Emergency Management Operational Plan - HSE

Emergency Management Operational Plan - HSE

V010218 1 Emergency Management Operational Plan 2018

V010218 2 TABLE OF CONTENTS Executive Summary … 3 Introduction … 5 Overview of Service … 6 EM Organisational Chart … 7 2018 Priorities … 8 Resources: Emergency Management Budget . 9 Resources: Workforce . 10 Introduction . 10 Staff Engagement . 10 Pay and Staffing Strategy 2018 and funded workforce plans … 10 The Public Service Stability Agreement 2018–2020 . 10 Workforce planning . 10 Education and Development … 11 Attendance Management . 11 Emergency Management and Health Business Services . 11 Emergency Management and Health and Wellbeing .

11 EM Operational Plan actions … 12 Risks to the delivery of the plan . 15 Emergency Management Project Plans . 16 Business Plan Action 01 … … Business Plan Action 02 … … Business Plan Action 03 … … Business Plan Action 04 . .

Business Plan Action 05 . . Business Plan Action 06 . . Business Plan Action 07 . . Business Plan Action 08 . . Business Plan Action 09 . . Business Plan Action 10 . . Business Plan Action 11 . .

V010218 3 Executive Summary: The HSE Emergency Management (EM) function is a National Service and a key Health Service enabler. The function works at strategic, tactical and operational levels with all HSE services, and on an inter-agency and inter-departmental basis to ensure that appropriate Emergency Plans are developed, updated and tested as required with the goal of avoiding the dislocation of Health Services in the face of a national emergency/crisis situation.

The HSE National Emergency Management Office (NEMO) provides support to the HSE Leadership Team by advising on contingency, business continuity and response planning for Major Emergencies. With consolidation and development ongoing surrounding new HSE structures, Emergency Management staff will continue to support HSE structures in line with the updated Emergency Management governance document (2016).

Key priorities for 2018: In the context of finite financial resources and increasing operational demands, it is essential that focus continues on the integration of emergency management preparedness in all HSE services. The following priorities have been identified for 2018: • Emergency Management will continue to address HSE Mass Casualty Incident preparedness. It will do this through revision of existing plans/protocols based on international experience and or learning, also through the implementation of a suitable programme of education and training and the identification of capability initiatives to augment HSE response to such an incident (Action 1).

• Identify HSE planning and response needs in order to deal with a Chemical. Biological, Radiological and Nuclear incident and make recommendations to HSE Leadership around capability requirements in this specialist field (Action 2) • Initiate and Chair Business Continuity Management working group to oversee the implementation of the Terms of Reference agreed with HSE Leadership team (Action 3) • Emergency Management will continue to plan for cross border cooperation in order to identify areas where mutual support in emergency scenarios is possible. Emergency Management will also ensure cross-border initiatives are considered in all HSE EM planning and protocol development (Action 4) • Core EM activity such as the execution of the of work identified by completion of the Major Emergency Management annual risk assessments and the implementation of the HSE management commitments relating to the 2018 interagency work programme (Framework for Emergency Management 2006) will continue during the year.

(Action 6 and Action 5) • Emergency Management will participate in the review of the Framework for Major Emergency Management 2006. It will coordinate input to the redraft of same. (Action 5) • EM will meet its obligations in relation to crowd event planning following legal advice on mandated actions surrounding crowd event planning (Action 7) • Work will continue to meet legislative requirements in relation to Seveso site plans (Action 8) • The Major Emergency Hospital Plan template will continue to be rolled out in 2018 to promote a common approach to EM in all hospitals. Emergency Management staff will support all

V010218 4 Hospital Groups in the development and population of their Hospital Major Emergency Plans (Action 9) • Develop a syllabus of training to support a course covering the Strategic, tactical and operational aspects of MEM within the Hospital Environment (Action 10). • The Emergency Management function will develop a checklist and guidance document for CHO services for Emergency and crisis situations (Action 11) Resources: In 2018, our objective is to maintain quality, deliver good outcomes, and recognise that there are opportunities even in a constrained financial environment to provide excellent Emergency Management Services to the HSE.

The EM function recognises that it is now more important than ever to secure value for money, achieving maximum benefit from the available financial and staffing resources. The 2018 EM budget OF €1,551m is based on a roll over budget from 2017 and is inclusive of an additional €45k for pay cost pressures. The Emergency Management function has a staff complement of 21 approved WTE positions with 19 WTEs currently in post and two WTE positions to be filled early in 2018.

Achievement and progress versus targets and outputs will be formally monitored and reviewed on a monthly basis both in terms of individual project plans and financial budgets Vs expenditure. Performance Management and Engagement: Within the Emergency Management sub-division, there will be a continued emphasis on performance management and engagement at all levels with a focus on increasing the frequency of line manager/staff meetings to develop a culture of teamwork, communication and innovation to ensure the most effective utilisation of resources to support and achieve the actions outlined in the EM operational plan.

V010218 5 Introduction: A major emergency is any event which, usually with little or no warning, causes or threatens death or injury, serious disruption of essential service or damage to property, the environment or infrastructure beyond the normal capabilities of the HSE and the other emergency services either locally, regionally or nationally, and requires the activation of specific additional procedures and the mobilisation of additional resources to ensure an effective, coordinated response. Examples of Major Emergencies in Ireland include the Air India aircraft crash in 1985, the Stardust fire in 1981, severe weather episodes of 2015/2016 and the widespread flood experienced in 2009/2010 and infectious disease outbreaks such as the Influenza Pandemic in 2009.

The HSE requires Major Emergency Plans to provide for an effective and coordinated response. The development of major emergency plans and their associated procedures and the coordination of response to Major Emergencies are collectively known as 'Emergency Management'. The Emergency Management function is a National service and a key enabler in supporting Health Service delivery. The HSE Emergency Management function works at both national and regional level; with all HSE services and on an inter-agency basis to ensure that appropriate Emergency Plans are developed updated and tested as required with the goal of enhanced operational readiness to respond to emergencies.

The HSE National Emergency Management Office (NEMO) provides support to the HSE Leadership Team by advising on contingency, business continuity and response planning for Major Emergencies. NEMO also engages with external agencies with regard to major emergency planning, coordination, response and recovery. The execution of these responsibilities requires engagement and coordination with HSE Corporate structures, Community Healthcare Organisations, Hospital Groups, National Ambulance Service, Public Health, Environmental Health, Government Departments and other interagency groups. Within NEMO, the Assistant National Director of Emergency Management liaises with key National Directors and the Department of Health’s Health Protection Unit to ensure that there is cross service preparedness in place that is in line with Department of Health and HSE policy.

The HSE has a set of emergency management governance arrangements, processes and support functions that enable it to plan, prepare and respond internally and also alongside other government agencies to major emergencies. The governance arrangements are independent of the type of emergency but are underpinned by specific emergency guidance relative to the nature of the emergency, e.g. severe weather plan or mass casualty incident plan. The Emergency Management Governance document (2016) will be updated during quarter 1 2018 to reflect key learning points since its inception.

As Emergency Management is a dynamic process, guidance requires constant review, updating and testing. Recent international events such as terrorist attacks and national severe weather events such as Storm Ophelia highlight the importance of an integrated system-wide response being in place within the health and social care system, and with other government agencies. Emergency Management personnel will drive this agenda on a partnership basis, building on the work already undertaken in recent years. In addition to core work this Emergency Management operational plan will continue to advance key priorities as set out in previous plans.

It will detail the priorities, actions and type of services that will be delivered by Emergency Management in 2018. This plan will also detail the financial and workforce framework that supports the plan.

V010218 6 Implementation of the actions set out in this operational plan will be commensurate with available resources. Many are to be delivered on a partnership basis, with other HSE Divisions, Government Departments, other principal response agencies such as the Local Authorities and An Garda Siochana, the Health and Safety Authority, the Environmental Protection Agency, Port Authorities, An Bord Pleanala, Seveso Site operators, as well as Event organisers. This reflects the collaborative approach necessary to deliver on Emergency Management priorities.

Overview of service: The HSE EM function currently works at strategic, tactical and operational levels with all HSE services, and on an inter-agency and inter-departmental basis to avoid the dislocation of Health Services in the face of a national emergency/crisis situation.

Key areas of work include: • Support National and Area Crisis Management Teams in response to Major Emergencies • Support managers at all levels in planning for, and response to, major emergencies • Develop and deliver training and education programmes around emergency management across all HSE services and functions involved in response • Coordinate inter-agency working with Local Authorities and An Garda Síochána and other agencies • Represent the HSE in engaging with the Department of Health1 and other Government departments across National Coordination Groups.

• Review and update statutory external Emergency Plans for top tier Seveso sites and carry out exercises as required under the Chemicals Act (Control of Major Accident Hazards involving Dangerous substances) Regulations 2015. Seveso exercises provide evidence based assessment to monitor and strengthen emergency preparedness. • Meet HSE obligation in relation to crowd events • Assess, review, modify and update as necessary all HSE Emergency Management guidance The HSE EM function is organised into three Emergency Management (EM) Administrative Areas; East, West & South. These Administrative Areas have dedicated EM staff and are structured to support all HSE activities across the nine (9) CHO geographic areas (See Figure 1 below).

The agreed structure also provides for HSE services that remain organised on a regional basis, for example disciplines such as environmental health and procurement to be accommodated in both EM planning and response. EM provides a support function for all HSE activities in each Emergency Management Administrative area. This will be achieved by interaction with the nine CHO EM planning Groups (these groups include representatives of all Hospitals and HSE services) and by providing training, advice and direction with regard to EM issues in each area.

Figure 1. 1 For example, the function will support the National Public Health Emergency Team (NPHET) in response to the Public Health Emergency surrounding CPE.

V010218 7 EM Organisational Chart *For administrative and operational purposes the CEMO from each Administrative Area is positioned within the National Emergency Management office EM Officer (3) Grade IV (1) Grade III (1) EM Officer (2) Grade III (1) EM Officer (2) AEM Officer (1) Grade V (1) Grade IV (1)

V010218 8 2018 Priorities The 2018 functional planning process has been underpinned by the development of supporting project planning material, setting out the high level milestones, key stakeholders and the potential risks to our plans.

Achievement and progress versus targets and outputs will be formally monitored by the EM Management team and reviewed on a monthly basis both in terms of individual project plans and financial budgets Vs expenditure. • Emergency Management will continue to address HSE Mass Casualty Incident preparedness. It will do this through revision of existing plans/protocols based on international experience and or learning, also through the implementation of a suitable programme of education and training and the identification of capability initiatives to augment HSE response to such an incident (Action 1).

• Identify HSE planning and response needs in order to deal with a Chemical. Biological, Radiological and Nuclear incident and make recommendations to HSE Leadership around capability requirements in this specialist field (Action 2) • Initiate and Chair Business Continuity Management working group to oversee the implementation of the Terms of Reference agreed with HSE Leadership team (Action 3) • Emergency Management will continue to plan for cross border cooperation in order to identify areas where mutual support in emergency scenarios is possible. Emergency Management will also ensure cross-border initiatives are considered in all HSE EM planning and protocol development (Action 4) • Core EM activity such as the execution of the of work identified by completion of the Major Emergency Management annual risk assessments and the implementation of the HSE management commitments relating to the 2018 interagency work programme (Framework for Emergency Management 2006) will continue during the year.

(Action 6 and Action 5) • Emergency Management will participate in the review of the Framework for Major Emergency Management 2006. It will coordinate input to the redraft of same. (Action 5) • EM will meet its obligations in relation to crowd event planning following legal advice on mandated actions surrounding crowd event planning (Action 7) • Work will continue to meet legislative requirements in relation to Seveso site plans (Action 8) • The Major Emergency Hospital Plan template will continue to be rolled out in 2018 to promote a common approach to EM in all hospitals. Emergency Management staff will support all Hospital Groups in the development and population of their Hospital Major Emergency Plans (Action 9) • Develop a syllabus of training to support a course covering the Strategic, tactical and operational aspects of MEM within the Hospital Environment (Action 10).

• The Emergency Management function will develop a checklist and guidance document for CHO services for Emergency and crisis situations (Action 11)

V010218 9 Financial Framework Emergency Management Budget allocation: Budget Allocation Pay €1.331m Non-pay €0.420m Gross €1.751m Income €(200)m Net expenditure €1.551m Budget 2018 versus Budget 2017 The total net revenue budget available to Emergency Management in 2018 is €1.551m. This 2018 budget level represents an overall increase of 45k on the final 2017 EM budget. The increase of 45k has been allocated under existing level of service to fund pay cost pressures relating to National pay agreements and a marginal allocation for pay increments.

Financial Challenges/Key risk areas While living within our financial allocation will be a fundamental priority for Emergency Management., a number of financial risks exist: NSP 2018 notes that while emergency management scenarios were previously covered by contingency funding held by the HSE, these contingency funds are no longer available, and accordingly, in the event that such costs arise, they fall outside what has been provided for the NSP and will need to be the subject of separate engagement with the DOH.

While options are being explored, the HSE EM South office currently has no designated Crisis Management team facility. Refurbishment costs may be incurred if an identified site is deemed in need of works/upgrading by HSE Estates. On-going investment in Emergency Management is required to mitigate the severity and impact of emergencies in the HSE. The cost of reacting to emergency situations in 2018 cannot be factored or measured in advance. The budgetary allocation for 2018 will be regularly monitored and tight financial controls as per the National Financial Regulations will be adhered to, with a goal toward a break even status at year end.

Pay ceilings will be monitored and adhered to. Any opportunities for EM cost reduction and value improvement will be explored and implemented in line with the relevant themes of the forthcoming Value Improvement programme and direction from the HSE Leadership team.

EM will continue to work with our Corporate Finance partner to further align non-pay regional budgets in the most appropriate way across the ledgers.

V010218 10 Resources: Workforce Introduction: Sub - divisional breakdown by staff category Service Medical / Dental Nursing and Midwifery Health and Social Care Professionals Management / Admin. General Support Staff Other Patient and Client Care Total2 Projected Outturn Dec. 2014 Emergency Management 14 7 Total 14 7 There are 19 WTEs currently working in the EM sub division with an additional two positions to be filled in Qtr.

1, 2018 Emergency Management staff are its most valuable resource in achieving its goals. Recruiting and retaining motivated and skilled staff is a high priority for Emergency Management. A recruitment process is underway to all existing vacancies.

2018 will continue to see a focus on The People Strategy 2015 -2018 which has been developed in recognition of the vital role the workforce plays in delivering safer and better healthcare. This strategy is underpinned by a commitment to engage, develop, value and support the workforce, thereby creating a culture of high trust between management and employees, supporting the achievement of performance. Staff engagement Within the Emergency Management function, there will be a continued emphasis on performance management and engagement at all levels with a focus on increasing the frequency of line manager/staff meetings to develop a culture of teamwork, communication and innovation to ensure the most effective utilisation of resources to support and achieve the actions outlined in the EM operational plan.

Pay and Staffing Strategy 2018 and Funded Workforce Plans In line with Government policy, Emergency Management will work to operate within the allocated pay framework while ensuring that service is maintained to the maximum extent. Overall pay expenditure will continue to be robustly monitored, managed and controlled to ensure compliance with EM allocated budget as set out in the annual funded workforce plan at Divisional level. Emergency Management will continue to comply with public sector pay policy and public sector appointments.

The Public Service Stability Agreement 2018 -2020 The Public Service Stability Agreement represents an extension of the Lansdowne Road agreement of 2015.

The Emergency Management function will comply with all necessary requirements under the agreement. Workforce Planning In 2018, the focus of the Emergency Management workforce will be to continue to consolidate the new EM structure in order to be capable of supporting the new CHOs, Hospital Groups, NAS and other HSE services and functions. To achieve this, there is a requirement increase the current Emergency Management workforce capacity to include two include two Grade extra Grade VII Emergency Management Officers to be associated with CHO 3 and CHO 6. There is also a requirement to provide administrative support at a number of EM locations.

V010218 11 Education and Development The National Emergency Management office will examine our overall budget allocation for 2018 with a view to maximising professional development, education and up skilling of all Emergency Management staff. A review of HSE Statutory Occupational Safety and Health training requirements will take place in Quarter 1, 2018 to ensure continued EM compliance with mandatory training requirements. Attendance Management Staff attendance in Emergency Management during 2017 was well in advance of the organisational average of 3.5% staff absence rate. The performance target for 2018 remains at 3.5% staff absence rate.

This continues to be a key priority area for Emergency Management. Emergency Management and Health Business Services Emergency Management will work with Health Business Services (HBS) in relation to the supports available in areas such as: • Recruitment • Procurement with an emphasis on supporting the Procurement Compliance Programme • Shared services in Payroll and Accounts Payable • The delivery of a SAP HR system • Developing and maintaining Health Service infrastructure, particularly in relation to a HSE Crisis Management Team facility for the South • Replacement of end of life equipment • Mid-term review of the Health Service Executive’s Capital plan.

Emergency Management and Health and Wellbeing Emergency Management will work to implement identified staff Health and Wellbeing measures including the promotion of increased staff uptake of the Flu Vaccine.

V010218 12 Operational Plan Actions Actions 2018 Measure of Performance Target / Expected Activity 2018 Lead Start Date Completion Date Action 1 Continue to develop HSE Mass Casualty Incident preparedness plans, MCI education and training for personnel and identify capability requirements to augment HSE response to such an incident. Completed MCI protocol arrangements in place, supported by training and education arrangements covering all areas of the country. Continued development of MCI protocol with all Stakeholders through the MCI working group. MCI Working group EM Acute Hospitals CHOs NAS Q1 Q4 Action 2 Identify HSE planning and response needs in order to deal with a Chemical, Biological, Radiological and Nuclear incident and make recommendations to HSE Leadership around capability requirements in this specialist field.

CBRN needs assessment conducted across the HSE. Memorandum identifying capability requirements presented to HSE Leadership team. CBRN needs assessment conducted by Working group. Memorandum presented to Leadership team. HSE CBRN working group Q1 Q3 Action 3 Initiate and chair Business Continuity Management working group to oversee the Terms of Reference agreed with Leadership team. The Working group will progress the Terms of Reference as agreed by HSE Leadership team. The Working group will progress the Terms of Reference as agreed by HSE Leadership team. BCM working group Q1 Q3 Action 4 Emergency Management will continue to plan for cross border cooperation in order to identify areas where mutual support in emergency Development of cross border protocols.

The inclusion of cross border protocols into all HSE EM preparations. Working strategic cross border protocols developed. NEMO CEMOs Q1 Q4

V010218 13 Actions 2018 Measure of Performance Target / Expected Activity 2018 Lead Start Date Completion Date scenarios is possible. EM will also ensure cross-border initiatives are considered in all HSE EM planning and protocol development. Action 5 Complete HSE Major Emergency Management (MEM) Risk assessment Completion of HSE MEM Risk assessment and provision of support for the inter- agency annual risk assessment. HSE MEM Risk assessment completed and interagency Risk assessment supported. CEMOs Q1 Q4 Action 6 Engage with the Principal Response Agencies (PRAs) on the implementation of the annual interagency work programme as agreed by the Interagency National Working group.

Implementation of relevant actions from the Inter- agency work programme. HSE relevant actions implemented. CEMOs Q1 Q4 Action 7 Crowd Events working group to identify and prescribe a standard, based on received legal advice, for HSE engagement with licence granting authorities and event organisers for licenced events, local authority events, and non-licenced events in relation to medical event planning. Compliance with the relevant legislation and/or applicable codes of practice/best practice. Engagement by Emergency Planning with key stakeholders in relation to event medical planning. CEMOs Q1 Q4

V010218 14 Actions 2018 Measure of Performance Target / Expected Activity 2018 Lead Start Date Completion Date Action 8 Development of an External Plan for all newly designated Seveso sites within the specified timeframe and review, update and exercise plans due for review in 2018 All Seveso External Plans to conform with legislation Emergency Management to meet its HSE commitments under the Seveso legislation and engage with all Upper Tier Seveso sites as required. CEMOs Q1 Q4 Action 9 Continue to support the implementation of the Major Emergency Plan template for Acute Hospitals Emergency Management to support all Hospital Groups in the transition from the current hospital Major Emergency Plan to the new Hospital Major Emergency Plan Template (HMEP), through regular engagement Emergency Management to continue to support all Hospital Groups in the implementation of the new HMEP CEMOs Q1 Q4 Action 10 Develop a syllabus of training to support a course covering the Strategic, tactical and operational aspects of MEM within the Hospital Environment Completion of a functional and operational syllabus Standard operational syllabus is accepted NEMO Q1 Q4 Action 11 Develop a standardised checklist and guidance document for Community Healthcare Organisations services.

The standardised checklist and guidance document for Community Healthcare Organisations services will be developed and rolled out. CHO Chief Officers will be facilitated in mitigating risk to their services for emergency or crisis situations. NEMO CEMOs CHO Leads Q1 Q4

V010218 15 Risks to the delivery of the Plan In identifying potential risks to the delivery of this operational plan it is acknowledged that while every effort will be made to mitigate these risks, it may not be possible to eliminate them in full. The risks identified to this plan are: • The current shortage within the Emergency Management workforce may mean that the function may not be in a position to adequately support HSE services and interagency demands • Further loss of human resources in EM leading to inability to deliver on key priorities • Availability constraints on key stakeholders to actively engage with Emergency Management in a timely manner • Unscheduled emergency or crisis event • Absence of specific legislation relating to various areas covered by the emergency management function • Absence of overarching strategies i.e.

DOH, Cross Border and other Government Departments.

• There is no capacity for Emergency Management to respond in 2018 to further pay pressures beyond those already funded. • The lack of a defined pathway/protocol to access contingency funding • Brexit. • There is a lack of identified funding for EM training • There is a lack of integrated training for complex EM responses • A capability deficiency exists e.g. Chemical, Biological, Radiological and Nuclear(CBRN), Mass Casualty Incident • Extra allocated tasks outside of core function business would present an additional risk.

V010218 16 Appendices Appendix 1: Emergency Management Project plans Unique Identifier No Action 1 Operational Plan Action Continue to develop HSE Mass Casualty Incident preparedness plans, MCI education and training for personnel and identify capability requirements to augment HSE response to such an incident Measure of Performance Completed MCI protocol arrangements in place, supported by, appropriate training and education arrangements covering all areas of the country.

Target/Expected Activity 2018 Continued development of MCI protocol with all stakeholders through the MCI working group.

Overall objective/s of action HSE preparedness for an MCI event within current resources. Lead MCI working group Emergency Management Acute Hospitals CHOs NAS Key Stakeholders / Partners All HSE services HSE Leadership teams Principal Response Agencies Phasing of Implementation Q1 Continued development of MCI protocol in the greater Dublin area and regionally. Q2 Continued development of MCI protocol in the greater Dublin area and regionally. MCI working group to provide education and training for key stakeholders Q3 Continued development of MCI protocol in the greater Dublin area and regionally.

MCI working group to coordinate with Principal Response Agencies in relation to interagency exercise. Q4 Continued development of MCI protocol in the greater Dublin area and regionally. Risks • Lack of key stakeholder engagement • Capability gaps • Lack of finance • Unscheduled major emergency event • Divergent objectives by other Principal Response agencies

V010218 17 Unique Identifier No Action 2 Operational Plan Action Identify HSE planning and response needs in order to deal with a Chemical. Biological, Radiological and Nuclear incident and make recommendations to HSE Leadership around capability requirements in this specialist field.

Measure of Performance CBRN needs assessment conducted across the HSE. Memorandum identifying capability requirements presented to HSE Leadership team. Target/Expected Activity 2018 CBRN needs assessment conducted by Working Group. Memorandum presented to Leadership team. Overall objective/s of action HSE service requirements and capability gaps identified. Lead HSE CBRN working group Key Stakeholders / Partners Emergency Management Public Health Acute Hospitals NAS Environmental Health Phasing of Implementation Q1 CBRN needs assessment commenced by CBRN Working group. Q2 CBRN needs assessment ongoing.

Q3 Memorandum Presented to HSE Leadership team. Q4 Risks • Lack of key stakeholder engagement • Unscheduled major emergency event Unique Identifier No Action 3 Operational Plan Action Initiate and Chair Business Continuity Management working group to oversee the implementation of the Terms of Reference agreed with HSE Leadership team. Measure of Performance The working group will progress the Terms of reference as agreed by HSE Leadership team. Target/Expected Activity 2018 The working group will progress the Terms of reference as agreed by HSE Leadership team.

Overall objective/s of action To initiate a process that will see the eventual implementation of BCM as a standard practice of management across the HSE.

Lead BCM working group Key Stakeholders / Partners Emergency Management National Emergency Planning Group members Phasing of Implementation Q1 CBRN needs assessment commenced by CBRN Working group. Q2 CBRN needs assessment ongoing. Q3 Memorandum Presented to Leadership team. Q4 Risks • Lack of key stakeholder engagement • Lack of finance • Unscheduled major emergency event

V010218 18 Unique Identifier No Action 4 Operational Plan Action Emergency Management will continue to plan for cross border cooperation in order to identify areas where mutual support in emergency scenarios is possible. Emergency Management will also ensure cross-border initiatives are considered in all HSE EM planning and protocol development. Measure of Performance Development of cross border protocols. The inclusion of cross border considerations into all HSE EM preparations. Target/Expected Activity 2018 Working strategic cross border protocols developed Overall objective/s of action Development of a cross border protocols The inclusion of cross border considerations into all HSE EM preparations.

Lead NEMO CEMOs Key Stakeholders / Partners All requisite stakeholders within the HSE Local Authorities An Garda Siochana P.S.N.I.

Northern Ireland Local Authorities Northern Ireland Fire Service Northern Ireland Ambulance Service Public Health Agency Northern Ireland Phasing of Implementation Q1 The cross border interagency working group to meet and establish workplan for 2018. Q2 The cross border interagency working group to meet and execute the cross border workplan. Q3 The cross border interagency working group to meet and execute the cross border workplan. Q4 The cross border interagency working group to meet and execute the cross border workplan.

Risks • Lower than required level of manpower resource • Unscheduled emergency activity • Constraints on the availability of key stakeholders • Brexit

V010218 19 Unique Identifier No Action 5 Operational Plan Action Complete HSE Major Emergency Management (MEM) Annual Risk Assessment Measure of Performance Completion of HSE MEM Risk assessment and provision of support for the inter-agency annual risk assessment Target/Expected Activity 2018 HSE MEM Annual Risk assessment completed and interagency Risk assessment supported Overall objective/s of action Fulfil HSE interagency obligations under the Framework for MEM Lead Chief Emergency Management Officers Key Stakeholders / Partners Engagement of Services/Functions Phasing of Implementation Q1 Undertake HSE MEM Annual Risk Assessment 2018 Q2 Complete HSE MEM Annual Risk Assessment 2018 Q3 Support the Interagency Annual Risk Assessment Q4 Appraisal/review of 2018 Annual Risk Assessment Risks • Unscheduled emergency activity.

• Constraints on the availability of key stakeholders in the PRAs to engage in a timely manner.

V010218 20 Unique Identifier No Action 6 Operational Plan Action Engage with the Principal Response Agencies [PRAs] on the implementation of the annual Interagency Work Programme as agreed by the Interagency National Working Group Measure of Performance Implementation of relevant actions from the Interagency work programme Target / Expected Activity 2018 HSE relevant actions implemented Overall objective(s) of action Complete the Regional Interagency Work Programme as outlined by the National Working Group and Regional Steering Group for MEM Lead Chief Emergency Management Officers Key Stakeholders / Partners PRAs - the Local Authorities, An Garda Síochána and the Health Service Executive Phasing of Implementation Q1 Agree the Regional Interagency Work Programme.

Revise and complete the Interagency MEM Appraisal.

Q2 Engage with the Principal Response Agencies to complete the Regional Interagency Work Programme. Revise and complete the Interagency MEM Risk Assessment and incorporate the HSE risk assessment Q3 Engage with the Principal Response Agencies to complete the Regional Interagency Work Programme. Revise and complete the Interagency MEM exercise evaluation system. Q4 Engage with the Principal Response Agencies to complete the Regional Interagency Work Programme. Risks • Due to work commitments of the PRAs, slower than expected pace of National Working group led outputs.

• Constraints on the availability of key stakeholders in the PRAs to engage in a timely manner in planning and implementation processes.

• Constrained EM workforce to execute HSE planning requirements under the Framework for Major Emergency Management. • Work pressures to deal with EM strategic and operational work outputs. • Unscheduled emergency activity

V010218 21 Unique Identifier No Action 7 Operational Plan Action Crowd Events working group to identify and prescribe a standard, based on received legal advice, for HSE engagement with licence granting authorities and event organisers for licenced events, local authority events, and non-licenced events in relation to event medical planning. Measure of Performance Compliance with the relevant legislation and/or applicable codes of practice/best practice. Target/Expected Activity 2018 Engagement by Emergency Management with key stakeholders in relation to event medical planning.

Overall objective/s of action To ensure Emergency Management planning is undertaken for events.

To mitigate the potential impacts of events on HSE services. To ensure adequate medical services are provided for event attendees and event staff. Lead Chief Emergency Management Officers Key Stakeholders / Partners Event Organiser Local Authority An Garda Siochana HSE Stakeholders Phasing of Implementation – This work will be phased throughout the year pending on notification of events Q1 To prepare a draft standard for engagement surrounding crowd events for consideration by the Emergency Management function and the National Emergency Planning group based on legal advice. Q2 Finalise draft standard for engagement surrounding crowd events and put into operational use.

Q3 Q4 Risks • Existing legislation is poorly constructed and does not provide HSE EM with appropriate powers of recommendation, supervision and enforcement at this time • The continued increase in the number of notified annual events and the time availability of EM workforce. • Non-notified events. • Lower than required level of manpower resource to meet best practice. • Unscheduled emergency activity.

V010218 22 Unique Identifier No Action 8 Operational Plan Action Development of an External Plan for all newly designated Seveso sites within the specified timeframe and review, update and exercise plans due for review in 2018 Measure of Performance All Seveso External Plans to conform with legislation Target/Expected Activity 2018 Emergency Management to meet its HSE commitments under the Seveso legislation and engage with all Upper Tier Seveso sites as required.

Overall objective/s of action Fulfil EM HSE’s Legislative Requirements Lead Chief Emergency Management Officers Key Stakeholders / Partners Local Authorities An Garda Siochána H&S Authority Site Operators Phasing of Implementation - This work will be phased throughout the year pending on notifications and renewals of plans Q1 Develop an External Emergency Plan for all newly designated Upper Tier Seveso sites within the specified timeframe.

Review, update and exercise External Emergency Plans due. Participate in the updating of inter-agency arrangements in relation to upper tier Seveso sites, as per the Seveso III Directive. Q2 Develop an External Emergency Plan for all newly designated Upper Tier Seveso sites within the specified timeframe. Review, update and exercise External Emergency Plans due. Participate in the updating of inter-agency arrangements in relation to upper tier Seveso sites, as per the Seveso III Directive. Q3 Develop an External Emergency Plan for all newly designated Upper Tier Seveso sites within the specified timeframe.

Review, update and exercise External Emergency Plans due. Participate in the updating of inter-agency arrangements in relation to upper tier Seveso sites, as per the Seveso III Directive. Q4 Develop an External Emergency Plan for all newly designated Upper Tier Seveso sites within the specified timeframe. Review, update and exercise External Emergency Plans due. Participate in the updating of inter-agency arrangements in relation to upper tier Seveso sites, as per the Seveso III Directive. Risks • Constraints on availability of key stakeholders. • The requirements to deal with unscheduled emergency activity.

V010218 23 Unique Identifier No Action 9 Operational Plan Action Continue to support implementation of the Major Emergency Plan template for Acute Hospitals Measure of Performance Emergency Management to support all Hospital Groups in the transition from the current hospital Major Emergency Plan to the new Hospital Major Emergency Plan (HMEP)Template, through regular engagement Target / Expected Activity 2018 Emergency Management to continue to support all Hospital Groups in the implementation of the new HMEP Overall objective(s) of action Ensure that acute hospitals adopt the new Hospital Major Emergency Plan Template Lead Chief Emergency Management Officers Key Stakeholders / Partners Hospital Groups Acute Hospitals National Ambulance Service Emergency Management Phasing of Implementation Q1 Continue to engage and support Hospital Major Emergency Staff in the development and population of their new Hospital Major Emergency Plan Template.

Q2 Continue to engage and support Hospital Major Emergency Staff in the development and population of their new Hospital Major Emergency Plan Template. Q3 Continue to engage and support Hospital Major Emergency Staff in the development and population of their new Hospital Major Emergency Plan Template. Q4 Complete the transition to the new HMEP. Risks • Constraints on availability of key HSE stakeholders to execute the outlined project plan. • Limited EM workforce to adequately support hospitals in roll-out of the new HMEP.

• Dealing with strategic and operational priority activity.

V010218 24 Unique Identifier No Action 10 Operational Plan Action Develop a syllabus of training to support a course covering the Strategic, tactical and operational aspects of MEM within the Hospital Environment Measure of Performance Completion of a functional and operational syllabus Target/Expected Activity 2018 Standard operational syllabus is accepted Overall objective/s of action To develop a syllabus that is fit for National purposes Lead NEMO Key Stakeholders / Partners HG Corporate Lead NAS CEMOs Phasing of Implementation Q1 Convene a working group with key stakeholders to define TOR and agree workplan Q2 Working group ongoing Q3 Working group ongoing Q4 Acceptance of syllabus by National Director, Acute Hospitals Division Risks • Lower than required level of manpower resource • Unscheduled emergency activity.

V010218 25 Unique Identifier No Action 11 Operational Plan Action Develop a standardised checklist and guidance document for Emergency Preparedness, Response and Recovery for Community Healthcare Organisations services. Measure of Performance The standardised checklist and guidance document for Community Healthcare Organisations services will be developed and rolled out. Target / Expected Activity 2018 CHO Chief Officers will be facilitated in mitigating risk to their services for emergency or crisis situations.

Overall objective(s) of action Standardise the preparation of Emergency plans for all CHO services.

Lead NEMO CEMOs CHO leads Key Stakeholders / Partners CHO leads Area Emergency Planning Groups Phasing of Implementation Q1 NEMO to seek nominees from the Chief Officers group to work with CEMOs on the development of a standardised checklist and guidance document for Community Healthcare Organisations services. Q2 CEMOs and CHO leads to convene a working group, identify terms of reference and draft a workplan. Q3 Draft the standardised checklist and guidance document for CHO services. Q4 Finalise and commence rollout of the standardised checklist and guidance document for CHO services.

Risks • Unscheduled emergency activity • Constraints on the availability of key stakeholders

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