Agenda item

Meradin Peachey (Director of Public Health), Matthew Drinkwater (Head of Emergency Preparedness and Response, NHS Kent and Medway), Paul Mullane (Head of Emergency Planning, Response and Resilience, 2012 Olympics Lead, NHS Kent and Medway), Jon Amos (Contingency Planning and Resilience Manager, South East Coast Ambulance Service NHS Foundation Trust), and Geraint Davies (Director of Commercial Services, South East Coast Ambulance Service NHS Foundation Trust) were in attendance for this item.

(1)       The Chairman welcomed and introduced the guests before explaining that the purpose of the meeting was for Members of the Committee to seek reassurances from the NHS on behalf of the people of Kent that the appropriate plans were in place relating to emergency resilience, and specifically to the Olympics and Paralympics Games.

(2)       The Director of Public Health was invited to introduce the item and did so by explaining that she was the lead director for NHS Kent and Medway. The overall principle was to ensure there was one clear approach to mobilising emergency plans across all provider Trusts and the Primary Care Trusts in Kent and Medway. The call system operated 24-hours a day and the plans meant the whole resource of the NHS could be mobilised.

(3)       The publicly available plans produced by the NHS were contained in the Strategic Major Incident Response Plan which each NHS Trust produced and refreshed each year. This ran alongside the Business Continuity Plans which all organisations produced annually. This was a practice mirrored across all the organisations which were Category 1 and 2 responders and so were part of the Kent Resilience Forum.

(4)       There were a few key messages about NHS emergency resilience planning running through the information provided at the meeting. Representatives from the NHS were keen to stress that the emphasis was on developing capabilities rather than responses to specific scenarios as it was difficult to predict and plan for every possible event. This was complemented by the fact that plans could be scaled up across the local area, then regionally and nationally. What this meant in practice was that where necessary the NHS could call on the resources of any Trust, near or far, to provide resources and assistance, as well as call on the support of other organisations such as the police, fire and rescue service and the military.

(5)       While there were limits to how much detail could be provided on the lessons learnt from actual incidents elsewhere, representatives of the local NHS explained that events in New York and Mumbai had been closely studied and there was sharing of good practice relating to other events around the world, such as in Norway and Belgium. The particular position of Kent and Medway, neighbouring London as it does and containing a number of transport hubs, was incorporated into the planning. For example, in response to a couple of specific concerns raised about Manston Airport, it was explained that yearly interagency exercises were carried out at the airport, with a live one taking place every 3-4 years; the last one took place last year.

(6)       The Ambulance Service was key to the implementation of any plans. Most calls triggering an emergency response came through the ambulance service which coordinated NHS Gold Command. This in turn was able to allocate NHS resources across Trusts in case of need, with the Folkestone earthquake given as an example in recent years. The Trust reported that recent changes in the way the ambulance service was organised meant it could deliver a more flexible response. This included the availability of 60 Critical Care Paramedics and the introduction of the Make Ready Depots. The two Hazardous Area Response Teams (HART) at Ashford and Gatwick formed an important part of the resources the South East Coast Ambulance Service NHS Foundation Trust (SECAmb) could deploy. These were specially trained teams of 42 staff, each on permanent standby and able to enter ‘hot zones’ in the event of chemical spills and similar events.

(7)       Related to this, the Director of Public Health explained that there was a greater need now than 20 years ago to plan for biological and chemical incidents. She was the lead STAC for Gold Command in the County. STAC stood for Science & Technical Advice Cell and meant that she had the responsibility for pulling together the best advice relating to poisons and poisonous substances. This system was designed to avoid the situation which occurred at the Buncefield oil disaster a few years ago when it took 3 days to pull together the proper advice. There were 12 public health consultants in Kent and Medway STAC trained when 3 from the Health Protection Agency were included. Continual STAC coverage for 3 days had been rehearsed.

(8)       A number of Members raised a number of related concerns about the impact of the Olympic and Paralympic Games. The whole period of the Games would see a marked increase in the number of people travelling through Kent and Ebbsfleet Station was seen as a major pinch point. One Member felt that little had been done to warn the general public of the anticipated impact of the Games on the wider transport network. There would still be the regular amount of commuter traffic over this period and recent high winds had shown how quickly the traffic system could seize up. Alongside the impact on the continuity of daily life, Members also expressed concerns about the ability of the NHS to continue providing a regular level of service, as people would still require medical treatment over this time.

(9)       In response, representatives from the ambulance service explained that the core assumption behind the plans was to keep the regular 999 service continuing as normal. Modelling from previous Games as well as modelling carried out by the London Ambulance Service and Office of National Statistics, meant that an increase in activity of between 1% and 7% was predicted as a result of the Games. While the service was lean, it was used to dealing with a flux in demand. The NHS was already used to dealing with extra demands over winter and was used to dealing with such occurrences as Operation Stack and Kent had recently hosted the Open Golf Tournament which saw an increase in the number of people travelling through the County. Leave restrictions and other measures such as a bank system had been brought in to make sure the appropriate capacity was available. A more coordinated response with police and other services was being brought in at control room level with weekly Gold level meetings during the Games. Specific funding for days when events were taking place had been requested by the ambulance service. In addition, SECAmb were in negotiation with commissioners over their 2012/13 contract around the anticipated 1-7% increase in activity. The Trust offered to report back to the Committee in April as to the outcome of this process.

(10)     With regards the Olympic Park in London, there was a national scalable Department of Health plan which would enable appropriate resources to be brought in from the most appropriate source, including the military. This could involve calling on Trusts based in Kent and Medway, as when SECAmb provided assistance during the London riots in 2011. During the period of the Games, 28 staff from across the SECAmb area would move to assist covering the London area. While none of the Olympic lanes reserved for Olympic athletes and officials would be in Kent, patients in Kent and Medway did access London acute services and so there was a potential impact. SECAmb was working with Transport for London and the London Ambulance Service over the best ways to ensure continuity of service. 

(11)     In relation to the Paralympic cycling events to be held at Brands Hatch, SECAmb was working with St. John Ambulance and specialist Olympics and Paralympics medical staff on preparations. The regular ambulance fleet would be able to provide the necessary cover. In addition, there were three air ambulances across the SECAmb area, with the helicopters of the RAF Coastguard on standby. London and Essex were in a position to provide mutual aid.

(12)     The Chairman thanked the guests for their valuable contributions and looked forward to receiving further information from SECAmb in April.

(13)     AGREED that the Committee thank representatives of the local heath sector for their contribution to its review of this important subject, commends the work they have done in conjunction with other partners and wish them all every success for this Olympics year.