Preparing for Emergencies Guidance

Section 6 - Roles and Responsibilities

This section outlines the role of key public bodies in civil protection and resilience from a health perspective. It also highlights the action to be taken by Health Boards when faced with exceptional service pressures as a result of a major incident.

Role of the Scottish Government

6.1 The Scottish Government, although not a CCA Category 1 or 2 responder, has a key role in civil protection and resilience. This can be broken down into:

• Preparation: having appropriate structures, policies, and procedures in place to respond to major incidents and to develop relevant legislation and guidance
• Response/Recovery: creating the conditions to support Category 1 and 2 responders and other non- designated responders and the option of invoking emergency powers under Part 2 of the Civil Contingencies Act 2004 to enable responders to deal with exceptionally serious emergencies, including requesting cross-border mutual aid

6.2 When the scale or complexity of an incident is such that it would benefit from government coordination or support, Scottish Government (SG) will activate its emergency response arrangements through the Scottish Government Resilience Room (SGoRR). The role of SGoRR will vary according to the nature, scale, and impact of the incident. This may include supporting Health Boards in their CCA-mandated duties, including on informing and advising the public through media engagement.

6.3 During a SGoRR activation, Health Boards should submit Situation Reports (SitRep) to SG Health and Social Care Directorates (HSCD) via Health EPRR. The reporting requirement and frequency will vary according to the impact of the incident and Health Boards will be informed of this at the time of the response.

Role of the Scottish Government Health and Social Care Directorates (HSCD)

6.4 During incident response and/or a SGoRR activation, HSCD role includes:

• providing strategic direction for the NHS in Scotland and the particular Health Board(s) involved and ensure that all other Health Boards are prepared to support if necessary
• advising and supporting the Scottish Ministers with responsibility for health and social care, NHS Chief Executive, NHS Chief Operating Officer, and other senior officials
• maintaining an up-to-date overview of national critical care capacity
• assessing, in consultation with the Board, the impact of the incident on the Board’s scheduled work and any national impacts and determine any action that needs to be taken, including mutual aid from other UK nations or specialists
• maximising available communication channels at national and local levels

Health Board responsibilities

6.5 The following actions should be taken by a Health Board when the consequences of a major incident require external support. They are predicated on:

• decision-making in the interests of patients
• the safety of patients and staff being paramount
• the existence of up-to-date surge capacity plans for critical/intensive care and other priority services
• mutual aid agreements with identified triggers with neighbouring Health Boards and other planning partners

6.6 When the Health Board has invoked its Major Incident Plan, the Command, Control and Coordination (C3) Group should, among other functions, monitor the impact of the emergency situation as ‘business as usual’.

Suspension of legislative obligations in exceptional circumstances

6.7 Some major/mass casualty incidents will place considerable pressure on the Health Board’s total capacity and capability and have a wider impact on the delivery of services in line with legislative obligations, such as Treatment Time Guarantees (TTG).

6.8 The Chief Executive or named Deputy may request mutual aid from other Health Boards to maintain scheduled appointments and TTG.

6.9 In exceptional circumstances a request for the suspension of applicable regulations may be made to SGHSCD (utilising national governance structures) in the first instance, if it is clear that all reasonable interventions have been taken by the Health Board to help manage the incident.

6.10 The SGHSCD has measures in place to process such requests which require approval by Scottish Ministers.

6.11 Once operational pressures linked to the management of the major incident have receded, SGHSCD will continue to support the Health Board to restore service levels as quickly as possible.