severe weather response plan• severe weather and climate change. climate change forecasts indicate...

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SEVERE WEATHER RESPONSE PLAN

Author:

Sharn Elton, Director of Operations

Date of Implementation:

1st February 2015

Reviewed:

November 2016

Version

Issue 3

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FREEDOM OF INFORMATION The contents of this plan are assumed to be accessible to the public and to staff, unless an exemption under the Freedom of Information Act 2000 has been identified during the drafting process.

Please indicate opposite any exemptions you are claiming.

Remember that some exemptions can be overridden if it is in the public interest to disclose – as decided by the FOI multi- disciplinary team.

Exemptions normally apply for a limited time and the information may be released once the exemption lapses.

This plan contains information;

Please insert an “x” if relevant

1. That is personal data

2. Provided in confidence

3. Intended for future publication

X

4. Related to criminal proceedings

5. That might prejudice law enforcement

6. That might prejudice ongoing external audit investigations

7. That could prejudice the conduct of public affairs

8. Information that could endanger an individual’s health & safety

9. That is subject to legal privilege

10. That is commercially confidential

11. That may not be disclosed by law

12. Other Please describe

Remember to destroy all unnecessary drafts and unneeded correspondence, once the final version of this plan is agreed.

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CONTENTS

FREEDOM OF INFORMATION ..................................................................................... 2 CONTENTS ................................................................................................................... 3 DISTRIBUTION .............................................................................................................. 5 GLOSSARY ................................................................................................................... 6 INTRODUCTION ........................................................................................................... 7 1. AIM ........................................................................................................................ 8 2. OBJECTIVES ........................................................................................................ 8 3. RISK ...................................................................................................................... 8 4. VULNERABLE PEOPLE ……………………………………………………………….10 5. WEATHER AND INFORMATION SERVICES ……………………………………….12 6. ALERTING AND ACTIVATION OF EMERGENCY RESPONSE ..........................15 7. GENERIC CONCEPT OF EMERGENCY RESPONSE TO A SEVERE……………. WEATHER EVENT ……………………………………………………………………..16 8. ROLES AND RESPONSIBILITIES .......................................................................17 9. WARNING AND INFORMING ..............................................................................21 10. RECOVERY .........................................................................................................21 12. TRAINING ............................................................................................................21 13. EQUIPMENT ........................................................................................................21 14. HEALTH AND SAFETY ........................................................................................21 15. FINANCE ..............................................................................................................21 ANNEX A SEVERE WEATHER ALERT LEVELS AND RESPONSE ACTIONS ........22 ANNEX B WEATHER ACTIVITY TABLE FOR EMERGENCY RESPONDERS .........22 ANNED C WARNING AND INFORMING - CCG COMMUNICATIONS ACTION ….. PLAN FOR SEVERE WEATHER .…………………………………………………………..27 ANNEX D PROVIDERS - LEVELS 0-4 ………………………………………………….39 ANNEX E KEY TRIGGER TEMPERATURES ………………………………………….40 ANNEX F ACTION CARDS PUBLIC HEALTH ENGLAND …………………………….41 ANNEX G LA and VCS CONTACTS ……………………………………………………...42

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AMENDMENTS

AMENDMENT DATE OF ORIGINAL

AMENDED

CHANGE

Updated in line with Cold Weather Plan for England

February 2015 December 2015

Updated December 2015 June 2016 Updates Updated June 2016 November 2016 Updates

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DISTRIBUTION

East and North Herts Trust Hertfordshire Urgent Care Health and Community Services Hertfordshire Partnership Foundation Trust Hertfordshire Community Services Hertfordshire County Council Hertfordshire Borough Council Hertfordshire Fire & Rescue NHS England - East Anglia Area Team Hertfordshire CCGs East of England Ambulance Service NHS Trust Environment Agency Public Health England - Anglia Public Health Team

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GLOSSARY

Abbreviation Description

ACS Hertfordshire County Council Adult and Community Services Di t t CCGs Clinical Commissioning Groups

CYP Hertfordshire County Council Children’s and Young People’s Di t t DCLG Department for Communities and Local Government

EPRR Emergency Preparedness, Resilience and Response

HA Highways Agency HWB Health and Wellbeing Boards

HWS Health and Wellbeing Strategy

LA Local Authority LHRP Local Health Resilience Partnership

MIU Minor Injuries Unit

NRC Network Response Centre

NSWWS National Severe Weather Warning Service

OGD Other Government Department

PHE Public Health England

RED Resilience and Emergencies Division, DCLG

The Cabinet Office has produced the Civil Protection Lexicon. This is a single point of reference for terminology used in UK civil protection. The lexicon provides a common, agreed set of definitions for terms used across the range of Integrated Emergency Management activities.

https://www.gov.uk/government/publications/emergency-responder-interoperability-lexicon

INTRODUCTION This plan is the multi-agency response plan for severe weather events in Hertfordshire and provides outline information on the response, management and roles and responsibilities of individual agencies.

Despite the warming effects of climate change, cold weather remains the biggest cause of weather related mortality in England. The Cold Weather Plan for England (‘the plan’) aims to prevent avoidable harm to health, by alerting people to the negative health effects of cold weather, and enabling them to prepare and respond appropriately. The plan recommends a series of steps, to be taken throughout the year, to reduce the risks to health from cold weather for:

• the NHS, local authorities, social care, and other public agencies • professionals working with people at risk • individuals, local communities and voluntary groups

This plan was devised and written by Sharn Elton, Director of Operations.

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1. AIM The aim of this plan is to provide a multi-agency emergency response framework for all agencies responding to a severe weather event in Hertfordshire.

2. OBJECTIVES

a. Identify the risks and provide advice and information to communities and

individuals to enable them to be prepared for the effects of a severe weather event.

b. To provide a clear and concise procedure for the assessment of weather

warnings, together with a corresponding escalation procedure and plan activation process.

c. Agree specific roles, responsibilities and actions for all agencies involved in the

response to a severe weather event.

d. Identify key response issues that should be considered at both strategic and tactical levels in responding to a severe weather event.

e. Determine activities to reduce disruption to the communities, utilities,

businesses, and to protect the environment.

f. Lead recovery activity to support the recovery of communities and businesses. 3. RISK

a. Overview. The nature of Hertfordshire is such that in the past it has been subject to a wide variety of severe weather events. These have included heavy snowfall in 2003, 2009 and 2010 which caused widespread disruption, heat waves in 2003 and 2006 and damage caused by the high winds in 1987 and 1990. The county will continue to be susceptible to severe weather conditions which are likely to change as the effects of climate change will present new challenges or effects of greater consequences.

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b. Community Risk Register. A variety of severe weather risks have been rated as to their likelihood and potential effects on the county in the Hertfordshire Community Risk Register. http://m.hertsdirect.org/services/commsafe/commprotect/emeresilience/hertsrespartnership/

Risk Rating Hazard Description

HIGH

Low Temperatures and Heavy Snow

Snow falling and lying over most of the county for at least one week. After an initial fall of snow there is further snow fall on and off for at least 7 days. Most areas experience some falls in excess of 10cm, some drifts in excess of 30cm and a period of at least 7 consecutive days with daily mean temperature below -3ºC. There is likely to be some disruption to transport networks, businesses, power supply and water supply, and also school closures.

HIGH

Storms and Gales

Storm force winds affecting most of a county for at least 6 hours. Most areas experience mean speeds in excess of 55mph with gusts in excess of 85mph. Short term disruption to infrastructure including power, transport networks, homes and businesses.

HIGH

Heatwave

Daily maximum temperatures in excess of 32°C and minimum temperatures in excess of 15°C over most of a county for at least 5 consecutive days. There is likely to be disruption to power supply and transport infrastructure.

• Severe Weather and Climate Change. Climate change forecasts indicate that Hertfordshire is likely to experience:

• Blocked weather patterns leading to prolonged periods of similar, possibly

extreme, weather. • Greater winter rainfall leading to an increase in flooding. • Reduction in summer rainfall amounts. • Increases in summer rainfall intensities. • More severe storm events – windstorms and extreme rainstorms • Overall increases in annual mean temperatures. • Increases in the number of very hot days. • Increase in fire risk due to changes in biodiversity for upland areas.

The Recovery Plan will need to be flexible in its approach and be responsive to severe weather as the climate changes and adapt its plans in an appropriate manner.

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http://m.hertsdirect.org/services/commsafe/commprotect/emeresilience/hertsrespartnership/


4. VULNERABLE PEOPLE

a. During a significant severe weather event anyone has the potential to become vulnerable due to the factors in disaster-related incidents. However, for a significant number of people the experience can be serious as it has the potential to remove them from established support mechanisms or expose particular vulnerabilities.

b. Vulnerable groups within the community will need special provision both in implementing any preparatory and precautionary measures for a potential severe weather event, and also in response to an incident. There are 3 categories of individuals that may fall into a ‘vulnerable group’:

• People who are generally independent, albeit with a structured support

environment, in their normal daily circumstances, i.e. residential health / social home, or similar circumstances, or;

• People who due to an event or situation, such as illness, operation or accident who are now dependent upon others to support and care for them to survive independently within the community or;

• People who through individual circumstances (age, disability, or language barriers) may require extra support and care to deal with the consequences of being involved in an emergency.

c. Separate plans and guidance are being devised to assist in the identification of vulnerable groups and individuals. These provide a flexible process for collating and sharing information between responders whilst maintaining confidentiality, and detail additional support measures or actions that may be required to assist these groups or individuals during an incident. Individuals from the following key groups are considered to be particularly at-risk in the event of severe weather event:

• Older people (over 75 years old) • Pregnant Women • People assessed as being at risk of, or having had, recurrent falls. • Elderly people who live alone and do not have additional social services

support people who are housebound or otherwise low mobility. • Frail elderly. • Children under the age of five or with disabilities. • Homeless or people sleeping rough. • People who have had operations – temporary. • People with pre-existing or long term serious medical conditions medical

conditions, especially those requiring medical support equipment or regular medication.

• People with long term mental health problems or learning difficulties that reduces individual’s ability to self-care (including dementia).

• Pregnant women and new-born children. • People living in isolated rural villages. • People living in deprived circumstances or who are fuel poor • Other marginalised groups

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The Impact of Cold Weather on Health The impact of cold weather on health is predictable and mostly preventable. Direct effects of winter weather include an increase in incidence of:

• heart attack • stroke • respiratory disease • influenza • falls and injuries • hypothermia

Indirect effects of cold include mental health illnesses such as depression, and carbon monoxide poisoning from poorly maintained or poorly ventilated boilers, cooking and heating appliances and heating. Groups at greater risk of harm from cold weather

• older people (in particular 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 fetus) • 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 • other marginalised or socially isolated individuals or groups

Key Public Health Messages Keep in the warmth by:

• fitting draught proofing to seal any gaps around windows and doors • making sure you have loft insulation. And if you have cavity walls, make sure they are

insulated too • insulate your hot water cylinder and pipes • draw your curtains at dusk to help keep heat generated inside your rooms • make sure your radiators are not obstructed by furniture or curtains

Look after yourself:

• food is a vital source of energy and helps to keep your body warm so have plenty of hot food and drinks

• aim to include five daily portions of fruit and vegetables. Tinned and frozen vegetables count toward your five a day

• stock up on tinned and frozen foods so you don’t have to go out too much when it’s cold or icy

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• exercise is good for you all year round and it can keep you warm in winter • if possible, try to move around at least once an hour. But remember to speak to your GP

before starting any exercise plans • wear lots of thin layers – clothes made from cotton, wool or fleecy fibres are particularly

good and maintain body heat • wear good-fitting slippers with a good grip indoors and shoes with a good grip outside to

prevent trips, slips and falls • make sure you have spare medication in case you are unable to go out • Check if you are eligible for inclusion on the priority services register operated by your

water and power supplier. Look after others:

• check on older neighbours or relatives, especially those living alone or who have serious illnesses to make sure they are safe, warm and well

Get financial support:

• there are grants, benefits and sources of advice to make your home more energy efficient, improve your heating or help with bills. It’s worthwhile claiming all the benefits you are entitled to before winter sets in

• Free flu vaccinations • Keep your home warm, heating to at least 18 degrees C • Look after others • Get financial support • Look after yourself, eat well, exercise, wear lots of thin layers • Beat the Heat Poster: an infographic for the public with key advice for staying safe in

hot weather and supporting leaflet • Beat the Heat: keep cool at home checklist – to help people identify situations where

overheating in the home may cause harm to health Free flu vaccinations are available for those who: • are aged 65 or older • are aged two, three or four years old (but not five years or older) on 31 August 2015 • are children of school years 1 to 3 • are primary school-aged children in areas that previously participated in primary school

pilots in 2014/15 • are pregnant • have a serious medical condition such as chronic heart, lung, neurological, liver or

kidney disease, or diabetes • have a weakened immune system due to disease or treatments that suppress the

immune system such as chemotherapy • have had a stroke or transient ischaemic attack (TIA) or post-polio syndrome • are living in a long-stay residential care home or other long-stay care facility (not prison

or university halls) • are the main carer for an elderly or disabled person whose welfare may be at risk if you

fall ill

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Stay Well This Winter Public Health England and NHS England have developed an integrated marketing campaign, Stay Well This Winter, which starts in October. The campaign aims to help those with long term health conditions, 65 or over, pregnant women and parents of under 5s stay well and keep their loved ones well this winter. Further information is available from: https://campaignresources.phe.gov.uk/resources/campaigns/34-stay-well-this-winter/overview The behaviour change campaign targets a range of self-care behaviours including: • Encouraging flu vaccination • Heating your home to at least 18 degrees (65 Fahrenheit) • Seeking early advice and help from pharmacists • Preparing ahead of holiday periods or bad weather (ensuring you have prescription medicine, food supplies and looking out for others). Publication of new leaflet entitled ‘Top Tips for Keeping Warm and Well’ -

Keep_warm_keep_well_leaflet_2016.pdf Recommended indoor temperatures for homes in winter Heating homes to at least 18°C (65F) in winter poses minimal risk to the health of a sedentary person, wearing suitable clothing. Daytime recommendations:

• the 18°C (65F) threshold is particularly important for people 65 years and over or with pre-existing medical conditions; having temperatures slightly above this threshold may be beneficial for health

• the 18°C (65F) threshold also applies to healthy people (1 –to 64 years)*; if they are wearing appropriate clothing and are active, they may wish to heat their homes to slightly less than 18°C (65F)

Overnight recommendations

• maintaining the 18°C (65F) threshold overnight may be beneficial to protect the health of those 65 years and over or with pre-exisiting medical conditions; they should continue to use sufficient bedding, clothing and thermal blankets, or heating aids as appropriate

• overnight, the 18°C (65F) threshold may be less important for healthy people (1 to 64)* if they have sufficient bedding, clothing and use thermal blankets or heating aids as appropriate

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https://campaignresources.phe.gov.uk/resources/campaigns/34-stay-well-this-winter/overview

https://campaignresources.phe.gov.uk/resources/campaigns/34-stay-well-this-winter/overview

5. WEATHER AND INFORMATION SERVICES

The trigger for the activation of this plan will be by notification to responder agencies from: Met Office Service and Notifications

Service Purpose Distribution Timing General weather forecast

To enable the UK public to make informed decisions about their day-to-day activities

Web, TV, radio Every day

National Severe Weather Warning Service (NSWWS)

Provision of weather warnings to: a) the public to alert in advance of high impact weather and to prompt consideration of actions they may need to take b) Civil emergency authorities and the MoD to trigger their plans to protect the public from impacts in advance of an event, and to help them recover from any impacts after the event.

Email, web, TV, radio, print media, Twitter, SMS, Facebook

When required

Cold Weather Alerts To provide early warning of low temperature and or widespread ice/heavy snow to health and social care organisations and professionals registered with the service

Email, Twitter, Web Alert issued as soon as agreed threshold has been reached and when there is a change in alert level. Issued between 1 November and 31 March.

Cold Weather Planning Advice

To provide planning advice throughout the winter period relating to low temperatures or widespread ice/heavy snow to health and social care organisations and professionals registered with the service

Email Twice a week (9am each Monday and Friday from 1 November to 31 March.

a. Met Office National Severe Weather Warning Service1. This service notifies agencies through the provision of warnings of severe or hazardous weather which can cause problems ranging from widespread disruption of communications to conditions resulting in transport difficulties or threat to life. The National Severe Weather Warning Service provides two levels of warning for the following types of weather conditions and these will be reinforced using the following icons:

• rain; • ice; • wind; • fog. • snow;

The two levels of warning are:

(i) Alerts: These are issued more than 24 hours ahead.

(ii) Warnings: These are issued up to 24 hours ahead.

Weather warnings will be assigned a colour indicating a combination of the level of impact and the likelihood of the severe weather. The colours will be assigned according to a matrix (Fig 1) to give each warning a colour:

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http://www.metoffice.gov.uk/publicsector/nswws


Fig 1:

High Likelihood

Medium Likelihood

Low Likelihood

Very Low Likelihood

Very Low Impact

Low Impact

Medium Impact

High Impact

The tables on the Met Office website provide examples of the level of disruption which might be found at each of the impact levels and for each weather element (rain, snow etc.). Note weather assessed as having a “Very Low” impact may still have some minor impacts.

The basic messages associated with each of the colour states are:

1 http://www.metoffice.gov.uk/publicsector/nswws

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No Severe Weather

Be Aware

Be Prepared

Take Action

In addition, the Chief Forecaster’s assessment explains why the warning has been issued and the likely impacts as well as indicating where any uncertainties lie.

Further advice on any warnings issued can be obtained from the duty forecasters at the Met Office, or from the regional Public Weather Service (PWS) Advisor2. The PWS Advisor for the Eastern Region can provide more localised interpretation of forecasts. They can also be called upon to provide advice at multi-agency or Strategic Coordinating Group (SCG) meetings.

b. Hazard Manager3. Hazard Manager is a one-stop information source for the emergency response community. It is designed to supplement the role of the PWS Advisors in providing consistent weather-related information and interpretation of severe weather events. The services currently available on Hazard Manager are:

• Interactive Map Viewer with weather information. • Flood Guidance Statements. • Weather warnings. • Hazard Advice. • FireMet and CHEMET services.

c. Heat-Health Watch System.4 The Heat-Health Watch system is operated by the Met Office and the Department of Health from the 1st of June until the 15th of September each year. The Met Office issues weekly notifications by email during this period. All agencies ensure they are signed up to receive these notifications and will act in accordance with the activity levels shown in Annex B. The Met Office may forecast a heatwave where regional trigger threshold temperatures are met or exceeded. The system operates with five levels – Blue, Green, Yellow, Amber and Red – full details can be found in Annex A of this plan. The JEPU and Hertfordshire Clinical Commissioning Groups (CCGs) receive email forecasts / alerts from the Met Office along similar lines of warnings received through the National Severe Weather Warning Service (NSWWS).

d. Cold Watch System. A Cold Watch system will operate from 1st November to 31st March each year. During this period, the Met Office may forecast extreme winter weather, as defined by forecasts of temperatures, snow and ice formation and their duration. There will be consultation between the Met Office and the Department of Health to raise alerts at appropriate level in view of the weather forecasts and their likely impacts. There are five levels of alert – 0 to 4 – full details can be found in Annex A of this plan.

2 http://www.metoffice.gov.uk/publicsector/PWSA 3 http://www.metoffice.gov.uk/publicsector/hazardmanager/access - please note: this service is not publicly available 4 http://www.metoffice.gov.uk/weather/uk/heathealth

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http://www.metoffice.gov.uk/publicsector/PWSA


http://www.metoffice.gov.uk/publicsector/hazardmanager/access


http://www.metoffice.gov.uk/weather/uk/heathealth

https://www.gov.uk/government/publications/cold-weather-plan-for-england-2013



http://www.metoffice.gov.uk/weather/uk/heathealth

An alert for snow and ice will be issued when there is a high likelihood (60% or more) that there will be snow or widespread ice affecting one or more regions in the next five days, A level 2 will be issued when this weather is forecast and a level 3 when the snow and ice is occurring. Heavy snow – Snow that is expected to fall for at least two hours. Geographic extent is not considered, and sometimes the event can be quite localised, but the Met Office will always try to indicate which area will be affected in the alert. Widespread ice – Ice forms when rain falls on surfaces at or below zero; or already wet surfaces fall to or below zero. The ice is usually clear and difficult to distinguish from a wet surface. It usually forms in sheets. Warnings are issued when any depth of ice is expected over a widespread area. Warnings will also be issued after a snowfall when compacted snow is expected to cause an ice risk. The term “widespread” indicates that icy surfaces will be found extensively over the area defined by the Met Office in the alert.

The Met Office issues these alerts down to a county level, so either of the warnings above could be issued even if only one county is likely to be affected. e. Highways. Hertfordshire County Council receives daily forecasts from which service decisions are made by the HCC Winter Service – Senior Decision Maker. When severe weather is predicted or in place, then direct contact can be made with the forecasters to discuss and plan accordingly. f. Highways Agency. A Highways Agency Winter Service is operated from the 1st

October to the 31st April each year. A daily road weather forecast enables winter decisions to be made. The Highways Agency Emergency Planning Team also has access to the Met Office weather updates from embedded forecasters at their National Traffic Control Centre.

g. Other Means of Notification. Any Hertfordshire Category 1 or 2 Responder can use the Hertfordshire Alerting Directory to initiate the generation of all or part of the Hertfordshire crisis management structure, in response to a severe weather warning. Notification may also be made to activate the plan due to the consequential issues that have arisen due to a severe weather event. Information may also be provided by members of the public contacting individual emergency services or other Hertfordshire partners in response to specific severe weather related events.

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Individual agencies conduct Risk Assessment

(Consider range of factors - other prevailing conditions, recent weather

conditions)

6. ALERTING AND ACTIVATION OF EMERGENCY RESPONSE

Receive NSWWS Alert / Warning

Met Off PWS Advisor email Intelligence from Cat 1/2 responder

Monitor Situation

Multi-agency No Teleconference

required?

Yes

Insufficient resources for single

No agency response? Coordinated

activity required?

Yes

Establish TCG and / or SCG,

as appropriate

Implement Multi-agency

Response

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7. GENERIC CONCEPT OF EMERGENCY RESPONSE TO A SEVERE WEATHER EVENT

Emergency Management

The process of declaring a Multi-agency or Major Incident will follow procedures laid down in the Hertfordshire Generic Response and Recovery Plan. The management of severe weather events is split into 4 levels; these mirror the alert levels for the specific response plans:

a. Level 0 – Long-term planning

- Identify Emergency Services and other multi-agency partners likely to be affected by severe weather event.

- Review plans, contingency arrangements and responsibilities in the pre- seasonal period.

b. Level 2 – Prevention

- At start of appropriate severe weather season, review public information and advice.

- Issue general preparation messages to public and multi-agency partners.

c. Level 3 – Response

- On receipt of specific severe weather warnings, Emergency Managers conduct risk assessments and either monitor situation or: - Implement response plan activities. - Issue messages to public and other multi-agency partners.

d. Level 4 – Emergency Response

- As appropriate, implement multi-agency coordination or Major Incident command and control when services are being severely affected (power failure, major transport disruption, etc.).

The multi-agency action plan for severe weather events is at Annex B. Further details on specific agency response actions are included in individual organisation’s response plans.

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8. ROLES AND RESPONSIBILITIES The following roles and responsibilities are more specifically envisaged in a Hertfordshire response to a severe weather event:

Hertfordshire Resilience Forum (HRF):

• Monitor the situation for significant weather changes or new warnings being

issued; • Consider declaration of Multi-Agency Incident or Major Incident, as appropriate • Identify requirements for any cross-agency staff or resources from Multi-Agency

partners; • Provision of coordinated public warnings and advice in response to hazardous

situations. DCLG RED:

• Support the co-ordination of the response where the emergency crosses a number of counties within the region and brokerage of mutual aid across the region and between regions;

• Co-ordinate regional response activity with national response activity including coordination of resource requests.

East of England Ambulance Service NHS Trust (EEAST):

• Identify, in conjunction with partners, those persons who will require evacuation or special care measures from the ‘At Risk Register’;

• Coordinate the use of the voluntary and private sector in health emergency response.

Environment Agency (EA):

• Prevent/control and monitor the input of pollutants to the environment; • Provide advice and technical support to other partners on the disposal of waste; • Provide advice and technical support to partners on the environmental issues; • Monitor water resource situation and put in place appropriate measures if

required. Hertfordshire Constabulary:

• Lead and co-ordinate the evacuation of a given area if considered appropriate; • Traffic management, assisted by Highways Agency and Hertfordshire

Highways, as appropriate; • Closure of roads as appropriate; • Control of movement in areas where hazards are present.

Hertfordshire Fire and Rescue Service:

• In conjunction with other agencies, assist with rescue operations.

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Hertfordshire Local Authorities:

Hertfordshire County Council: • Disseminate warning messages to social care and voluntary providers; • Provide business continuity advice to businesses and voluntary

organisations to enable them to mitigate the effects of severe weather; • Provision of emergency transport if required; • Provide specialist advice on the safety of roads/bridges; • Social care support for vulnerable or displaced people; • Assist traffic management through provision of highways support - roads &

signs, road clearance; • Treatment of roads to clear snow and ice; • Mitigation of any environmental hazards (e.g. Closure of countryside parks or

Rights of Way); • Management of environmental, food and water safety, pollution issues; • Liaison and coordination of support to and from community resilience groups.

District / Borough:

• Provision of emergency welfare for people, pets and livestock who become unavoidably detained and stranded;

• Provision of temporary emergency accommodation; • Liaise with Town/Parish councils resilience groups; • Provision of emergency transport (IBC only); • Monitor/repair coastal protection structures; • Local management of environmental, food and water safety, pollution issues; • Confirm building structural safety and suitability for human occupation; • Assist in the clearance of debris; • Coordinate and provide advice on waste disposal and collection.

Public Health England and Director of Public Health:

• Provide clear and unambiguous advice on the health implications of a severe weather event;

• Provide health guidance and advice where necessary directly Hertfordshire Clinical Commissioning Groups (CCGs):

• The CCG is responsible for leading the system and co-ordinating the health system response. At the declaration of alert level 3 (p15) the CCG must take the lead in ensuring that key providers and partners have taken appropriate action, including:

• Conducting risk assessments • Implementing response plans and ensuring message to the public and other

multi agency partners, as required • Co-ordinating and leading the system response

Highways Agency:

• Provide temporary traffic management at any incident in support of the Police; • Set strategic and tactical Vehicle Management Signs to support road closures; • Provision of timely advice to the public on route availability and any diversion routes; • Restore the highway to operational use, by snow clearance, treatment of the road /

making the surface safe, removal of debris as a result of the conditions or incidents.

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Military:

• Provision of specialist advice and support, as available under the Military Aid to the

Civil Authorities (MACA) arrangements. Utilities:

Major utilities such as National Grid (Gas) and National Grid (Electricity), UK Power Networks, Anglian Water, Essex & Hertfordshire Water, British Telecom have their own contingency plans, which would be activated as required. Companies will be required to liaise closely with emergency services and local authorities during the response and recovery phase, including linking in with Hertfordshire crisis management structures.

Voluntary Sector:

• The numerous voluntary organisations, nationally, regionally and in Hertfordshire,

have the potential to provide additional capacity and specialist capability for any incident response or during the recovery phase;

• Responsibility for coordinating the response of voluntary groups is likely to rest with the Local Authority, through Hertfordshire Voluntary Organisations Group (HVOG).

Community Resilience

A number of Parish, Town Councils and other community groups, have developed Community Emergency Plans for their areas. The County Council and District Council Community Teams will liaise with and coordinate Community Emergency Teams to enable a coordinated and supported response of communities with the Emergency Services.

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http://www.suffolkresilience.com/about-the-srf/membership/other-agencies-and-organisations/

9. WARNING AND INFORMING

a. Warning and Informing the Public

One of the key aspects of any preparation and response to a severe weather event is the timely dissemination of accurate information, advice and warnings to the public. As severe weather tends to be seasonal, advice and preparatory information will be circulated as part of a coordinated strategy, linked to the 4 preparedness and response levels. This strategy is aimed at raising awareness and escalating from advice to warnings on notification of specific severe weather. Hertfordshire District Council will lead on the planning and development of generic media advice in respect of warning / information. This will consider key messages (normally no more than 4), who the information is targeted at, what methods should be used for dissemination and what detailed information should be given (supplied by emergency planners). These messages should be pre-prepared and reviewed at Level 1 and available for release from Level 2 onwards in the appropriate annexes to this plan.

General advice to the public on preparing for and action to take in the event of severe weather is available from a number of sources listed below:

- Hertfordshire Resilience - general severe weather preparation information -http://m.hertsdirect.org/services/commsafe/commprotect/emeresilience/hertsrespartnership/

- Hertfordshire Community Emergency Preparedness - advice and information -http://m.hertsdirect.org/importantnews/

- The Met Office website - general severe weather preparation information - Met Office: What to do in severe weather.

- Department of Health, Public Health England websites – provide health-related information, guidance and advice.

- Department for Education - provide advice to educational establishments on preparation for severe weather.

- The Highways Agency provides information on routes and travel disruptions on their website Traffic England. UK wide travel information is available from Transport Direct.

- AA Roadwatch will also be used to broadcast warnings - http://www.theaa.com/travelwatch/travel_news.jsp.

- Regional or national television may broadcast weather warning information during major events.

- Local radio stations.

An outline of the likely advice, information and warnings that will be issued by the CCG communication team - Annex C.

b. Media

The media interest in any significant severe weather event, based upon historical evidence, is likely to be very high. The management of the Hertfordshire media response will be guided by Hertfordshire County Council

23



http://m.hertsdirect.org/importantnews/

http://www.metoffice.gov.uk/weather/uk/advice

http://www.metoffice.gov.uk/weather/uk/advice

http://www.dh.gov.uk/en/index.htm

https://www.gov.uk/government/organisations/public-health-england

https://www.gov.uk/emergencies-and-severe-weather-schools-and-early-years-settings

http://www.trafficengland.com/index.aspx

http://www.transportdirect.info/Web2/LiveTravel/Home.aspx?cacheparam=2

http://www.theaa.com/travelwatch/travel_news.jsp

10. RECOVERY

At, or shortly after the declaration of a Multi-Agency or Major Incident, the County Council will convene a Recovery Working Group (RWG) to prepare for the management of the post response activity aimed at restoring and rebuilding affected communities in the aftermath of a major severe weather event.

12. TRAINING Any additional staff brought in to augment Hertfordshire responders may require to be trained and equipped to complete assigned tasks. Training of responders will take place either by individual agencies or multi-agency to ensure people can conduct the required response role and operate collectively.

13. EQUIPMENT Procurement of equipment and supplies during an emergency response should wherever possible follow existing agency procedures. However, the multi-agency County Council Logistics Cell may co-ordinate the procurement and distribution of additional or specialist emergency supplies during a major incident

14. HEALTH AND SAFETY All organisations referred to in this plan will have relevant risk assessments in place to carry out their organisation’s responsibilities.

15. FINANCE Initially the provision of support to an emergency response is provided at the cost to the providing organisation. Where costs are significant, applications can be submitted by local authorities via the Bellwin Scheme which provides details on who is eligible for financial support

Annexes

Annex A – Severe Weather Alert Levels and Response Actions.

Annex B - Weather Activity Table for Emergency Responders

Annex C - Warning and Informing – CCG Communications Action Plan for Severe Weather Annex D – Health and social care staff in all settings (community, hospitals and care homes) Annex E – Key Trigger Temperatures Annex F – Action Cards from Public Health England

Annex G – LA and VCS Contact

24

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/5943/2160230.pdf

ANNEX A SEVERE WEATHER ALERT LEVELS AND RESPONSE ACTIONS 1. HEATWAVE

The Heat-Health Watch system operates from 1 June to 15 September each year. The Met Office uses this system to trigger heatwave warnings where the regional threshold temperatures are met or exceeded. The average threshold temperatures for this region are:

• Day time temperature of 30°C or more. • Night time minimum threshold temperature of 15°C or more.

Level 0 Long-term planning All year

Level 1 Heatwave and Summer preparedness programme 1 June – 15 September

Level 2 Heatwave is forecast – Alert and readiness 60% risk of heatwave in the next 2–3 days

Level 3

Heatwave Action Temperature reached in one or more Met Office National Severe Weather Warning Service regions

Level 4

Major incident – Emergency response Central Government will declare a Level 4 alert in the event of severe or prolonged heatwave affecting sectors other than health

2. COLD WATCH

A Cold Watch system will operate in England and Wales from 1st November to 31st March each year. During this period, the Met Office consults with the Department of Health, the Cabinet Office and other experts to raise alerts at appropriate level in response to the weather forecasts and their likely impacts.

Level 0 Long-term planning All year

Level 1 Winter preparedness and action programme 1 November to 31 March

Level 2

Severe winter weather is forecast – Alert and readiness Mean temperature of 2°C and/or widespread ice and heavy snow are predicted within 48 hours, with 60% confidence.

Level 3

Response to severe winter weather – Severe weather action Severe winter weather is now occurring: mean temperature of 2°C or less and/or widespread ice and heavy snow.

Level 4

Major incident – Emergency response Central Government will declare a Level 4 alert in the event of severe or prolonged cold weather affecting sectors other than health

25

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ANNEX B WEATHER ACTIVITY TABLE FOR EMERGENCY RESPONDERS

Activity Level Level 0 Level 1 Level 2 Level 3 Level 4

Generic activity levels for ALL SEVERE WEATHER for emergency responder organisations

LONG TERM PLANNING

All year

PREPAREDNESS

ALERT AND READINESS

ACTION

MAJOR INCIDENT - EMERGENCY RESPONSE

Warning and Informing activity

Develop communications strategies to encourage resilience and preparedness.

Prepare core messages to be broadcast alongside national, PHE messages aligned to warnings and weather forecasts.

Appropriate agencies register to receive weekly Heat-Health Watch and Cold Weather Plan notifications and alerts.

Consider issue of general media messages.

Post advice links on agency’s websites.

Appropriate agencies receive weekly Heat- Health Watch and Cold Weather Plan notifications and alerts

Issue media messages – especially ‘hard to reach groups’.

Agencies to receive Met Office weekly notifications

Update Community Resilience partners and encourage review of community emergency plans.

Agencies to receive Met Office weekly notifications

Update Community Resilience partners and ask them to activate their community emergency plans

Specific activity levels associated with Heatwave

All Agencies

Make environmental improvements to provide a safe environment for clients in the event of a heatwave.

Prepare business continuity plans to cover the event of a heatwave (e.g. storage of medicines, computer resilience, etc.).

Work with partners and staff to raise awareness of the impacts of severe heat and on risk reduction awareness

All Agencies

Coordinate individual agency heatwave Contingency plans & business continuity arrangements.

Liaise with partners on joint preparedness arrangements.

Circulate National heatwave guidance and advice – schools, care settings, prisons, and voluntary organisations.

All Agencies

Liaise and confirm status of heatwave response, logistics and monitoring mechanisms (Cat 2 responders as appropriate).

Communicate alerts to staff and make sure that they are aware of heatwave plans

Increase advice to health and social care workers working in community, care homes and hospitals

All Agencies

Convene Hertfordshire teleconference to identify Particular heatwave related issues and potential mitigation strategies (NHS lead).

Review safety of public events.

Issue warning information and media alerts.

NHS & Local Authority (ACS & CYP)

Continue to distribute DH advice / guidance to…

All Agencies

Convene TCG/SCG to coordinate implementation of mitigation measures and national guidance (NHS lead).

Update warnings, information and media alerts.

NHS & Local Authority

Coordinate the implementation of DH advice / guidance

…cont…

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Hertfordshire District Council

Engaging the community & voluntary sector to support development of local community emergency plans

Encourage development of community emergency plans to identify and support vulnerable neighbours.

PHE / NHS England

Issue general advice to the public and professionals.

Health / Care providers

Identify high risk individuals and monitor care settings.

PHE / NHS England

Provide guidance to professional partners and advice to Public.

Routinely monitor syndromic and mortality surveillance

Health / Care providers

Communicate alerts to staff

Implement heatwave measures and arrangements to monitor those identified at high risk.

PHE / NHS England

Issue Level 2 alert to professional partners and advice to Public.

Continue to monitor syndromic and mortality surveillance

people at risk, residential care managers and carers.

Commission additional care and support, involving at least daily contact, as necessary for at risk individuals living at home. This may involve informal carers, volunteers and care workers.

Continue to distribute guidance to head teachers.

guidance to residential care managers, carers and head teachers.

Specific activity levels associated with WIND

All Agencies


All Agencies

Confirm individual agency contingency & business continuity plans.

Cat 1 and 2 agencies liaise on joint preparedness arrangements.

Review pre-prepared general information and guidance.

All Agencies

Cat 1 EP practitioners liaise and confirm status of response, logistics and monitoring mechanisms (Cat 2 responders as appropriate).

Identify public events likely to be affected.

Issue public information advice and guidance.

All Agencies

Convene Hertfordshire teleconference to identify particular issues and potential mitigation strategies (LA lead).



Police, LA & HA

Manage disruption to transport infrastructure

All Agencies

Convene TCG / SCG to coordinate implementation of mitigation measures and national guidance (LA lead).


LA & HA

Coordinate and prioritise route maintenance operations.

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Specific activity levels associated with RAIN

All Agencies

Business as usual

Activity as per WIND (Above).

All Agencies

Business as usual

Activity as per WIND (above).

All Agencies5

Convene Hertfordshire Flood Advisory Telecon to identify particular issues and potential mitigation strategies (LA lead).

Inform partners of identified risk area(s).

Consider establishing TCG / SCG

Consider implementing Operational Flood Plan actions.

Review supporting Emergency Plans.

Consider mobilisations of resources – personnel, plant, flood protection, voluntary organisations

Consider / Implement activation of evacuation plans and arrange for rest centres to be set up.

All Agencies10

Convene Hertfordshire

TCG / SCG to coordinate implementation of mitigation measures and national guidance (LA lead).

Identify risk / effected areas.

Consider wider flood risks and refer to the Hertfordshire Flood Plan Activate Operational Flood Plan actions.

Consider / Implement activation of evacuation plans and arrange for rest centres to be set up.

5 Medium and High activity as detailed in the HERTFORDSHIRE Flood Plan v.5

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Specific activity levels associated with SNOW & ICE

All Agencies

Review actions and guidance from PHE Cold Weather Plan.

Work with partner agencies to ensure that cold weather planning features within wider winter resilience planning.

Work with partners and staff on risk reduction awareness (e.g. flu vaccinations, signposting for winter warmth initiatives.


Engage with local statutory partners to agree how voluntary organisations can contribute to local community resilience arrangements.

PHE and NHS England

Issue general advice to the public and professionals and work closely with other government departments

All Agencies

Confirm individual agency winter contingency & business continuity plans.

Cat 1 and 2 agencies liaise on joint preparedness arrangements.

Identify categories of vulnerable individuals & groups.

Review pre-prepared general information and guidance.

LA in consultation with HA

Review winter service plans (Snow clearance and gritting) strategy.


Identify measures to reduce effects of cold on at risk groups - vulnerable adults and young people.

All Agencies

Cat 1 EP practitioners liaise and confirm status of winter response, logistics and monitoring mechanisms (Cat 2 responders as appropriate).

Identify public events likely to be affected.

Issue public information advice and guidance.


Distribution of DH & DfE guidance to residential care managers and carers, schools, Sure Start centres and children’s nurseries.

LA

Deliver winter service plan, which includes actions for severe weather situation.

All Agencies

Convene Hertfordshire teleconference to identify particular snow-related issues and potential mitigation strategies (LA or NHS lead).




Continue to distribute DH & DfE guidance and advice.

Identify and provide any specific support requirements for at risk individuals or groups.

LA and HCC

Implement snow clearance and gritting contingency plans.

Police and HCC

Manage disruption to transport infrastructure.

Coordinate route information.

All Agencies

Convene TCG / SCG to coordinate implementation of mitigation measures and national guidance (LA lead).



Liaise on implementation of DH advice / guidance.

Continue distribution of guidance to residential care managers, carers and head teachers.

LA & HCS

Establish severe weather desk to manage and coordinate winter service activities.

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Activity Level Level 0 Level 1 Level 2 Level 3 Level 4 and other national

organisations that produce winter warmth advice.

Specific activity levels associated with FOG

All Agencies

Business as usual


All Agencies

Business as usual


All Agencies

Consider media messages

Police and HA

Manage transport disruptions

Activate matrix signs

All Agencies

N/A

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ANNEX C - WARNING AND INFORMING CCG communications action plan for severe weather CCG communications action plan for severe weather

Introduction

In anticipation of, and in the event of severe weather (either heat or cold) the CCG communications team will work collaboratively with communications leads from partner and provider organisations to ‘warn and inform’ the public, health professionals, staff and provider organisations. This is to ensure that anyone at risk and the organisations that care for them have the information they need to mitigate against weather-related health conditions, thereby safeguarding their own health and reducing the strain on NHS services.

The level and nature of severe weather communications activity is dictated by the nationally-agreed actions linked to the Met Office’s ‘watch alert’ system, which links communications actions to day and night-time temperatures and the duration of those temperatures. Met Office alerts are received by the communications team through the CCG’s ‘enquiries’ email inbox.

Who does what?

The Director of Public Health (based at Hertfordshire County Council) is responsible for population health outcomes, supported by Public Health England (PHE), which provides national leadership and expert services to support public health. East and North Hertfordshire CCG chairs regular county-wide communications meetings and collaborative working on shared objectives is already well-established. In the event of severe weather, the CCG will work closely with our partner organisations and providers, adhering to national communications guidance from Public Health England to ensure that all communications:

• follow public health advice consistently • are targeted to the health needs of specific groups of the population • are disseminated effectively and in a timely manner to their intended audiences.

CCG communications responsibilities

Specific communications responsibilities for CCGs in the event of severe weather have been outlined by Public Health England, NHS England and the Department of Health. East and North Hertfordshire CCG is responsible for:

1. Alerting and informing the public of the possible impacts of severe weather with accurate and timely information

2. Working with local partner agencies to undertake the actions prescribed in the action plans on pages 5-8 in response to weather alerts

3. Working with providers to keep all those involved informed of progress on the local response to the effects of severe weather

4. Communicating with CCG staff to activate/deactivate business continuity arrangements.

1. Alerting and informing the public: It falls within the CCG’s remit to communicate health messages1 directly to the public and to Hertfordshire County Council to manage the media response2 . By working together, the

1 according to Public Health England Action Card for Commissioners (health and social care) and local authorities 2 P19 ENH CCG Severe Weather Response Plan

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CCG can assist Hertfordshire County Council by providing clinical evidence and information to strengthen the council’s media output, i.e. by providing GP quotes and statistics. The resulting media coverage will in turn support the CCG to reach a large audience with public health messages. Other communications channels that the CCG will employ to alert and inform the public include: the organisation’s website, the New QEII Hospital website, information screens in GP surgeries, social media posts on Facebook and Twitter linked to health advice, our wide and established stakeholder contact group.

2. Working with local partner agencies and authorities: the CCG communications team plays an active part in fostering mutually beneficial relationships between local partner agencies and authorities. During severe weather, this joint working would step-up to enable the CCG to meet the challenge of the actions outlined in the action plan on pages 5-8. This could include daily communications teleconference calls, attendance at local health resilience forum events and the setting up of inter-agency staff briefings.

3. Working with providers: The CCG communications team will communicate to providers the risks to their patients associated with severe weather and will remind them to implement their own action plans in alignment with MET Office alerts. Correspondence should be emailed to CCG commissioned services such as: planned hospital care, rehabilitative care, urgent and emergency care, community health services, mental health and learning disability services. In addition, the CCG is now jointly or ‘co-commissioning’ primary care services in conjunction with NHS England and has close working relationships with its 60 member GP practices. There are established communications channels between the CCG and member practices, through which the CCG can pass on advice and support about planning and coping with severe weather. The CCG communications team is specifically responsible for the regular GP bulletin and also has access to email addresses for every practice manager.

4. Communicating with CCG staff It is essential that staff receive regular communications during severe weather. This is so that they can protect their own health and that of their families and also so that they can be kept informed of any business continuity arrangements that have been put into place. A variety of communications channels can be employed for these purposes:

• email – staff can be communicated with via the CCG-wide distribution list in normal working hours. A ‘read receipt’ option may be a useful consideration to confirm that messages have been received

• via a telephone cascade system through directorates and teams • through an update posted on the CCG intranet, which staff can log into from home (providing

they have created a login in advance)

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Specific considerations in the event of a heatwave In contrast to deaths associated with cold snaps in winter, the rise in mortality as a result of very hot weather follows very sharply – within one or two days of the temperature rising.3 This means that by the time a heatwave starts, the window of opportunity for effective communications action is very short indeed. Advanced planning and preparedness is essential. Public Health England has agreed the key messages below, which can be issued as necessary: Key public health messages4 Stay out of the heat:

• keep out of the sun between 11am and 3pm • if you have to go out in the heat, walk in the shade, apply sunscreen and wear a hat and light

scarf • avoid extreme physical exertion • wear light, loose-fitting cotton clothes

Cool yourself down:

• have plenty of cold drinks, and avoid excess alcohol, caffeine and hot drinks • eat cold foods, particularly salads and fruit with a high water content • take a cool shower, bath or body wash • sprinkle water over the skin or clothing, or keep a damp cloth on the back of your neck

Keep your environment cool:

• keeping your living space cool is especially important for infants, the elderly or those with chronic health conditions or who can’t look after themselves

• place a thermometer in your main living room and bedroom to check temperatures • keep windows that are exposed to the sun closed during the day, and open windows at night

when the temperature has dropped • close curtains that receive morning or afternoon sun, however, care should be taken with

metal blinds and dark curtains, as these can absorb heat – consider replacing or putting reflective material in-between them and the window space

• turn off non-essential lights and electrical equipment – they generate heat • keep indoor plants and bowls of water in the house as evaporation helps cool the air • if possible, move into a cooler room, especially for sleeping • electric fans may provide some relief, if temperatures are below 35°C

Look out for others:

• keep an eye on isolated, elderly, ill or very young people and make sure they are able to keep cool

• ensure that babies, children or elderly people are not left alone in stationary cars • check on elderly or sick neighbours, family or friends every day during a heatwave • be alert and call a doctor or social services if someone is unwell or further help is needed

If you have a health problem:

• keep medicines below 25 °C or in the refrigerator (read packaging instructions) • seek medical advice if you are suffering from a chronic medical condition or taking multiple

medications If you or others feel unwell:

• try to get help if you feel dizzy, weak, anxious or have intense thirst and headache; • move to a cool place as soon as possible and measure your body temperature

3 PHE Heatwave plan for England – Chapter 1 – Why this plan is needed 4 From 3.2 box 1 key public health messages – PHE Heatwave Plan for England 2015

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• drink some water or fruit juice to rehydrate • rest immediately in a cool place if you have painful muscular spasms (particularly in the legs,

arms or abdomen, in many cases after sustained exercise during very hot weather), and drink oral rehydration solutions containing electrolytes. Medical attention is needed if heat cramps last more than one hour

• consult your doctor if you feel unusual symptoms or if symptoms persist

Heat health advice during Ramadan Many members of the Muslim community may fast during the daylight hours in the month of Ramadan. All local areas should familiarise themselves with the dates of Ramadan each year and build appropriate actions into their local plans if it falls during the summer months. Suggested Public Health England quote for Ramadan: “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. If you start to feel unwell, disoriented or confused, or collapse or faint, advice 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. “Also, make sure to check on others 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 with further information available on NHS Choices – Healthy Ramadan.” Public health suggested quotes These official PHE warnings will provide the framework for locally transmitted messages. They can be modified with quotes from CCG clinical leads5: Alert Level 1 No warning is required unless there is a 60 per cent probability of the situation reaching level 2 somewhere in the UK within the next three days, then: “If this does turn out to be a heatwave, we will 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 or ring NHS 111”.

Alert level 2 “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, ring NHS 111, or visit your local chemist”. Alert level 3 and 4 “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. If there is anybody you know, for example an older person living on their own, who might be at special risk, make sure they know what to do.”

The action plans below show the required communications actions for the CCG, in alignment with Public Health England plans for heatwaves and cold severe weather.

5 Public health core messages. Annex 2 PHE Heatwave plan for England

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CCG communications heatwave action plan Actions taken from CCG severe weather plan (Annexe B) and PHE Heatwave plan (Figure 3.1 commissioners and local authority).

Activity Level Level 0 Level 1 Level 2 Level 3 Level 4 Specific activity levels associated with heatwave

Long Term Planning all year

Preparedness Alert and Readiness Action Major Incident – Emergency Response

Messages to service users and public

Develop communications strategies to encourage resilience and preparedness. Prepare core messages to be broadcast alongside national, PHE messages aligned to warnings and weather forecasts

Issue media messages in alignment with national messages from PHE

Issue media messages – especially with ‘hard to reach’ vulnerable groups.

Issue warning information and media alerts in alignment with national messages from PHE Media alerts about keeping cool

National Emergency Continue actions as per level 3 unless advised to the contrary

Communications with staff

Ensure business continuity plans cover the event of a heatwave and how they will be communicated to staff and how it may affect them

Communicate alerts to staff and make sure that they are aware of heatwave plans Implement business continuity

Business continuity in place

Continue actions as per level 3 unless advised to the contrary Business continuity in place

Communications with providers

Share information over the importance of heatwave preparation.

Work with partner agencies, providers and businesses to coordinate heatwave plans, ensuring vulnerable and marginalised groups are appropriately supported

Remind providers to: provide cool areas and monitor indoor temperatures to reduce the risk of heat-related illness and death in the most vulnerable populations

Ensure that key providers and partners have taken appropriate action including: conducting risk assessments.

Continue actions as per level 3 unless advised to the contrary

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Remind providers to: identify or create cool rooms/areas (able to be maintained below 26 °C) install thermometers where vulnerable individuals spend substantial time

Review and prioritise high risk people Ensure sufficient cold water and ice

Communications coordination with local agencies and authorities

Ensure that a local, joined-up programme is in place between partner communications teams

Liaise with partners on joint preparedness arrangements

Liaise with partners and communicate public media messages – especially to ‘hard to reach’ vulnerable groups

Convene Hertfordshire communications leads teleconference to coordinate joined up communications response. (NHS lead).


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CCG communications action plan for cold weather Actions taken from PHE action cards for commissioners and local authorities.

Activity Level Level 0 Level 1 Level 2 Level 3 Level 4 Specific activity levels associated with cold weather




Communicate public health media messages

Continue to communicate public health media messages



Messages to CCG staff

Work with partners and staff on risk reduction awareness (e.g. flu vaccination for staff in September/October), information and education

Review the distribution of the cold weather alerts across the system and ensure staff are aware of winter plans and advice

Communicate alerts to staff and make sure that they can take appropriate actions Activate business continuity arrangements and emergency plans as required

Communicate alerts to staff and make sure that winter plans are in operation


Messages to providers

Ensure key partners, including all managers of care, residential and nursing homes are aware of the alert system and can access advice

Ensure key partners are undertaking action in response to alerts Ensure continuity arrangements are working with provider organisations


Comms coordination with local agencies and authorities

Work with local organisations to coordinate locally appropriate cold weather plans in accordance with the local and national Cold

Support local community organisations to mobilise community emergency plans Work with partner


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Weather Plan

agencies (e.g. transport) to ensure road and pavement gritting arrangements are in effect to allow access to critical services and high-use pedestrian areas

CCG communications heatwave action plan Actions taken from CCG severe weather plan (Annexe B) and PHE Heatwave plan (Figure 3.1 commissioners and local authority). Activity Level Level 0 Level 1 Level 2 Level 3 Level 4 Specific activity levels associated with heatwave




Develop communications strategies to encourage resilience and preparedness. Prepare core messages to be broadcast alongside national, PHE messages aligned to warnings and weather forecasts

Issue media messages in alignment with national messages from PHE

Issue media messages – especially with ‘hard to reach’ vulnerable groups.

Issue warning information and media alerts in alignment with national messages from PHE Media alerts about keeping cool

National Emergency Continue actions as per level 3 unless advised to the contrary

Communications with staff

Ensure business continuity plans cover the event of a heatwave and how they will be communicated to staff and how it may affect them

Communicate alerts to staff and make sure that they are aware of heatwave plans Implement business continuity

Business continuity in place

Continue actions as per level 3 unless advised to the contrary Business continuity in place

Communications with providers

Share information over the importance of heatwave preparation.

Work with partner agencies, providers and businesses to coordinate heatwave plans, ensuring vulnerable and marginalised groups

Remind providers to: provide cool areas and monitor indoor temperatures to reduce the risk of heat-related illness and death in the

Ensure that key providers and partners have taken appropriate action including: conducting risk assessments.


are appropriately supported Remind providers to: identify or create cool rooms/areas (able to be maintained below 26 °C) install thermometers where vulnerable individuals spend substantial time

most vulnerable populations Review and prioritise high risk people Ensure sufficient cold water and ice

Communications coordination with local agencies and authorities

Ensure that a local, joined-up programme is in place between partner communications teams

Liaise with partners on joint preparedness arrangements

Liaise with partners and communicate public media messages – especially to ‘hard to reach’ vulnerable groups

Convene Hertfordshire communications leads teleconference to coordinate joined up communications response. (NHS lead).


CCG communications action plan for cold weather Actions taken from PHE action cards for commissioners and local authorities. Activity Level Level 0 Level 1 Level 2 Level 3 Level 4 Specific activity levels associated with cold weather




Communicate public health media messages




Messages to CCG staff

Work with partners and staff on risk reduction awareness (e.g. flu vaccination for staff in September/October), information and education

Review the distribution of the cold weather alerts across the system and ensure staff are aware of winter plans and advice

Communicate alerts to staff and make sure that they can take appropriate actions Activate business continuity arrangements and emergency plans as required

Communicate alerts to staff and make sure that winter plans are in operation


Messages to providers

Ensure key partners, including all managers of care, residential and nursing homes are aware of the alert system and can access advice

Ensure key partners are undertaking action in response to alerts Ensure continuity arrangements are working with provider organisations


Comms coordination with local agencies and authorities

Work with local organisations to coordinate locally appropriate cold

Support local community organisations to mobilise community


weather plans in accordance with the local and national Cold Weather Plan

emergency plans Work with partner agencies (e.g. transport) to ensure road and pavement gritting arrangements are in effect to allow access to critical services and high-use pedestrian areas

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Annexe D Figure 3.2: Providers – health and social care staff in all settings (community, hospitals and care homes)

Level 0

Level 1

Level 2

Level 3

Level 4

Long-term planning All year Work with partner agencies to ensure that cold weather planning features within wider winter resilience planning. Work with partners to ensure a strategic approach to the reduction of EWDs and fuel poverty is taken across the local health and social care economy. Work with partner agencies to: d e ve lo p a s h a re d understanding of EWDs and what partners can do to reduce them id e n tify th o s e m o s t a t ris k from seasonal variations im p ro ve w in te r re s ilie n c e o f those at risk e n s u re a lo c a l, jo in e d-up programme is in place to support improved housing, heating and insulation, including uptake of energy efficient, low carbon solutions a c h ie ve a re d u c tio n in c a rb o n emissions and assess the implications of climate change Consider how your winter plans can help to reduce health inequalities, target high risk groups and address the wider determinants of health. Ensure that organisations and staff are prompted to signpost vulnerable clients onwards (eg for energy efficiency measures, benefits or related advice). Work with partners and staff on risk reduction awareness (eg flu vaccination for staff in September/October), information and education. Engage with local VCS organisations for planning and implementation of all stages of the plan.

Heatwave and Summer preparedness programme 1 June – 15 September Communicate public health media messages (see executive summary). Consider the revisions to the CWP and ensure that the changes are understood across the system. Work with partner agencies to co-ordinate locally appropriate cold weather plans. Ensure key partners, including all managers of care, residential and nursing homes are aware of the alert system and can access advice. Review the distribution of the alerts across the system and ensure staff are aware of winter plans and advice. Ensure that local organisations and professionals are taking appropriate actions in light of the cold weather alerts in accordance with local and national CWP. Ensure that organisations and staff are prompted to signpost vulnerable clients onwards (eg for energy efficiency measures, benefits or related advice). Liaise with providers of emergency shelter for homeless people to agree plans for severe weather and ensure capacity to scale up provision. Support communities to help those at risk. Support the development of community emergency plans. Identify which local health, social care and voluntary and community sector organisations are most vulnerable to the effects of winter weather. Agree plans for winter surge in demand for services. Make sure emergency contacts are up to date.

Severe winter weather is forecast–Alert and readiness Mean temperatures of 2°C and/or widespread ice and heavy snow is predicted with 60% confidence Continue to communicate public health messages. Communicate alerts to staff and make sure that they can take appropriate actions. Ensure partners, including all managers of care, residential & nursing homes are aware of the alerts and can access advice. Support local VCS organisations to activate community emergency plans. Activate business continuity arrangements and emergency plans as required. Consider how to make best use of available capacity, for example by using community beds for at risk patients who do not need an acute bed and enabling access to step-down care and reablement. Work with partner agencies (eg transport) to ensure road/ pavement gritting preparations are in place to allow access to critical services and pedestrian hotspots.

Severe weather action Mean temperatures of 2°C and/or widespread ice and heavy snow Continue to communicate public health messages. Communicate alerts to staff and make sure that winter plans are in operation. Ensure key partners are undertaking action in response to alerts. Support local voluntary and community sector organisations to mobilise community emergency plans. Ensure continuity arrangements are working with provider organisations. Work with partner agencies (eg transport) to ensure road/ pavement gritting arrangements are in effect to allow access to critical services and pedestrian hotspots.

Major incident –Emergency response

Central government will declare a level 4 alert in the event of severe or prolonged cold weather affecting sectors other than health. Response likely to involve: na tiona l gove rnme nt departments e xe cutive a ge ncie s public s e ctor, including health sector volunta ry a nd community sector All level 3 responsibilities must be maintained during a level 4 incident Implementation of national emergency response arrangements by central government

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

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Annexe E This figure summarises the key trigger temperatures during a heatwave. Although excess seasonal deaths start to occur at approximately 25°C, for practical reasons the Health Heatwave alert system is based upon temperature thresholds where the odds ratio is above 1.15–1.2 (a 15–20% increased risk). The different trigger temperatures for local areas are summarised below with regional

Figure 4. Trigger temperatures

variations due to relative adaptation to heat. However, a significant proportion of excess summer deaths occur before the Health Heatwave alert is triggered, which emphasises the importance of long-term planning actions by local authorities and the health sector.

52°C and 48°C – when train rails reach these temperatures a Temporary Speed Restriction (TSR) is introduced. Train speeds are reduced by 50% and 30% respectively

41.5°C and 36.2°C Temperatures recorded on the tube and on the platform during 2003 heatwave.

38.5°C Highest daytime temperature recorded in the UK

33°C Tarmac Roads may

begin to melt.

36°C Network Rail would be experiencing railhead temperatures of 50+°C when air temperatures of 36°C are reached. Extreme precautions would then be introduced.

24.5°C Temperature at which any excess deaths may first become apparent

24°C (for 3 days running) – London Underground deploy hot weather notices and supply bottled water. Maintenance workers begin work to stop rails buckling. Network rail also begin additional precautions to their track

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Annexe F Action Cards from Public Health England

CVS_action_card_commissioners_21Octob

CVS_action_card_providers_17_October_

VCS_action_card_21October_2014.pdf

VCS_action_card_GPs_17October_2014.p

VCS_action_card_individuals_17October_2

VCS_action_card_professional_staff_21O

Action Card 2016.pdf

Annexe G – LA and VCS Contacts

LA VCS - Heatwave Cold Weather Contac

severe weather response plan• severe weather and climate change. climate change forecasts indicate...

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