Major incident planning in primary care trusts in north-west England: a cross-sectional survey

Abstract

The Civil Contingencies Act (2004) requires UK primary care trusts (PCTs) to plan and respond to major health incidents. We carried out a cross-sectional survey of all PCTs in the north-west region of England using a telephone interview with a structured questionnaire. We assessed: (1) staff members responsible for emergency planning; (2) risk assessment; (3) training and exercises; and (4) the planned response to a major incident. Response rate was 61% (20/33). Twelve out of 20 employed an emergency planning officer. All responding PCTs had participated in a tabletop exercise in the previous year and nine of 20 in a live exercise in the previous three years. Nine provided major incident training to new staff. Fifteen had discussed major incident preparations with their local acute trust but none could quantify the support they would be able to provide in terms of accelerated discharges. We have revealed potentially serious deficiencies in the emergency preparedness of many PCTs. PCTs are expected to play a vital role in coordinating the National Health Service (NHS) response to a major incident and these results have important implications for the ability of the NHS as a whole to effective respond to such incidents.

Emergency planning and management in health care: priority research topics

“…The U.K. research studies (Anathallee et al , 2007; Williams et al , 2007; Fell, 2008; Day et al , 2010) typically indicate shortfalls in the emergency preparedness of health-care services. Training and exercises are a major component of developing preparedness, but knowledge is lacking regarding their effectiveness.…”

Emergency management in health: key issues and challenges in the UK

“…The application of the evidence-base is also reported to be patchy [3-5], and decision-making tends to be dependent on the individual and organisational culture of the agencies involved [13]. This was clearly exemplified by the current approach of emergency planning practitioners tending to “muddle through” situations, often relying on their previous experience and intuition, rather than any robust evidence base or understanding of the wider socio-political or behavioural aspects.…”

“…Previously, this work was conducted in the background but the horrifying terrorist attacks of 11 September 2001 and 7 July 2005 have catapulted the emergency management field up the political agenda [2]. Since then, research and publications in this field have accelerated, as demonstrated by the US experience following 11 September 2011 where in the past decade nearly seven hundred articles were published pertaining to this single event alone [3]. …”

“…However, deficiencies in NHS emergency planning have been previously noted [3-6], and questions have been raised as to the evidence-base that underpins much of the activity of emergency planning for major incidents [8]. Also lacking is an evidence-base to support planning around longer-term “rising tide” incidents such as infectious disease outbreaks, covert chemical, biological, radiological, and nuclear events, and threats to infrastructure, and business continuity, such as floods and transport strikes.…”

The evidence base of primary research in public health emergency preparedness: a scoping review and stakeholder consultation

“…Capacity assessment and capacity-building [26][27][28][29][30][31]: A study in this theme reports that surveys at the local health department level can provide information to guide development of capacity [31]. Evaluative information that relates to emergency preparedness and response can inform a deeper understanding of the capabilities important to preparedness [27].…”