Report of the Council of Ministers On the establishment of the: Isle of Man Joint Clinical and Public Health Advisory Group - Emergency Advisory ...
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GD 2021/0013
Report of the Council of Ministers
On the establishment of the:
Isle of Man Joint Clinical and
Public Health Advisory Group
[Emergency Advisory Group]
March 2021
1
1. Background
At the January 2021 sitting of Tynwald Court, it resolved as part of an amended motion that
it:
“Requires a report by the Council of Ministers at the March [2021] sitting on the
establishment of the Emergency Advisory Group including details of the broad
advice and input this group has provided to support decision m aking in a
collaborative and transparent manner.”
The Council of Ministers welcomes the opportunity to advise on the establishment of the Isle
of Man Joint Public Health and Clinical Advisory Group (“PHCAG”) – a body serving the
function of an Emergency Advisory Group in such times as required. A similar group already
existed in the Department of Health and Social Care (DHSC) during the first lockdown and
continued for a period of three months, following the transfer of the Public Health
Directorate to the Cabinet Office.
2. UK , Devolved Administrations and Isle of Man context
In December 2020, the UK’s Institute for Government reported 1 on the provision of scientific
advice in a crisis and observed that ‘using advice well to inform decisions’ and
‘communicating those decisions to the public’ was at times challenging.
In the United Kingdom, the Scientific Advisory Group for Emergencies (“SAGE”) provides
‘scientific and technical advice to support government decision makers during emergencies 2’.
Its role has been prominent throughout the Covid-19 crisis to date.
In the UK, the membership of SAGE depends on the nature of the emergency but typically
includes ‘leading experts from within government and leading specialists from the fields of
academia and industry 3’.
The current group is chaired by the UK Government Chief Scientific Adviser (Sir Patrick
Vallance) and co-chaired by the UK Chief Medical Officer (Professor Chris Whitty) and also
includes experts from within government and leading specialists from the fields of
healthcare and academia.
In the Isle of Man, the establishment of an Emergency Advisory Group is somewhat
different, and ought to take into the account the Island’s own particular context, community,
scale and operational circumstances.
In Scotland, Scottish Ministers, the Chief Medical Officer and Deputy Chief Medical Officer in
Scotland, in consultation with the Chief Scientific Advisor for Scotland have ‘identified the
need for additional scientific analysis of the impact of COVID-19 in Scotland, based on
regularly updated advice and modelling from SAGE 4’ – this is delivered by the “Scottish
Government COVID-19 Advisory Group” which is a time limited expert group.
1
The Institute for Government, “Science Advice in a Crisis”, December 2020, p2.
2
https://www.gov.uk/government/organisations/scientific-advisory-group-for-emergencies
3
Ibid
4
https://www.gov.scot/groups/scottish-government-covid-19-advisory-group/
2
In Wales, a similar advisory body exists, termed the “Technical Advisory Cell 5” it provides
coordination of scientific and technical advice to support Welsh Government decision makers
during emergencies – including the Coronavirus.
In Northern Ireland, further comparable bodies in operation are the “Covid-19 Modelling
Group” and “Strategic Intelligence Group 6”, with the Northern Ireland Executive’s Chief
Scientific Advisor representing it on UK SAGE.
The Isle of Man’s Director of Public Health is a standing invitee to high-level teleconference
meetings of senior Public Health leaders in the UK, devolved administrations and the Crown
Dependencies – and has participated in such throughout the present pandemic.
The Isle of Man’s DHSC interim Chief Executive Officer is a standing invitee to high-level
teleconference meetings of senior government officials across England, devolved nations
and the Crown Dependencies – participating in such throughout the pandemic.
Within DHSC a Clinical Advisory Group (attended by a cross section of clinicians from across
the Health and Care system), co-chaired by the Medical Director and Director of Nursing in
DHSC, continue to provide appropriate clinical advice to the Department, and through the
DHSC Executive Team relevant recommendations to GOLD and Council of Ministers.
3. Breadth and Scope of Membership
The Council of Ministers notes that some Honourable Members have indicated their support
for any Emergency Advisory Group equivalent body to include wider external perspectives –
beyond clinical and public health – for example, with business representation from an
economic impact perspective, or the inclusion of emergency services (represented elsewhere
in the emergency command structure).
Whilst this may appear desirable, there is merit in remaining focused.
The UK Institute for Government’s recognises that the UK’s own Scientific Advisory Group
for Emergencies ‘…cannot (and should not attempt to) cover everything 7’ – recognising that
different strands of expertise need to be integrated at the higher level of policy formation.
Similarly, the Isle of Man’s Joint Public Health and Clinical Advisory Group cannot cover all
facets and therefore remains rightly focused on the provision of clinical and public health
advice.
However, in recognition of the value of appropriate and relevant advice – the Group could
consider opportunity for others to attend as appropriate to the particulars of any given
specific emergency.
Honourable Members have commented on the need to maintain sight of a broader picture
during the recent emergency, and the ability to call-in additional insight or contributions
from others provides the Isle of Man Joint Public Health and Clinical Advisory Group with a
degree of flexibility, and fosters an ability to pivot to circumstances, whilst retaining the core
5
https://gov.wales/technical-advisory-cell
6
https://www.executiveoffice-ni.gov.uk/news/executive-daily-update-initiatives-deal-coronavirus-13-may-
2020-0
7
Ibid, p.33
3scientific and clinical advisory function of the body. This has not been needed to date as
any expertise is currently sourced from within the DHSC or Public Health teams.
4. Overview of activity
In the Isle of Man, the governance structure of the DHSC closely monitors the output of the
UK’s Scientific Advisory Group for Emergencies – together with the equivalent bodies
advising the administrations of Scotland, Wales, Northern Ireland, and the other Crown
Dependencies.
The DHSC provides strategic advice through policy recommendations to the Council of
Ministers, informing considerations in respect of operational and political responses to
challenges such as the Coronavirus pandemic, and other comparable emergencies.
Routinely, the Clinical Advisory Group (‘CAG’) ordinarily sits within the Department for Health
and Social Care’s internal governance structure – and was, prior to the Covid-19 pandemic –
primarily operational in nature, and specifically focused on matters pertaining to the
operation and delivery of healthcare in the Island.
Following the expedient response to the pandemic, the Clinical Advisory Group forum was
subsequently used to harness the valued input, insight, and views of the Island’s senior
clinicians at this important time.
In the course of a viral pandemic, such as Covid-19, the input of Public Health professionals
is rightly considered vital.
Whist clinicians sit within the Department of Health and Social Care; the Public Health
Directorate has since 01 April 2020 sat under the Cabinet Office 8.
As such, and cognisant of the wishes of Honourable Members, a joint body was formed that
brought together the Island’s senior clinicians and scientists – alongside senior Public Health
practitioners – under the co-chairmanship of the Chief Secretary and the Chief Executive of
the Department of Health and Social Care: i.e. the Isle of Man Joint Clinical and Public
Health Advisory Group.
In coalescing these complimentary skillsets, the group can be said to function akin to an
Emergency Advisory Group. Additionally, there are added benefits to working collectively, as
opposed to isolation, including fostering peer review.
The Isle of Man Joint Clinical and Public Health Advisory Group meets only as and when it is
required – and is extraordinarily convened when there is particular need for advice to be
debated between professionals, ultimately feeding its collective view into the Council of
Ministers – distinctly, or as part of informed policy recommendations cognisant of its advice.
There has been relatively consistent views expressed between professionals independently
and through other command groups where these individuals attend. In addition, where the
same attendees have already discussed collectively the input into policy recommendations
(for example DHSC silver), duplicate discussions have not been required.
The Joint Clinical and Public Health Advisory Group has therefore met where necessary, and
its recommendations have been fed into meetings of the Council of Ministers. The outputs
8
As part of the planned work within the Healthcare Transformation Programme and in support of
Recommendation 9 from Sir Jonathan's Michael Independent Review of the Isle of Man Health and Social Care
System [GD 2019/0021] https://www.gov.im/media/1365879/independent-health-and-social-care-review-
final-report.pdf
4also feed into the emergency response GOLD command structure planning, where other
senior representatives, for example, the Chief Constable of the IoM Constabulary attends.
Presently the Group and wider attendees across government are actively engaged in
constructive dialogue, in the form of joint workshops with both SILVER and GOLD regarding
broad considerations for the next phase of the Coronavirus Covid-19 response in the Island,
including ‘exit planning’ and the safe transition to a revised ‘new normal’ for residents –
combined with the rapid deployment of a comprehensive vaccination programme at pace.
5. Conclusion
At all times the purpose of the body remains the provision of balanced, and impartial advice
pertaining the relevant clinical, or public health, emergency at hand.
The Council of Ministers reiterates sincere thanks to all the Island’s dedicated healthcare
staff – and in this instance particularly the senior clinicians, scientists and Public Health
practitioners for the provision of their considered and valued advice to date, and into the
future.
The collective work of the professionals represented in the Joint Clinical and Public Health
Advisory Group, and others, is testament to the many examples of exceptional commitment,
dedication and contribution shown during the response to the Coronavirus pandemic in the
best traditions of our public service and patient centred care.
The Council of Ministers invites this Honourable Court to note the progress made thus far
with the Isle of Man Joint Clinical and Public Health Advisory Group, and continued efforts to
support the evolution of the forum akin to an emergency advisory group, ready, able and
willing to offer timely advice during any potential challenging times for the Island.
5ANNEX 1 Isle of Man Joint Public Health & Clinical Advisory Group
Chief Secretary CEO DHSC
Co-Chair Co-Chair
Director of Medical Director of
Public Health Director Nursing
Microbiology Pathology
Clinical
Directors
*Represented in
DHSC Clinical Advisory Group
6ANNEX 2
ANNEX 3
7ANNEX 4 Emergency Command Structure
GOLD COMMAND
Department Role Deputy Name and Role
Chair of Gold Command Chief Secretary Director of Change and Reform
DEFA Chief Executive Deputy Chief Executive Officer
Department of Education, Sport Chief Executive Director of Education and
and Culture Director of Strategy and
Corporate Services
Department for Enterprise Chief Executive Deputy Chief Executive Officer
Treasury Chief Financial Officer Executive Director Financial
Governance
Department of Home Affairs Chief Executive Deputy Chief Executive
DHSC Kathryn Magson, Chief Deputy Chief Executive
Executive
IoM Constabulary Chief Constable Superintendent
Public Health Chief Executive Health Protection Nurse
Infrastructure Chief Executive Director – Strategy, Policy and
Performance
Emergency Planning Office Emergency Planning Officer
Attorney General’s Office Attorney General Solicitor General
Silver Command Operations Head of Silver Command Project Manager, Council of
Operations Ministers
Communications Executive Director – Crown Head of Corporate
and External Relations Communications
Cabinet Office representative Director of Change and Head of Executive Office
Reform
Cabinet Office, Office of Human Executive Director Director of Learning Education
Resources and Development, Head of
Employment Services
Cabinet Office, Government Executive Director Director of Operations &
Technology Services Infrastructure
Cabinet Office Executive Assistant to the External Relations Executive
Chief Secretary Officer, Senior Brexit
Coordinator
Secretariat Member of the Council of
Ministers Secretariat
National Strategy Group - Coronavirus
Department Name and Role Deputy Name and Role
Chair of NSG – Coronavirus Chief Minister Minister
Treasury Treasury Minister Member for Treasury
Department for Enterprise Minister for Enterprise
Department for Health and Minister for Health and Social
Social Care Care
Attorney General’s Chambers HM Attorney General HM Solicitor General
Cabinet Office Chief Secretary Director Change and Reform
Treasury Chief Executive Executive Director Financial
Governance
Department for Enterprise Chief Executive Deputy Chief Executive Officer
Department for Home Affairs Chief Executive Deputy Chief Executive Officer
Department for Health and Chief Executive Deputy Chief Executive Officer
Social Care
8Cabinet Office Communications Executive Director – Crown Head of Corporate
and External Relations Communications
Silver Command Operations Head of Silver Command Project Manager, Council of
Operations Ministers
Cabinet Office – Secretariat Council of Ministers Executive Office
Chief Officer Group - Coronavirus
Department Name and Role Deputy Name and Role
Chair Chief Secretary Director Change and Reform
Treasury Chief Executive Executive Director Financial
Governance
Department for Enterprise Chief Executive Deputy CEO
Department for Home Affairs Chief Executive
Department for Health and Interim Chief Executive Deputy CEO
Social Care
Department for Education, Interim Chief Executive Director of Strategy and
Sports and Culture Corporate Services
Department for Infrastructure Chief Executive
Department for Environment, Chief Executive Deputy Chief Executive
Food and Agriculture
Public Health Director of Public Health
Communications Interim Head of Corporate Executive Director – Crown
Communications and External Relations
Silver Command Operations Head of Operations Control / Project Manager, CoMin
Team Executive Director, Covid
Response, CO
Cabinet Office Director Change and Reform Executive Director,
Programme Management, CO
Cabinet Office – Secretariat Executive Assistant to the Chief External Relations Executive
Secretary Officer
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