Pandemic Flu: A Scottish framework for responding to an influenza pandemic

4 STRUCTURES FOR PLANNING AND RESPONSE

Planning for and responding to the challenges of an influenza pandemic requires the combined and co-ordinated effort of all levels of government, public authorities/agencies and a wide range of private and voluntary organisations. At the international, UK and Scottish level, a number of structures are already in place for the planning and response phase and this chapter details those organisations and structures.

4.1 International

As an influenza pandemic will be an international public health emergency, the UK works closely with international bodies and other countries to encourage coordinated surveillance, planning, research and response. Key to this is the World Health Organisation ( WHO). WHO is the United Nations' specialised agency for health. It seeks to improve epidemic and pandemic influenza preparedness and responses by co-ordinating international surveillance, investigation and response.

At European level, the European Centre for Disease Prevention and Control was established in 2005 as an agency of the European Commission ( EC) to support improved control of communicable diseases in Europe. Its role is to identify, assess and communicate current and emerging threats from communicable diseases. The centre works with the EC, Member States, other agencies and international organisations to perform these tasks.

4.2 UK planning structures

4.2.1 MISC32 Cabinet Committee

A Ministerial Committee ( MISC 32) on pandemic influenza was established in 2005 to guide the preparations for a potential influenza pandemic and related international activity. It comprises Ministers from across central government departments and is attended by Scottish Ministers.

4.2.2 MISC32 Flu Working Group

MISC32 Flu Working Group is the UK officials group which guides the preparations for a potential influenza pandemic and related international activity. Scottish Government officials attend this group.

4.2.3 Scientific Groups

As detailed in section 2.3, there are a number of UK groups set up to ensure that the best scientific advice is fed into policy and the development of operational plans. These include the Scientific Advisory Group and UK National Influenza Pandemic Committee. Scottish Government officials attend these groups.

4.2.4 Committee on Ethical Aspects of Pandemic Influenza

As detailed in section 2.5, a UK Ethics Committee has been set up to consider ethical issues in public health, healthcare and community care arising from pandemic influenza. There is Scottish representation on the group and it is chaired by the Very Reverend Graham Forbes, Provost of St Mary's Cathedral, Edinburgh.

4.2.5 Programme Management Board

Department of Health ( DH) in England have set up new structures for their pandemic influenza planning. At the centre is the Programme Management Board which is made up of senior DH officials. The objectives of this group are to provide leadership, governance and assurance of all the projects and initiatives required to prepare for an influenza pandemic. DH has also set up a number of working groups to consider specific issues such as healthcare, community care and surveillance. Scottish Government officials attend these groups as observers to ensure consistency and communication with health pandemic influenza planning in England, Wales and Northern Ireland.

4.3 Scottish planning structures

The Scottish Government Fire and Civil Contingencies Division has overall responsibility for planning the pandemic influenza response in Scotland. Planning in the NHS and community care sector is lead by the Scottish Government Health Directorates through the Health and Community Care Pandemic Influenza Steering Group.

4.3.1 Cabinet Sub-Committee on Civil Contingencies

Scottish pandemic influenza planning is overseen by the Cabinet Sub-Committee on Civil Contingencies ( SEER² - CSC) which keeps under review the Government's policies for managing the consequences of major disruptive incidents in Scotland.

4.3.2 Scottish Emergencies Co-ordinating Committee

The Scottish Emergencies Co-ordinating Committee ( SECC) is the senior, multi-agency advisory committee involved in the Scottish Government's emergency response arrangements. The Scottish Government's Pandemic Influenza Preparedness work programme is managed at official level by the SECC's sub-group for Pandemic Influenza - SECC (Flu). This Group, chaired by a senior official from the Scottish Government Justice and Communities Directorates, brings together policy leads from across the Scottish Government with representatives of responder organisations.

4.3.3 Health and Community Care Pandemic Influenza Steering Group

The Health and Community Care Pandemic Influenza Steering Group was established by Scottish Government Health Directorates to lead the planning process for pandemic influenza across health and community care services in Scotland. Its aim is to set clear strategic and policy direction and is accountable to the Cabinet Secretary for Health and Wellbeing for progress. It is a partnership between the Scottish Government and the health and community care services with a wide membership including NHS Boards, National Services Scotland and Health Protection Scotland.

4.3.4 Strategic Co-ordinating Groups

Under the terms of the Civil Contingencies Act, Strategic Co-ordinating Groups ( SCGs) were established in each of the eight Scottish Police Force areas. They comprise Category 1 and 2 responders and representatives of relevant local organisations. SCGs are required to ensure the effective management of a multi-agency response to an emergency in their area by promoting sound partnership working, developing a unified emergency management framework and ensuring that all partners are prepared for joint response to any emergency at any time. The SCG is normally chaired by the area Chief Constable or Local Authority Chief Executive.

4.4 UK response structures

4.4.1 Civil Contingencies Committee

The Civil Contingencies Committee ( CCC) will take the Ministerial lead for the UK response on behalf of the Westminster Cabinet. It will receive advice from the lead government department and the Cabinet Office Briefing Room. Scottish Ministers and officials will participate in meetings of the CCC, and/or its official counterpart CCC (Officials), as appropriate.

4.4.2 Department for Health - Lead Government Department

DH will be responsible for the overall government response and will be supported by the Cabinet Office Briefing Room.

4.4.3 Cabinet Office Briefing Room

The Cabinet Office Briefing Room ( COBR) will be activated following direction from senior officials within DH. It will comprise groups of senior officials providing advice and information to the CCC. Links will be made with the Scottish Executive Emergency Room.

4.4.4 Scotland Office

When COBR is activated, the Scotland Office will also support Scottish interests and will liaise with officials in the Scottish Executive Emergency Room.

Figure 2 - Scottish Government generic primary response structure for national emergencies

4.5 Scottish response structures

4.5.1 Cabinet Sub-Committee on Civil Contingencies

SEER- CSC will take the Ministerial lead for the response in Scotland on behalf of the Scottish Cabinet. Its responsibilities will include ensuring that Scottish Government directorates and where appropriate, other organisations, work to meet the overall objectives set by the UK Government. SEER- CSC will also take the lead on prioritising the allocation of limited national resources and set the strategy for communicating with the public and media. This committee will be involved in regular dialogue with Ministerial colleagues and officials at UK level to maintain a coherent approach to the emergency response.

4.5.2 Scottish Emergencies Co-ordinating Committee

SECC is the senior multi-agency committee involved in the Scottish Government's emergency response. Its membership during a pandemic will consist of senior civil servants from relevant Scottish Government directorates, and non-executive members drawn from the most senior officers in each of the main responding agencies (the emergency services, Local Authorities, NHS, Scottish Environment Protection Agency, military, etc). Its functions include advising the Government on how best to respond to the emergency; setting the strategic direction of the Scottish Government's response and taking responsibility for long-term recovery issues at a national level.

4.5.3 Scottish Executive Emergency Room

SEER will be activated following direction from senior officials within the Health and Justice Directorates. SEER encompasses the corporate Scottish Government emergency response and acts as a focal point for the co-ordination of government response activity. It performs its role through a number of integrated groups; such as the Emergency Action Team and the Emergency Support Team. It will analyse information received from the Scottish Government directorates and the Strategic Co-ordinating Groups; provide advice to SEER- CSC and SECC; oversee implementation of decisions taken by the UK Government; and, ensure overall co-ordination of Scottish Government activity. SEER will also liaise with COBR as required for both UK and Scottish interests.

4.5.4 Emergency Action Team

The Emergency Action Team ( EAT) comprises senior Scottish Government officials who are responsible for ensuring that the emergency response is effective, co-ordinated and timely. They will provide advice to Scottish Ministers, colleagues and to the SECC on options for handling the consequences of the emergency. They will also be responsible for overseeing implementation of decisions taken by the Government and the SECC.

4.5.5 Emergency Support Team

The Emergency Support Team ( EST) directly supports emergency response activity in the SEER. EST is directly responsible for gathering, processing and sharing information about the emergency to advise the Government and stakeholders of key aspects requiring attention. This information will be shared with co-ordinating committees across the UK in order to support both national and local decision making processes.

4.5.6 Strategic Co-ordinating Groups

SCGs will be convened to coordinate the local response. They will provide information to SEER on local issues and through SEER, will liaise with the Government on national issues.

4.5.7 Scottish Health Emergency Response Team

The Scottish Health Emergency Response Team ( SHERT) will:

• co-ordinate the Health Directorates' input into the Scottish Government's overall emergency response. This includes providing Health representation for the Scottish Government's emergency arrangements described above
• provide additional support to the Health Directorates by acting as the "health emergency room". This will allow efficient co-ordination of the Health Directorates' response, providing more detailed health information to senior officials and to the Cabinet Secretary for Health and Wellbeing and the Minister for Public Health.

SHERT will work with the Emergency Support Team and Emergency Action Team.