National incident response levels: guidance for health boards

Annex A

Incident Response Criteria

Level 1 – Organisation level response (impact in a single, limited location)

1. Capacity and demand reaches, or threatens to surpass, a level that requires wider resources that cannot be accessed by the provider.

2. A Business Continuity Incident that threatens the delivery of patient services.

3. Responding to a declared Major Incident (MI) or Major Incident standby.

4. A media or public confidence issue that may result in local interest.

5. A significant operational issue that may have implications out with the area of that health board e.g., public health outbreak affecting a limited number of people in a limited area, suspected high consequence infectious disease (HCID), security incident, Hazmat/CBRNe incident.

Level 2 – Local level response (impact felt across a single Health Board)

1. Capacity and demand reaches, or threatens to surpass, a level that requires wider resources that cannot be accessed by the Health Board.

2. A Critical Incident that threatens the delivery of critical services or presents a risk of harm to patients and/or staff.

3. Responding to a declared Major Incident (MI) or Major Incident standby.

4. A media or public confidence issue that may result in local or regional interest.

5. A significant operational issue that may have implications wider than the local IJB/HSCP e.g., public health outbreak, suspected high consequence infectious disease (HCID), security incident, Hazmat/ CBRNe incident.

6. Impacts arising from a shortage of blood and transfusion supplies.

Level 3 – Regional/Multi-Agency level response (impact felt across more than one Health Board and/or regionally).

1. Capacity and demand reaches, or threatens to surpass, a level that requires regional/national coordination or NHS mutual aid e.g. need for HCID, burns treatment or other specialist functions.

2. A Business Continuity Incident that threatens the delivery of an essential NHS function or a protracted incident effecting one or more NHS sites/ Boards.

3. A Critical Incident with potential to impact several Health Boards/ national services.

4. Responding to a declared Major Incident (MI) which may have a significant NHS impact and/or the establishment of regional/multi agency level coordination.

5. A media or public confidence issue that may result in regional, national, or international interest.

6. A significant operational issue that may have implications wider than the remit of one NHS Board or region e.g., flooding, security incident, Hazmat/ CBRNe incident, Critical National Infrastructure (CNI).

7. Impacts arising from a widespread and severe shortage of blood and transfusion supplies.

8. Collapse of a commissioned supplier that provides services to more than one health board area.

9. An incident that may require the request and activation of Military Aid to Civil Authorities (MACA).

Level 4 – National level response (impact felt across several Health Boards and/or impacting national capacity and capability).

1. Capacity and demand reaches, or threatens to surpass, a level that requires international coordination e.g., need for HCID, burns treatment or other specialist functions.

2. A Business Continuity Incident with the potential to impact on significant aspects of the NHS Scotland, e.g. NHSS Supply Chain.

3. A Critical Incident with potential to impact several Health Boards/national services.

4. Responding to a declared Major Incident (MI) which may have a significant NHS impact and/or the establishment of national level coordination.

5. A media or public confidence issue that may result in national or international interest.

6. A significant operational issue that may have implications across NHS Scotland e.g. Critical National Infrastructure (CNI).

7. Impacts arising from a widespread and severe shortage of blood and transfusion supplies.

8. Collapse of a commissioned supplier that provides services to more than one health board area.

9. An incident that may require the request and activation of Military Aid to Civil Authorities (MACA) or require use of legislation and/or emergency powers.

10. Activation of full national response e.g., National Strategic Health Group (SHG).