days Service regions
Professional staff (all settings):
Professional staff (all settings): Professional staff (all settings):
1. develop systems to identify and Professional staff (all settings):
1. identify high-risk individuals on your 1. visit/phone high-risk people
improve resilience of high-risk 1. check high-risk people have visitor/
caseload and raise awareness of reconfirm key public health
individuals phone call arrangements in place
heat illnesses and their prevention messages to clients
2. request an HHSRS assessment reconfirm key public health
among clients and carers (see key 2. advise carers to contact GP if
from EH for clients at particular risk messages to clients
public health messages – box 1) 3. concerns re health
encourage cycling/walking where 2. check client’s room temperature if
2. include risk in care records and Care homes and hospitals:
possible to reduce heat levels and visiting
consider whether changes might be 1. activate plans to maintain business
3. poor air quality in urban areas Care homes and hospitals: National emergency
necessary to care plans in the event of continuity – including a possible
Care homes and hospitals: 1. check indoor temperatures are 1. Continue actions as per Level 3
a heatwave (e.g. initiating daily visits surge in demand
1. work with commissioners to develop recorded regularly during the hottest unless advised to the contrary
by formal or informal care givers for 2. check indoor temperatures are
longer term plans to prepare for periods for all areas where patients 2. Central government will declare a
those living alone) recorded regularly during the hottest
heatwaves reside Level 4 alert in the event of
Care homes and hospitals: periods for all areas where patients
2. make environmental improvements to 2. ensure cool areas are below 26°C severe or prolonged heatwave
1. ensure business continuity plans are reside
provide a safe environment for review and prioritise high-risk people affecting sectors other than health
in place and implement as required; 3. ensure staff can help and advise
clients in the event of a heatwave ensure sufficient cold water and ice and if requiring coordinated multi-
ensure appropriate contact details clients including access to cool
3. prepare business continuity plans to 3. consider weighing clients regularly to agency response
are provided to LA/NHS emergency rooms, close monitoring of
cover the event of a heatwave (eg identify dehydration and
planning officersto facilitate transfer vulnerable individuals, reducing
storage of medicines, computer rescheduling physio to cooler hours
of emergency information internal temperatures through
resilience, etc) 4. communicate alerts to staff and
2. identify or create cool rooms/areas shading, turning off unnecessary
4. work with partners and staff to raise make sure that they are aware of
3. (able to be maintained below 26°C) lights/equipment,coolingbuildingat
awareness of the impacts of severe heatwave plans
4. install thermometers where night, ensuring discharge planning
heat and on risk reduction 5. ensure sufficient staffing
vulnerable individuals spend takes home temperatures and
awareness (key public health 6. implement business continuity
substantial time support into account
messages – box 1)
High-risk groups
Community: Over 75, female, living on own and isolated, severe physical or mental illness; urban areas, south-facing top flat; alcohol and/or drug dependency, homeless, babies and young children, multiple medications and
over-exertion
Care home or hospital: over 75, female, frail, severe physical or mental illness; multiple medications; babies and young children (hospitals).
*Because Level 2 is based on a prediction, there may be jumps between levels. Following Level 3, wait until temperatures cool to Level 1 before stopping Level 3 actions.
** Level 4: A decision to issue a Level 4 alert at national level will be taken in light of a cross-government assessment of the weather conditions, co-ordinated by the Civil Contingencies Secretariat
Authoring Department: EPRR & Risk Management Version Number: Version 1.0
Author Title: Head of EPRR & Risk Published Date: February 2019 (CP83)
Authoriser Title: Accountable Emergency Officer Review Date: February 2021
Page 16 of 25Appendix C – Heatwave Actions for Community and Individuals
Level 0 Level 1 Level 2 Level 3 Level 4
Heatwave is forecast – alert and Heatwave action
Heatwave and summer
Long-term planning readiness Temperature reached in one or more Major incident – emergency
preparedness programme
All year 60% risk of heatwave Met Office National Severe Weather response
1 June to 15 September
in the next 2 to 3 days Warning Service regions
Community:
1. develop a community emergency
plan to identify and support Community:
vulnerable neighbours in event of a Community: 1. keep an eye on people you know to
heatwave. 1. further develop community be at risk
2. assess the impact a heatwave might emergency plan 2. stay tuned into the weather forecast
have on the provision and use of 2. support the provision of good and keep stocked with food and National emergency
usual community venues. information about health risks medications Community: 1. Continue actions as per Level 3
3. support those at-risk to make sure especially with those vulnerable 3. check ambient room temperatures 1. activate community emergency unless advised to the contrary
they are receiving the benefits they groups and individuals (see key Individuals: plan check those you know are at 2. Central government will declare a
are entitled to. public health messages – box 1) 4. stay tuned into the weather forecast risk Level 4 alert in the event of
Individuals: Individuals: check ambient room temperatures Individuals: severe or prolonged heatwave
1. make environmental improvements 1. find good information about health especially those rooms where 1. follow key public health messages affecting sectors other than health
inside and outside the house which risks and key public health disabled or high-risk individuals check those you know are at risk and if requiring coordinated multi-
reduce internal energy and heat messages to stay healthy during spend most of their time agency response
2. install loft and wall insulation spells of severe heat (see key public 5. keep an eye on people you know to
3. identify cool areas in the house to health messages box 1) be at risk – ensure they have access
use in the event of a heatwave 2. look out for vulnerable neighbours to plenty of cool liquids
4. If on medications, ensure that these 6. look out for vulnerable neighbours
can be stored at safe levels in a
heatwave
High-risk groups
Community: Over 75, female, living on own and isolated, severe physical or mental illness; urban areas, south-facing top flat; alcohol and/or drug dependency, homeless, babies and young children, multiple
medications and over-exertion
Care home or hospital: over 75, female, frail, severe physical or mental illness; multiple medications; babies and young children (hospitals).
*Because Level 2 is based on a prediction, there may be jumps between levels. Following Level 3, wait until temperatures cool to Level 1 before stopping Level 3 actions.
** Level 4: A decision to issue a Level 4 alert at national level will be taken in light of a cross-government assessment of the weather conditions, co-ordinated by the Civil Contingencies Secretariat
Authoring Department: EPRR & Risk Management Version Number: Version 1.0
Author Title: Head of EPRR & Risk Published Date: February 2019 (CP83)
Authoriser Title: Accountable Emergency Officer Review Date: February 2021
Page 17 of 25OFFICIAL - SENSITIVE
Appendix D – Heatwave Alert Cascade
Notes
• ‡NHS England Regional and CCGs should work collaboratively to ensure that between them they have a cascade mechanism for heatwave
alerts to all providers of NHS commissioned care both in business as usual hours and the out of hours period in their area.
• *PHE Centres would be expected to liaise with Directors of Public Health to offer support, but formal alerting would be expected through
usual local authority channels.
• †LHRPs and HWBs are strategic and planning bodies but may wish to be included in local alert cascades .
Civil Public, via media
Contingencies eg TV, radio,
Secretariat newspapers
Summer
Resilience Department
Network of Health
Public Health
Other England
government
departments
and agencies
Social
NHS England Local Authority
Services
(CE/ DASS/DCS/
Corporate Emergency Planner) Schools
NHS Choices Team
and Directors Residential
of Public homes
Ambulance trusts Health* Nurseries
Regional Teams
and
Inc. Local kindergartens
Resilience
Pharmacies Forums and Voluntary
Regional‡ organisations
(Local Health
GPs and district
Resilience
nurses Day care
Partnerships†)
centres
Hospital trusts
Walk in centres
Clinical
Community health commissioning Health and
service providers
groups (CCGs)‡ Wellbeing
Mental health Boards†
trusts
Care and nursing
homes
Authoring Department: EPRR & Risk Management Version Number: Version 1.0
Author Title: Head of EPRR & Risk Published Date: February 2019 (CP83)
Authoriser Title: Accountable Emergency Officer Review Date: February 2021
Page 18 of 25OFFICIAL - SENSITIVE
Appendix E – Heatwave Trust Actions by Alert Level
Level One: 1st June – 15th September
Area/
Action Notes
Department
Ensure that all CPFT Staff are aware
of Heatwave, their responsibilities, and This should include the use of PHE materials, confirming the location of thermometers
All Areas
ways to protect themselves and and reviewing the at-risk groups in the trust.
patients
Wards/
Distribution of thermometers to all
Clinics/rehab Thermometers should be located out of direct sunlight or heat sources.
clinical areas of the trust
departments
A cool room is defined as areas that are consistently below 26°C and are for the use of
‘high risk’ patients during a Heatwave event. Support to identify and establish these areas
Wards Identification of ‘Cool Rooms’
id available from the estates department.
A schedule of wards with cooling is maintained by the Estates department.
Level 2: 60% chance of Heatwave in 2-3 days
Area/
Action Notes
Department
Temperatures should be recorded using the pro forma at Appendix 1.
Wards/ Clinics/ Record temperatures twice daily Suggested times for recording are at 1200hrs and 1600hrs although local conditions may
Rehab necessitate differences
Departments
Using the definitions found at section 7 individuals most likely to require the use of a ‘cool
Identify vulnerable individuals
room’ should be identified.
Authoring Department: EPRR & Risk Management Version Number: Version 1.0
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Authoriser Title: Accountable Emergency Officer Review Date: February 2021
Page 19 of 25OFFICIAL - SENSITIVE
Area/
Action Notes
Department
Ensure availability of ‘Cool rooms’ Review and update schedule of wards with cooling and cool rooms
Preliminary contact with suppliers of temporary cooling units. Be prepared to respond to
Estates Support clinical areas as appropriate
requests at short notice
Support and inform staff regarding Ensure appropriate drinking water arrangements are available for all staff, visitors and
All areas
safe working in hot weather people who use our service
Level 3 – Heatwave temperature reached locally
Area/
Action Notes
Department
This should include:
Implement appropriate protective
• Regular supplies and assistance with cold drinks
actions
• Increased monitoring of at risk patients
Ensure that cool rooms are Where temperatures cannot be maintained below 26ºC in a particular area, move
Wards/ Clinics/ consistently below 26ºC vulnerable patients to areas with cool room or another ward with cooling
Rehab depts Temperatures should be recorded using the proforma at Appendix 1.
Check that indoor temperatures are
Suggested times for recording are at 0900hrs, 1200hrs 1500hrs and 1800hrs although
recorded four times a day in all areas
local conditions may necessitate differences
This will include turning off unnecessary lights and electrical equipment. See Actions in
Reduce internal temperatures
appendix 2 for actions to reduce heat gains.
Authoring Department: EPRR & Risk Management Version Number: Version 1.0
Author Title: Head of EPRR & Risk Published Date: February 2019 (CP83)
Authoriser Title: Accountable Emergency Officer Review Date: February 2021
Page 20 of 25OFFICIAL - SENSITIVE
This can be achieved by opening windows on opposite sides of the ward to achieve
Make the most of cooling the area at
cross ventilation although the increase in potential cross infection should be taken into
night
consideration
Seek early medical help if an individual
starts to become unwell
Continue to monitor and support the
Trusts response to the situation
Provide a representative to the health
Tactical
Strategic Coordinating Group as
Control group
directed by the CCG.
Moving visiting to mornings and evenings can help to reduce afternoon heat from
Consider moving visiting hours
increased numbers of people
Appendix F - Cold Weather Trust Actions by Alert Level
Level One
Area/
Action Notes
Department
Ensure that local contingency plans
All are reviewed and updated, and that
Areas cascade arrangements are tested
every 3 months
Authoring Department: EPRR & Risk Management Version Number: Version 1.0
Author Title: Head of EPRR & Risk Published Date: February 2019 (CP83)
Authoriser Title: Accountable Emergency Officer Review Date: February 2021
Page 21 of 25OFFICIAL - SENSITIVE
Ensure staff aware of the business
continuity plan for winter weather;
plan for a winter surge in demand.
Review all patients and assess
those likely to be vulnerable to cold
weather and that arrangements are
in place to support them
Community appropriately.
Teams Ensure staff are undertaking
appropriate home checks when
visiting clients, e.g. room
temperature; medications and food
supplies.
Level 2 Cold Weather Alert
Area/
Action Notes
Department
Stand up the Adverse Weather Plan
Corporate and Surveillance Group (Virtual
Meetings)
Review arrangements for staff, people
who use our services and visitors
All Estates and Facilities to conduct regular monitoring checks across all CPFT sites.
including the monitoring of
temperature within all buildings
Authoring Department: EPRR & Risk Management Version Number: Version 1.0
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Authoriser Title: Accountable Emergency Officer Review Date: February 2021
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