Joint Committee on Draft Civil Contingencies Bill First Report

Appendix 10: Note by Jennifer Smookler, Committee Specialist - Summary of Responses from Category 1 and 2 Responders

In July, the Committee sent letters to organisations in the NHS and energy, media and food sectors, asking them if they would like to be included as Category 1 or 2 Responders.

This is a summary of their responses.

In brief:

  • 22 NHS bodies in England and Wales replied, all of which considered that some or all of the NHS should be included as Category 1 or 2 Responders.
  • Three organisations from the energy sector replied, none of which thought they should be included as Category 1 or 2 Responders.
  • The Food and Drink Federation stated that the food and drink industry should be included as a Category 2 Responder.
  • The BBC did not consider that it should be included in either Category 1 or 2.

Organisation Recommended for inclusion as Responders: Comment
Category 1Category 2 Neither
Health Protection Agency §  Health Protection Agency

§  Strategic Health Authorities

Office of the Strategic Health Authorities §  Acute Hospital Trusts

§  Primary Care Trusts

§  Strategic Health Authorities

§  Foundation Trusts (if legislation is passed)

§  Health Protection Agency

All NHS bodies have a specific role to play in the event of an emergency as defined in Part 1 of the draft Bill, and the NHS is obliged regularly to review its readiness to comply with emergency planning measures. It is therefore of some concern that the draft Bill does not adequately reflect the current structure of the NHS, nor its potential development.
Avon, Gloucestershire and Wiltshire Strategic Health Authority §  Acute Hospital Trusts

§  Primary Care Trusts

§  Ambulance Trusts

§  Strategic Health Authority

Each of these agencies provides an immediate response to Major Incidents in certain circumstances. The role of the Strategic Health Authority in such an incident would be to ensure the immediate and correct response by the parts of the NHS that would provide the emergency service. In a widespread incident we have a role in co-ordinating the NHS's response.
Bedfordshire and Hertfordshire Strategic Health Authority §  NHS The NHS is already fully involved in the assessment of the risk of emergencies and the construction of contingency plans through membership of both the Hertfordshire and Bedfordshire County Emergency Planning Committees. (Chief Exec representation). Other colleagues, e.g. the Director of Public Health of the lead Primary Care Trust and Consultants in Communicable Disease working for the new Health Protection Agency, are also involved in support of local emergency planning.
Birmingham & the Black Country Strategic Health Authority §  Ambulance Service Trusts

§  Primary Care Trusts

The main responsibility for emergency planning rests with Primary Care Trusts, but our experience in the recent Iraq war situation for example demonstrates that the Strategic Health Authority and Acute Hospital NHS Trusts had a major part to play too.
North & East Yorkshire & Northern Lincolnshire Strategic Health Authority §  Primary Care Trusts

§  Ambulance Trusts

§  Accident and Emergency Units in Acute Trusts

§  Strategic Health Authorities

§  Rest of hospital (not A&E)

§  Mental Health Trusts

Mental Health Trusts may require more consideration and may need to be Category 1 due to classification of inpatients but routinely would be Category 2.

The role of NHS Direct and NHS Logistics must also be considered, the former in terms of information giving during an emergency and the later regarding the overall long-term resilience of the health service.

It goes without saying that if some or all of the organisations mentioned above are to be included in either category, clear guidance will be needed as to the implications and requirements across health economy organisations.

Thames Valley Strategic Health Authority §  Strategic Health Authorities All NHS Trusts and Primary Care Trusts are expected to have emergency plans and at Strategic Health Authority we work to ensure that there is a co-ordinated approach to emergency planning. This work is in conjunction with the local teams of the new Health Protection Agency who have specialist staff in public health protection.

In terms of Emergency planning, we also share and are part of the overall Thames Valley Police emergency plan. In emergency situations, the Police service is in charge of initiating the "Gold Command" centre and Health is just one of the many agencies that are represented at Gold command. Furthermore local NHS Trusts will be represented at Police "Silver" and possibly "Bronze" command levels.

Overall, my thoughts are that if Local Authorities are Category 1 responders, then the local NHS should also be Category 1 responders (which probably will be best co-ordinated at Strategic Health Authority level).

Trent Strategic Health Authority§  NHS

§  Ambulance Trusts

The NHS has traditionally taken a major part in managing the health impact of civil emergencies - this is a broader role than just the response of the Ambulance Service - recent discussion with the DOH following the last, recent reorganisation of the NHS places responsibility on Strategic health Authorities (SHA) to ensure emergency preparedness of the NHS. The NHS is therefore obliged to have plans which are developed in conjunction with other local agencies. It would seem unhelpful to not have the NHS involved in the local planning for emergencies. It would also be unfortunate if the Ambulance Service - essentially a reactive front line service was categorised as Category 1 rather than the NHS. It has taken several years to make to the police and local Las aware of the more strategic role of the NHS in planning for disasters - emergency plans recently developed by SHAs make this distinction quite clear.
Northumberland and Tyne & Wear Strategic Health Authority There are very few (if any) areas of potential resilience response which do not have NHS implications. These implications are often of an emergency nature and require rapid implementation supported by excellent communications. Inclusion in the core process of planning certainly facilitates this.

In view of this, it is likely that the NHS will be a de facto category 1 organisation whatever the bill says, and it would seem sensible for the bill to reflect it.

Some clarity about what is meant by 'NHS' would also be useful in the structuring of the bill. It does seem a little odd, when the consultation includes NHS Ambulance Trusts under category 1, then to be asked whether the NHS should be included as well.

We need to ensure that the local NHS responds as a functional whole in a crisis, with clear lines of accountability that can be rapidly implemented. This is likely to be easier with greater pre-crisis involvement.

South Yorkshire Strategic Health Authority §  All NHS
West Yorkshire Strategic Health Authority §  Primary Care Trusts

§  Ambulance Trusts

§  Acute Trusts

§  Mental health Trusts (may need to be Cat 1 due to classification of inpatients but would routinely be Cat 2)

Strategic Health Authorities I would argue that primary care trusts and ambulance trusts should be included in Category 1, and SHAs in Category 2. Acute trusts could clearly have a responsibility under Category 1, and mental health trusts may need to be considered Category 1 due to classification of inpatients but routinely should be Category 2.

Also, the Regional Director of Public Health role as the Chief Medical Officer to the Region is not considered in the draft bill, although this is an important role in the NHS response to major incidents.

Surrey and Sussex Strategic Health Authority §  Primary Care Trusts

§  Receiving Hospitals

§  Strategic Health Authorities

Dorset and Somerset Strategic Health Authority NHS as a whole
Leicestershire, Northamptonshire and Rutland Strategic Health Authority §  NHS Trusts

§  Primary Care Trusts

§  Health Protection Agency

Strategic Health Authority Only in exceptional circumstances, where deemed necessary and agreed locally, would the SHA lead the management of an emergency. I therefore feel the SHA should be a 'Category 2 Responder'.

Due to the broad nature of the Bill, I do believe it is essential that the regulations specify the involvement of all NHS organisations and clearly define their roles and responsibilities.

Norfolk, Suffolk, and Cambridgeshire Strategic Health Authority NHS
Hampshire and Isle of Wight Strategic Health Authority NHS organisations We recognise that the multiplicity of NHS organisations would make it difficult for all to be represented as full members of Local Resilience Forums (LRFs). Our suggestion is that, in addition to representation by the local ambulance NHS Trust, the local NHS within a police force area should be represented on the LRF by either the Strategic Health Authority or one of the Lead Primary Care Trusts. These organisations should then have a responsibility to establish internal collaborative machinery to ensure that any action required by the local NHS is taken.
Wales Local Health Boards
Flintshire Local Health Board§  Local Health Boards (Wales)

§  Primary Care Trusts (England)

§  Public Health Services (Wales)

§  Health Protection Agency (England)

§  Acute/Integrated NHS Trusts

National Blood Transfusion Service
Ceredigion Local Health Board§  All levels of the NHS, Trusts, Local Health Boards, NPHS We were most surprised to read that the NHS was not included as a "Category 1 Responder" and it is our view that this is essential.

It is difficult to see how issues of availability, capacity etc. of the NHS facilities could be addressed by anyone else.

Health Boards of: Cardiff

Rhondda Cynon Taff

Vale of Glamorgan Blaenau Gwent




§  Welsh NHS Trusts Welsh National Public Health Service It is the general consensus that, while the ambulance Service is included as a Category I Responder, it would be inappropriate for the remainder of the NHS to be excluded from the contingency planning process at a local level.

However there are differing views as to which category of responder the different branches of the NHS should be classified.

In terms of Local Health Boards some are of the view that they should be Category 1 while others consider that Category 2 to be the more appropriate.

It is the considered view that NHS Trusts (in Wales) should be Category 1 responders while the National Public Health Service in Wales should be in Category 2.

Powys Local Health Board§  All NHS
Newport Local Health Board§  Receiving hospitals

§  Ambulance trusts

§  Local Health Boards

§  Statutory Health Authorities Primary Care Trusts

Neath Port Talbot LHB
§  All NHS The NHS should be included as a Category 1 Responder and should participate in the contingency planning process at the local level. There are very often health service implications in emergency situations and it is essential that the NHS is included at the planning stage.
LP Gas Association Neither
The Association of United Kingdom Oil Independents (AUKOI) Neither We are a Membership organisation representing independent companies involved in wholesale sales, distribution and retailing of petrol, diesel and other petroleum products in the UK. The Members of AUKOI are variously involved with retail supply, as both independent retailers and supermarkets and represent at least 25 % of the petrol/diesel retail market in the UK.

This Association is of the opinion that none of its Member companies should be included as Category 2 Responders within the framework of the proposed draft Bill. We concur with UKpia's views that this would in essence duplicate the requirements of the Downstream Oil Emergency Response Plan leading to unnecessary duplication of arrangements and possible confusion.

We are also concerned at the anti-competitive issues that might arise from the sharing of information and joint management of fuel supplies that might prove necessary under these provisions. AUKOI would not engage in any practices in breach of current UK or European competition law.

UK Petroleum Industry Association Limited Neither The construction of separate Emergency Response plans on a regional basis (let alone at the level of County Councils or Police Authority areas) to seek to deal with or manage fuel supplies in an emergency situation could give rise to significant logistical and operational problems. Any attempt to establish them could seriously undermine the effectiveness of the national plan that has been constructed.

The logistical and commercial information that the companies might be called upon as Category 2 Responders, to supply to Category 1 Responders could be highly confidential information from a commercial and competitive viewpoint. There would not seem to be any provision in the Bill for keeping this information confidential. .. To impose the obligations of a Category 2 Responder upon the highly competitive independent commercial oil companies, comprising the UK Downstream Oil Industry, would therefore constitute a very undesirable intrusion on the commercial activities and independence of these companies and could seriously undermine the proper and competitive working of the UK oil market.

Food and Drink
Food and Drink Federation Food and Drink industry After due consideration, the Food and Drink Federation (which represents the interests the interests of the UK food and drink manufacturing industry) firmly believes that the food and drink industry should be listed as a "Category 2 Responder".

The industry plays a key, strategic and vital role in the UK Economy and "Category 1 Responders" need to be aware of the "Emergency" impacts on the industry. The "Three day Week" power supply disputes in the early 1970's, the industrial disputes involving steel workers and lorry drivers in the early 1980's, and the more recent Fuel blockades have clearly demonstrated this.

Office of Telecommunications Broadcasters (if included at all) … if [broadcasters] were to be included, it would be more appropriate to include them in the 'Category 2 Responder' list along with the utilities and telecommunications firms.

However, under the Section 10 of the Broadcasting Act 1990, there are already provisions from the direction of broadcasters to broadcast specific announcements or to refrain from broadcasting specific matter… This existing obligation meets most of the requirements that the new Bill would require of broadcasters were they to become Category 2 responders.

BBC NeitherYou may well know that senior BBC Executives have been working with Cabinet Officials for some time on UK Civil Contingency Matters.

As a result of these meetings, it was decided that the BBC would not be included in the current legislation. Instead, we have set up a network of contacts between all BBC local radio stations and local emergency planners to exchange information in the event of an emergency. We will of course broadcast advice and instruction to local and national audiences as needed, should a serious incident occur.

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Prepared 28 November 2003