Checklist for the Review and Approval of Procedural Documents To be completed and attached to any document which guides practices when submitted to the appropriate committee for consideration and approval. Title of Document Could this policy be incorporated within an existing policy? Yes/No/ Unsure N Comments Severe Weather Plan Does this policy follow the style and format of the agreed template? Has the front sheet been completed? Is there an appropriate review date? Does the contents page reflect the body of the document? Are there measurable standards or KPIs to support the monitoring of compliance with and effectiveness of the document? Are all appendices appropriate and/or applicable? Have all appropriate stakeholders been consulted? Has an Equality Impact Assessment been undertaken? Is there a clear plan for implementation? Has the document control sheet been completed? Are key references cited and supporting documents referenced? Y Y Y Y Y Y Y Y Y Y Y Compliance will be measured against the NHSE Core Standards for EPRR Circulated to NHSE and EPRR Subgroup Does the document identify which Committee/Group will approve it? Y Plans for communicating policy to staff; practice membership; public (as appropriate) Y Link in the newsletter to policy brief 1
Individual Approval If you are happy to approve this document, please sign and date it and forward to the chair of the committee/group where it will receive final approval. Name Caroline Hall Date October 2017 Signature Committee Approval If the committee is happy to approve this document, please sign and date it and forward copies to the person with responsibility for disseminating and implementing the document and the person who is responsible for maintaining the organisation s database of approved documents. Name Kathryn Magson Date October 2017 Signature 2
SEVERE WEATHER PLAN Version Number V2.4 Ratified By Exec Team Date Ratified October 2017 Name of Originator/Author Amanda Yeates Responsible Director Chief Finance Officer Staff Audience All Staff Date Issued November 2017 Next Review Date October 2018 3
DOCUMENT CONTROL Plan Page Details of amendment Date Author Version V2.0 Plan re-write Jun 15 AY V2.1 Minor amendments and updating Jun 16 AY V2.2 4 Instruction added below referring to annexes C Nov 16 AY & D for direction on immediate actions required in an incident V2.4 7 Additional responsibilities added to section 3.5 Sep 17 AY and 3.7 V2.4 12 Additional actions added for HVCCG in section Sep 17 AY 3.5 V2.4 14 Plan details updated in section 4.5 Sep 17 AY V2.4 14 Electronic links in section 4.6 updated Sep 17 AY V2.4 16 Associated documentation updated Sep 17 AY V2.4 29 EQIA updated Sep 17 AY V2.4 All Sections re-numbered Sep 17 AY V2,4 17 Glossary updated Oct 17 AY Acknowledgement to Suffolk Resilience IF YOU ARE UNFAMILLIAR WITH THIS POLICY PLEASE TURN TO THE FLOW CHART IN ANNEXES C & D, PAGES 19-21 FOR DIRECTION ON IMMEDIATE ACTIONS REQUIRED IN AN INCIDENT. IF YOU ARE UNSURE ABOUT ANYTHING, SEEK ADVICE FROM THE SENIOR MANAGER / 4
DIRECTOR ON CALL OR THE EMERGENCY PLANNING LEAD. CONTENTS Section 1. INTRODUCTION 2. PURPOSE Page 6 6 3. ROLES AND RESPONSIBILITIES 6 3.1 HVCCG Roles and Responsibilities within the Organisation 6 3.2 3.3 4. 4.1 4.2 4.3 4.4 4.5 4.6 4.7 Multi-Agency Roles & Responsibilities Consultation and Communication with Stakeholders CONTENT Risk Vulnerable People Weather and Information Services Alerting and Activation of Emergency Response Emergency Management Warning and Informing Health and Safety 6 6 8 8 9 10 13 14 14 15 5. MONITORING COMPLIANCE 15 6. EDUCATION AND TRAINING 15 7. REFERENCES 16 8. ASSOCIATED DOCUMENTATION 16 ANNEX A ANNEX B ANNEX C ANNEX D ANNEX E ANNEX F GLOSSARY SEVERE WEATHER ALERT LEVELS AND RESPONSE ACTIONS WEATHER ACTIVITY TABLES CASCADE PROCESS PUBLIC HEALTH MESSAGES FULL EQUALITY IMPACT ASSESSMENT FORM 17 18 19 21 22 29 5
. 1. INTRODUCTION This plan sets out the HVCCG response to all types of extreme weather conditions at any time of the year. It is our intention to operate normally or as near to normally as possible regardless of the weather conditions. We do however recognise the need to take account of both the safety of staff and patients so may need to put contingency plans in place where a risk to this is identified. 2. PURPOSE The aim of this plan is to provide a framework for responding to a severe weather event in Hertfordshire. 3. ROLES AND RESPONSIBILITIES 3.1 Roles and Responsibilities within the Organisation 3.1.1 The Chief Finance Officer has been allocated the role of Accountable Emergency Officer and is responsible for the strategic implementation of incident and service/business continuity planning for HVCCG 3.1.2 The Head of Corporate Support is the Lead for Emergency Planning and Resilience and is responsible for: The regular review and update of the Severe Weather plan Appropriate distribution and day to day implementation of the plan Receiving and co-ordinating the distribution of alerts from the Met Office National Severe Weather Warning Service Ensuring the plan is appropriately exercised on an annual basis, in the absence of any severe weather events 3 All HVCCG staff are responsible for familiarising themselves with the Severe Weather plan 3.1.4 All independent contractors are encouraged to play a full part in any activation of the Severe Weather plan 3.2 Multi-Agency Roles and Responsibilities 3.2.1 The Health and Wellbeing Board is responsible for: Long-term planning between agencies to protect people and infrastructure from the effects of severe hot weather and thus reduce excess summer illness and death; 6
Long-term, multi-agency planning to adapt to and reduce the impact on climate change, including greening the built environment, building design, increasing energy efficiency and transport policies 3.2.2 DCLG Red is responsible for: Co-ordinating regional response activity with national response activity including coordination of resource requests 3.2.3 East of England Ambulance Service NHS trust is responsible for: Identifying, in conjunction with partners, those persons who will require evacuation or special care measures from the at Risk Register Co-ordinating the use of voluntary and private sector in health emergency response 3.2.4 NHS England Midlands and East Region is responsible for: Holding health services to account for taking appropriate actions to prepare for a severe weather event Mustering mutual aid when requested by local services 3.2.5 The Environment Agency is responsible for: Preventing, controlling and monitoring the input of pollutants to the environment; Providing advice and technical support to other partners on the disposal of waste; Providing advice and technical support to other partners on the environmental issues; Monitoring the water resource situation and putting in place appropriate measures if required Issuing alerts and warnings in relation to potential local flooding 3.2.6 Hertfordshire Constabulary are responsible for: Leading and co-ordinating the evacuation of a given area if considered appropriate; Traffic Management, assisted by the Highways Agency as appropriate; Closure of roads as appropriate; Control of movement in areas where hazards are present Initiating multi-agency teleconference in relation to flood preparations as and when appropriate 3.2.7 Hertfordshire Fire and Rescue Service are responsible for assisting with rescue operations in conjunction with other agencies; 3.2.8 Hertfordshire County Council are responsible for: Disseminating warning messages to service providers; Providing business continuity advice to businesses and voluntary organisations to enable them to mitigate the effects of severe weather; The provision of emergency transport if required; The provision of specialist advice on the safety of roads and bridges; Social care support for vulnerable or displaced people; Assisting traffic management through provision of highways support roads and 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); 7
Management of environmental, food and water safety, pollution issues; Liaison and coordination of support to and from community resilience groups 3.2.9 District/Borough Councils are responsible for; Provision of emergency welfare for people, pets and livestock who become unavoidably detained and stranded; Provision of temporary emergency accommodation: Liaising with Town/Parish councils resilience groups; Confirming building structural safety and suitability for human occupation; Assisting with the clearance of debris; Coordinating and providing advice on waste disposal and collection 3.2.10 Public Health England and Director of Public Health are responsible for: Providing clear and unambiguous advice on the health implications of a severe weather event; Providing health guidance and advice where necessary directly, or through the Scientific and Technical Advice Cell (STAC) 3.2.11 Herts Valleys CCG is responsible for: Coordinating the health response from local partners and ensuring that appropriate action has been taken Coordinating and disseminating key public health messages to the local population and staff Implementing the CCG s Business Continuity plan if appropriate Supporting staff to remain fit and well during spells of severe weather 3.2.12 The Highways Agency is responsible for: Precautionary treatment of roads where there is the likelihood of freezing or snow; Providing temporary traffic management at an incident in support of the police; Setting strategic and tactical Vehicle Management Signs to support road closures; Provision of timely advice to the public on route availability and any diversion routes; Restoring 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 3.2.13 The Military are responsible for the provision of specialist advice and support, as available under the Military Aid to the Civil Authorities (MACA) arrangements 3.2.14 Major Utility Companies such as National Grid (Gas) and National Grid (Electricity), UK Power Networks, Affinity and Thames Water or British Telecom have their own contingency plans, which would be activated as required. Companies will be required to liaise closely with emergency services. 3.2.15 The Voluntary Sector 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 rests with Hertfordshire County Council. 3.3 Consultation and Communication with Stakeholders This plan was forwarded to the following stakeholders for review as part of the overall approval process: 8
HVCCG Senior Leadership Team HVCCG Exec Team EPRR Subgroup 4. CONTENT 4.1 Risk A variety of severe weather risks have been rated as to their likelihood and potential effects of the county in the Hertfordshire Community Risk Register. Risk Hazard Description Rating HIGH Extreme Temperatures Low temperatures and heavy snow Heatwave HIGH Flooding Local river flooding Localised, extremely hazardous flash flooding (when rain falls at a rate that the underlying ground cannot cope with or drain it away) HIGH Storms and gales No further classification Future impacts on health due to climate change are anticipated to be substantially negative with rising temperatures, patterns of precipitation (any form of falling water in any form e.g. rain, sleet, snow, hail) and unpredictable weather becoming more common. 4.2 Vulnerable People 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. Vulnerable groups within the community will need special provision both in implementing and preparatory and precautionary measures for a potential severe weather event, and also in response to an incident, in line with the Care of people Framework. There are 3 categories of people 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 People who due to an event or situation, such as illness, operation or accident who are now dependent on 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 9
Individuals from the following key groups are considered to be particularly at risk during a severe weather event. Older people (over 75 years old) 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 5 with disabilities Homeless or people sleeping rough People who have had operations (temporary) People with pre-existing or long-term serious medical conditions, especially those requiring medical support equipment or regular medication People with long term mental health problems or learning difficulties that reduces an 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 who are fuel poor Other marginalised groups 4.3 Weather and Information Services The trigger for the activation of this plan will be by notification. 4.3.1 The Met Office National Severe Weather Warning Service (NSWWS) 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 Wind Snow Ice Fog The two levels of warning are: (a) Alerts these are issued more than 24 hours ahead (b) 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 the below matrix to give each a warning colour. High Likelihood Medium Likelihood Low 10
Likelihood Very Low Likelihood Very Low Impact Low Impact Medium Impact High Impact The Met Office tables provide examples of the level of disruption which might be found at each of the impact levels for each weather element (rain, snow etc). Note weather assessed as having very low impact may still have some minor impacts. The basic messages associated with each of the colour states are: 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. 4.3.2 Hazard Manager is a one-stop information source for the emergency response community. It is designed to supplement the role of the regional Public Weather Service 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 4.3.3 The Heat Health Watch System is operated by the Met Office and the Department of Health from 1 st June until 15 th September each year. The Met Office issues weekly notification 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 C. 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 B of this plan. HVCCG receives email forecasts/alerts from the Met Office along similar lines of warnings received through the national Severe Weather Warning Service. 4.3.4 The Cold Watch System is operated from 1 st November to 31 st 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 levels in view of the weather forecasts and their likely impacts. There are five levels of alerts 0 4 and full details can be found in annex B of this plan. 4.3.5 The Environment Agency issues three levels of flood warnings from Flood Alert (where there is a risk of flooding so the advice is to be aware and watch out) to Severe Flood Warning (where there is a severe risk of flooding and severe danger to property and life and action should be taken at once). 11
Further information about the risk of flooding can be found on the Environment Agencies website and in the local Flood Risk Management Strategy: https://flood-warning-information.service.gov.uk/ https://www.hertfordshire.gov.uk/media-library/documents/environment-andplanning/water/flood-risk-management/lfrms-for-hertfordshire-full-report.pdf Actions for HVCCG to consider for flooding preparation include: Internal communication; place staff on standby; assess current staffing levels and check business continuity plans to ensure critical business functions will still be met Have ready to go public messages on how to prepare for flooding, how to stay safe and who to contact (the public can call Floodline on 0345 988 1188 for up to date information) Ensure adequate stock and equipment and the readiness of the Incident Control Centre Report any flooding in the area to the local Environment Agency office and keep a watching brief Actions to for HVCCG consider for flooding response are: Activate HVCCG Incident plan and / or business continuity plans if appropriate Prepare for transport and staff disruption; open Incident Control Centre where appropriate Check the situation of critical sites and own infrastructure in flood risk areas Agree local media messages, continue to promote the floodline contact number; External communications with local partners 4.3.6 Information on air quality, such as regular updates of particulate matter (PM10), sulphur dioxide, nitrogen dioxide, ozone and carbon monoxide are available on the website www.airquality.co.uk (UK Air Quality Archive) or http://uk-air.defra.gov.uk which also offers health advice to those who may be particularly sensitive to air pollution. 4.3.7 Highways and the Highways Agency receive daily forecasts from which service decisions are made. A Highways Agency Winter Service is operated from 1 st October to 30th April each year. 12
45.4 Alerting and Activation of Emergency Response Receive NSWWS Alert/Warning Met Office PWS Advisor Email Intelligence from Cat 1/2 Responder Monitor Situation Individual Agencies Conduct Risk Assessment (Consider range of factors other prevailing conditions, recent weather conditions) NO Multi-agency Teleconference required? YES NO Insufficient resources for single agency response? Coordinated activity YES Establish TGC and/or SCG as appropriate 13
Implement Multiagency Response 4.5 Emergency Management The process of declaring a multi-agency or major incident will follow procedures laid down in the Herts Resilience Major Incident Framework and the HVCCG Incident plan. In the event that extreme weather conditions continue for a prolonged period it may be necessary for individual Directorates within HVCCG to invoke the contingency plans for critical services which are outlined in their completed Business Impact Assessments. All services should ensure that their contingency plans include actions to take should their building not be accessible or need to be evacuated. This decision will be made by the Senior Manager On Call and communicated to the appropriate Director however, all staff should be aware of how to access and activate these plans if an alert is issued. 4.6 Warning and Informing One of the key aspects of any preparation and response to a severe weather event is the timely dissemination of accurate information, advice and warning to the public. As severe weather tends to be seasonal, advice and preparatory information will be circulated as part of a coordinated strategy. This strategy is aimed at raising awareness and escalating from advice to warnings on notification of specific severe weather. When extreme weather is expected all HVCCG staff should remain vigilant to the weather conditions both where they work and for their route to and from work. The Emergency Planning and Resilience Lead will ensure that severe weather warnings are posted on the intranet, via the Communications Team if felt necessary. An e-mail will be sent to the Senior Manager on Call (SMOC) for the CCG, alerting them to the warning. If the communications team deem it appropriate, an all staff e-mail can also be sent. The Emergency Planning and Resilience Lead will work with the Communications Team to notify service providers of severe weather alerts in accordance with local cascade procedures where these have been agreed (e.g. for heatwave). Please see appendix D for details of the local cascade procedures which have been designed to ensure alerts reach those who need to take action. The Emergency Planning and Resilience Lead will also work with the Communications Team to ensure that relevant public health messages are distributed to the local population so they can make informed decisions about their day to day activities. Key messages during an episode of severe weather are included in appendix E. The Heatwave plan for England includes specific advice and key messages which should be communicated for Muslim communities during Ramadan Links to other advice such as safe driving will be added to staff communications and the intranet as necessary. All HVCCG communications to staff and service providers 14
will be co-ordinated via the Emergency Planning and Resilience Lead and/or Communications Team. Public Health England will lead on the planning and development of generic national media advice in respect of warnings and information. 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 https://www.hertfordshire.gov.uk/services/fire-and-rescue/are-you-ready-foranything.aspx Met Office website general severe weather preparation information www.metoffice.gov.uk/guide/weather/severe-weather-advice Department of Health, Public Health England websites provide health-related information, guidance and advice www.gov.uk The Highways Agency provides information on routes and travel disruptions on their website www.trafficengland.com/ AA Roadwatch will also be used to broadcast warnings http://www.theaa.com/traffic-news/index.jsp Regional or national television may broadcast weather warning information during major events NHS Choices provides reliable advice and guidance throughout the year on how to keep fit and well. It includes information on how to stall well in hot heather www.nhs.uk/summerhealth Beat the Heat: Keep cool at home checklist, Public Health England 2016 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/5 25361/Beattheheatkeepcoolathomechecklist.pdf Beat the Heat; Staying safe in hot weather leaflet, Public Health England 2016 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/5 25358/Beattheheatstayingsafeinhotweather.pdf 4.7 Health and Safety HVCCG is committed to providing a healthy, safe working environment and policies relating to Health and Safety are available on the intranet. Each employee has a duty to take reasonable care for the health and safety of themselves and other persons who may be affected by any acts or omissions by themselves and to co-operate with the organisation so far as is necessary to enable management to carry out its legal duties relating to health and safety matters. Existing risk assessments should be referred to where relevant and new risk assessments should be undertaken as appropriate. 5. MONITORING COMPLIANCE Compliance with national guidance will be monitored annually by way of: Annual exercise of the plan as appropriate Annual assessment against NHS England Core Standards for Emergency Preparedness, Resilience and Response Annual review of the plan against the most recent Public Health England 15
guidance 6. EDUCATION AND TRAINING 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. All HVCCG staff will be expected to undertake business continuity and emergency response awareness training bi-annually. HVCCG staff carrying out on-call duties will receive more specialist training in line with the organisational EPRR Training programme and strategy. It is the responsibility of Directors and Managers to ensure that they and their teams are aware and understand their roles and responsibilities in the event of a business disruption and/or emergency situation. All HVCCG staff should be aware of this policy. An electronic copy of the policy is available in the Resource Centre of HVCCG s website on the documents section. All emergency plans are also stored on memory sticks in case of internet failure. These memory sticks are located in the Battle Box in the Incident Room, with the Emergency Planning and Resilience Lead, the Accountable Officer and the Chief Finance Officer. Hard copies are also held in the Battle Boxes in Apsley Room, Hemel One. 7. REFERENCES Climate Change Act 2008 Health and Social Care Act 2012 Civil Contingencies Act (2004) The Equality Act (2010) Resilience Direct website http://www.hertsdirect.org/services/commsafe/commprotect/emeresilience/ 8. ASSOCIATED DOCUMENTATION Cold Weather Plan for England 2016/17 protecting health and reducing harm from severe cold; supporting the case; action card for health, social care and local authorities: commissioners. Heatwave Plan for England 2017 protecting health and reducing harm from severe heat and heatwaves; making the case, the impact of heat on health now and in the future; supporting vulnerable people before and during a heatwave, advice for health and social care professionals/care home workers and staff; Looking after yourself and others during hot weather (for individuals, families and carers); Herts Multi-Agency Flood & Reservoir Inundation Plan v2.5 May 2017 Hertfordshire Resilience Major Incident Framework v1.3 August 2017 Care of People framework August 2017 HVCCG Incident and Business Continuity Plans Oct 2017 HVCCG Flexible Working policy 2017 HVCCG Incident Plan Oct 2017 Senior Managers On Call Pack Oct 2017 v2.12 16
Annex A Glossary AEO CHEMET DCLG EPRR FIREMET HVCCG MACA NSWWS RED RWG SCG SMOC STAC TCG Accountable Emergency Officer A system that can be used to track the dispersal of a chemical release Department for Communities and Local government Emergency Planning, Resilience and Response A weather information system designed for emergency responders Herts Valleys Clinical Commissioning Group Military Aid to the Civil Authorities National Severe Weather Warning Service Resilience and Emergencies Division, DCLG Recovery Working Group Strategic Coordinating Group Senior Manager On Call Scientific and Technical Advice Cell Tactical Coordinating Group 17
Annex B 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: Daytime temperature of 30 degrees Celsius or more Night time minimum threshold temperature of 15 degrees Celsius or more Level 0 Level 1 Level 2 Level 3 Level 4 Long-term planning All year Heatwave and Summer preparedness programme 1 June 15 September Heatwave is forecast alert and readiness 60% risk of heatwave in the next 2-3 days Heatwave Action Temperature reached in one or more Met Office National Severe Weather Warning Service Region 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 1 November to 31 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 Level 1 Level 2 Level 3 Long-term planning All year Winter preparedness and action programme 1 November to 31 March Severe winter weather is forecast alert and readiness Mean temperature of 2 degrees Celsius and/or widespread ice and heavy snow are predicted within 48 hours, with 60% confidence Response to severe winter weather Severe weather action Severe winter weather is now occurring: mean temperature of 2 degrees Celsius or less and/or widespread ice and heavy snow 18
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 19
Annex C WEATHER ACTIVITY TABLES 20
21
Annex D CASCADE PROCESS 22
Annex E Key Public Health Messages Heatwave 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 keep a check on the temperature 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 thee 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 degrees celcius 23
(Longer-term) Consider putting up external shading outside windows Use pale, reflective external paints Have your loft and cavity walls insulated this keeps the heat in when it is cold and out when it is hot Grow trees and leafy plants near windows to act as natural air conditioners 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 needed If you have a health problem Keep medicines below 25 degrees Celsius or in the refrigerator (read the storage instructions on the packaging) 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 Drink some water or 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 for more than one hour Consult your doctor if you feel unusual symptoms or if symptoms persist 24
Heath advice during Ramadan Many members of the Muslim community may be fasting the daylight hours in the month of Ramadan. All local areas should familiarise themselves with the dates of Ramadan each and build appropriate actions into their local plans if it falls during the summer months. 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, disorientated 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 also been produced to help ensure that members of the Muslim Community have a safe and health Ramadan These are the core messages to be broadcast as official PHE warnings alongside national and regional weather forecasts. They may be expanded or otherwise refined in discussion with broadcasters and weather presenters. Level 1: Summer preparedness and long-term planning No warning 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 something along the lines of: If this does turn out to be a heatwave, we ll 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 at www.nhs.uk/summerhealth. Alternatively ring NHS 111. Level 2: Alert and readiness The Met Office, in conjunction with PHE, is issuing the following heatwave warning for [regions identified]: 25
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 at www.nhs.uk/summerhealth, NHS 111 or from your local chemist. Level 3 and 4: Heatwave action/emergency The Met Office, in conjunction with PHE, is issuing the following heatwave advice for [regions identified]: 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 s 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. 26
Cold Weather Keep in the warmth by: Fitting draft 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 towards your five a day Stock up on tinned and frozen foods so you don t have to go out too much when its cold or icy Exercise is good for you all year round and it can keep you warm in the 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 slips, trips 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. 27
Contact your GP or pharmacist if you think you, or someone you care for, might qualify for a free flu jab. There are three flu leaflets: one general, one for pregnancy and one about children. Free flu vaccinations are available for those who: Are aged 65 or older Are aged two, three or four years old Are pregnant Have a serious medical condition such as chronic heart, ling, neurological, liver or kidney disease, or diabetes Have a weakened immune system due to HIV or treatments that supress 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 Keep your home warm efficiently and safely: Heating your home to 18 degrees Celsius in winter poses minimal risk to your health when you are wearing suitable clothing Get your heating system and cooking appliances checked and keep your home well ventilated Use your electric blanket as instructed and get it tested every three years. Never use a hot water bottle with an electric blanket. Do not use a gas cooker or oven to heat your home; it is inefficient and there is a risk of carbon monoxide poisoning and this can kill Make sure you have a supply of heating oil or LPG or solid fuel if you are not on mains gas or electricity to make sure you do not run out in winter 28
These are the core messages to be broadcast as official PHE warnings alongside national and regional weather forecasts. They may be expanded or otherwise refined in discussion with broadcasters and weather presenters. Level 1: Winter preparedness and action This is in force from 1 November to 31 March and indicates that actions should be taking place to protect health from cold weather, and that preparations should be in place to ensure service continuity in the event of severe winter weather. No warning is required, unless the situation worsens to warrant a level 2 alert. A spell of chilly weather might warrant a message along the lines of: If this does turn out to be a spell of severe cold weather, we ll try to give you as much warning as possible. But in the meantime, if you want advice about protecting your health from the cold go to the winter health pages at NHS Choices (www.nhs.uk). If you are worried about your health or that of somebody you know, ring NHS 111. Level 2: Alert and readiness The Met Office, in conjunction with PHE, is issuing the following cold weather warning for [regions identified]: Severe cold weather 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 the winter health pages at NHS Choices (www.nhs.uk) or from your local chemist. If you are worried about your health or that of somebody you know, ring NHS 111. Level 3 and 4: Severe cold weather action/emergency The Met Office, in conjunction with PHE, is issuing the following severe cold weather advice for [regions identified]: If this does turn out to be a spell of severe cold weather, we ll try to stocked with food and medications. If you are Make sure that you stay warm. If going outside make sure you dress appropriately. If of somebody you know, ring NHS 111 indoors, make sure that you keep your heating to the right temperature; heating your home to at least 18 C in winter poses minimal risk to your health when you are wearing suitable clothing. If there is anyone you know who might be at special risk, for example, an older person living on their own, make sure they know what to do to stay warm and are well stocked with food and medications. If you are worried about your health or that of somebody you know, ring NHS 111 29
Annex F - Equality Analysis Full Equality Impact Assessment Title of policy, service, proposal etc being assessed: Severe Weather policy What are the intended outcomes of this work? This plan sets out the HVCCG response to all types of extreme weather conditions at any time of the year. It is our intention to operate normally or as near to normally as possible regardless of the weather conditions. We do however recognise the need to take account of both the safety of staff and patients so may need to put contingency plans in place where a risk to this is identified. How will these outcomes be achieved? The aim of this plan is to provide a framework for responding to a severe weather event in Hertfordshire. Who will be affected by this work? All staff and the general public within the catchment area of the CCG 30
Evidence What evidence have you considered? Legal requirements and guidance provided by agencies such as the Local Authority, Environment Agency, PHE and the Met Office. (see sections 7 & 8 of the policy) Age Very young and elderly people are more susceptible to the effects of adverse weather conditions (see section 4.2 of policy) Disability Housebound and those with low mobility, those with long-term conditions or mental health issues may be more susceptible to the effects of adverse weather conditions (see section 4.2 of the policy) Gender reassignment (including transgender) There is no evidence this category would be adversely affected Marriage and civil partnership There is no evidence this category would be adversely affected Pregnancy and maternity 31
Pregnant women and newborn children may be more susceptible to the effects of adverse weather conditions (see section 4.2 of the policy) Race There is no evidence that this category would be adversely affected. Religion or belief Muslims could be more susceptible to the effects of adverse weather during Ramadan (period of fasting). Sex There is no evidence that this category would be adversely affected. Sexual orientation There is no evidence that this category would be adversely affected. Carers There is no evidence that this category would be adversely affected. Other identified groups Those who : Are homeless Have undergone recent operations 32
Are isolated Are living in deprived circumstances Engagement and involvement How have you engaged stakeholders with an interest in protected characteristics in gathering evidence or testing the evidence available? See section 3.3 of the policy How have you engaged stakeholders in testing the policy or programme proposals? See sections 3.3 and 5 of the policy. For each engagement activity, please state who was involved, how and when they were engaged, and the key outputs: As above. Summary of Analysis We would work with our health partners and local authority in the event of a severe weather incident using a multi-agency approach which would be in line with the national cold weather and heatwave policies, as well as the Framework for Vulnerable people, to ensure as far as possible that we reduce the risk of vulnerable people being adversely affected. 33
Eliminate discrimination, harassment and victimisation N/A Advance equality of opportunity As above Promote good relations between groups N/A Next Steps The plan will be revised in line with the suggested amendments and made available on the intranet to staff and the public How will you share the findings of the Equality analysis? This can include sharing through corporate 34
governance or sharing with, for example, other directorates, partner organisations or the public. It will be attached to the corresponding plan. 35
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