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Emergency Planning is normally a term used in the context of local authority civil protection and is a statutory duty alongside business continuity planning for those organizations.  The term also corresponds with the statutory duties of first responders such as police, fire & rescue, coastguard and ambulance services.

In UK we appear to be over the first wave of pandemic flu (H1N1 or “Swine Flu”) so it’s time to look at lessons identified from phase one and to prepare for phase 2 which could begin anytime soon given the global nature of this emergency.

A key problem for nations is how to administer the H1N1 vaccine once it becomes available and in UK primary care trusts and strategic health organizations are working with the national health service and a variety of other stakeholders including General Practitioners to figure out how to get this done.

One element of the problem is the lack of capacity to deliver an inoculation programme in addition to existing services – as you can imagine, no business has boxes full of spare resource on tap to cope with a surge in demand.  At this time of year GPs are gearing up to deliver other vaccinations (not least the seasonal flu jab) and after Christmas are pretty maxed out doing the paperwork to support their various performance led payments which has to be submitted to the PCTs before the end of this financial year.

Another emergency planning issue is the sheer logistics of getting large numbers of people with work and family commitments, underlying health conditions, no transport, communication difficulties or other lifestyle factors that make them hard to reach through the doors of whichever venue you are able to use to receive the particular inoculation – with the accompanying paperwork, counselling and aftercare.  I’d estimate that each jab will take a minimum of 10 minutes so to get through any sensible number of people you will need to have a form of production line or inoculation centre which won’t feel as people friendly as one might prefer – particularly for those that are nervous about the process or difficult to communicate with.

With the first wave behind us we must also face the fact that there is likely to be a degree of complacency about coming forward for the jab and a mismatch between those you’d like to have it and those that are clamouring for it who don’t qualify medically for it – often referred to as the worried well.

To a degree this is uncharted territory so that provides an opportunity to leverage technology that didn’t previously exist as a means of filling the “funnel” with clients and filtering them into appointment slots that are mutually agreeable.  In terms of delivering the injections themselves we may be constrained by availability of the vaccine – and that could make it easier to match our limited capacity and provide a “reasonable” argument for not vaccinating everyone that presents for their injection; otherwise I feel it will be all hands to the pumps – drawing on voluntary organisations such as the Red Cross and St John’s Ambulance as well as qualified first aiders that can be cross-trained to deliver injections under a one to many supervision arrangements: perhaps in the workplace or nursing home?

In the coming months I will be directly involved in trying to solve this emergency planning problem with clients so I will let you know how things are working out and what seems to work as we plan, trial and adjust.

Watch this space.

Over the years we’ve spent a lot of time planning for, exercising and responding to major floods within the UK ranging from widespread coastal flooding of a large swathe of the south coast to rapid onset pluvial (rain related) flooding.

In light of this experience and several novel ideas that I’ve been discussing in multi-agency groups, I was approached yesterday to speak at the forthcoming public sector flooding conference to be held at the Barbican in London on 25 Jun 09 – which unfortunately I could not do due to other speaking commitments.

Nevertheless it got me focused on flooding again in between managing swine flu and other major contingency planning work and has encouraged me to put “fingers and mouse to keyboard” (is that the modern alternative to “pen to paper”?).

As ever, prevention is better than cure so making sure your business is not situated in a flood zone is a good start and most people have figured that out after seeing the recent widespread river-based floods in Gloucester and York over the past couple of years; but a lot of people haven’t yet clutched in to the risks associated with heavy rainfall in urban situations where increasing hard landscaping and aging, overwhelmed Victorian drainage often runs at 80% capacity even before the rain starts to fall.

I’ve seen several examples of this including schools and a GPs surgery situated at the bottom of a hill with a large sloping car park channelling the rain right into the reception and onward to the server room and call centre from which a county’s out of hours calls were handled!

The rainfall doesn’t even need to be heavy enough to cause any depth of flooding – just getting the drains to overflow when the system is mixed with sewage below ground can cause a major problem. In Portsmouth we had several schools and a nursery closed for several days after a 40 minute downpour because we had to clean and disinfect the entire school after pupils trudged raw sewage everywhere.

This event also highlighted the difficulties over who owns what part of the problem as local authorities outsource road and gulley cleaning to contractors, water companies split service provision between drinking water and wastewater/sewage providers and different parts of the pipework lie on various landowners property preventing all of the above from accessing the system to manage an incident at cause.

For the poor citizen caught in the middle of this, it’s a disaster. Passed from pillar to post by various call-centres and “help-desks” that refer them from one place to another as the waters continue to threaten the electrical sockets and ruin the often uninsured furniture and fittings. A situation exacerbated by the government’s social care policies which aim to provide independent living but instead put vulnerable people at increased risk during emergency situations.

One solution to this is advanced multi-agency planning (in both senses of the word) whereby a single emergency number is used to feed situational reports into a coordinated response centre that can triage the calls and provide the best service from pooled resources on a priority basis.

Regretably, in a “rising tide “situation (no pun intended) the multi-agency response is not triggered in time since the emergency services need to be at risk of being overwhelmed before they activate SILVER and most of the problems are tactically and politically low impact even if they are severe for individual families or businesses.

When you get into a coastal flooding scenario the problems multiply because you then involve the coastguard and even the military if MACC and MACP rules apply.

It is then that you really see which Emperors (or Generals) are naked as keen military staff officers start planning to put the QE2 off Hayling Island in a Force 10 onshore gale to pick up civilians wading from the beach and up the gangway with their kids, horses, dogs and pythons for a quick trip to Cowes (it was lovely when they were there with the regimental yacht – bless!) where they’ll drop them off (without cash or a hotel to go to and now separated from the mainland!).

As Black Adder would say “there’s only one problem with that plan Baldrick – it’s completely bollocks!”.

You might also find it’s more complicated than you imagine to find a boat or even a large volume of hardcore to repair sea defences at low tide until you try it. You might be surprised to learn that the Navy can’t help you because oddly enough their boats are on ships and their people are too so you end up relying on a couple of Fire and Rescue Service rigid inflatable boats (which can only operate in a meter and a half depth because of the outboard motor) provided that the local fire service has had the foresight and training to procure and use them and haven’t been replaced by a regional call centre!

I could go on but I already have. Plan, exercise, test, revise and don’t ASSuME. You know the routine…