EXERCISE COLD PLAY II

ACTION PLAN/LESSONS IDENTIFIED

Scenario	Exercise Questions	Where evidenced in your own Plan(s)	Further Actions Required?	Issues you can’t resolve that need cascading upwards & to whom	
BLOCK ONE 
H1N1v – Reviewing the first wave and preparing for a larger second wave.
	Plans and Planning Process

Review the spring / summer H1N1v flu wave. Consider the impact on:
•	Your organisation and your role.
•	The main issues arising and lessons identified.
•	What you feel could/should have been done differently.
				
	What percentage of regular work has had to be cancelled? 
				
	Now that you have experienced responding to an outbreak of H1N1v what additional/new training do you think you need? 
				
	How useful did you find your plans during the spring / summer H1N1v flu wave?

	Were your plans implemented?

	What improvements do you feel ought to be made to your plans? 
				
	Have you conducted debriefs within your organisation? How successful would you say they were?
				
	Have you held multi-agency debriefs?

Scenario	Exercise Questions	Where evidenced in your own Plan(s)	Further Actions Required?	Issues you can’t resolve that need cascading upwards & to whom	
BLOCK ONE 
H1N1v – Reviewing the first wave and preparing for a larger second wave.
	Roles & Responsibilities

When and how was the local pandemic flu plan activated? 

	What role did your organisation play, either directly or to assist, in the health services response?

How may this be improved?

	Who were your main partners and how did your organisation co-ordinate with them?

Which partners should now be included in your plans?

	What role did the LRF have and how did it operate? 

Will this change in the future?

	How did your organisation feed into regional arrangements?  

How may this be improved?

Scenario	Exercise Questions	Where evidenced in your own Plan(s)	Further Actions Required?	Issues you can’t resolve that need cascading upwards & to whom	
BLOCK ONE 
H1N1v – Reviewing the first wave and preparing for a larger second wave.
	Data Gathering & Surveillance 

There was a ‘grey area’ between WHO phase 5 and WHO phase 6 – what have you learned from this and how could the plans be improved?

	

			
	How and to whom did you communicate confirmed cases within your organisation?

	

			
	As a health organisation, from where were you obtaining the information on pandemic facts and figures, testing and reporting cases and how was this monitored?

				
	Who informed you of the school closures in your area? What impact did this have? 

				
	How does your organisation monitor staff absence, conduct surveillance or provide up to date situation reports?

				

Scenario	Exercise Questions	Where evidenced in your own Plan(s)	Further Actions Required?	Issues you can’t resolve that need cascading upwards & to whom	
BLOCK ONE 
H1N1v – Reviewing the first wave and preparing for a larger second wave.
	Co-ordination of Media & Public Communications

Have the communication strategies to staff in your organisation regarding flu information been effective during the first wave? How may they be improved?  

	

			
	How effective have the communication strategies regarding flu been to the public and media during the first wave?  How may they be improved?  

				
	How are local agencies working together in communicating to the public and media? 
How could this be improved?

	Anitvirals

How effective were your methods of distributing antivirals? 

How may these have been improved? 

	What new/ different strategies will be in place for the next wave?

				

Scenario	Exercise Questions	Where evidenced in your own Plan(s)	Further Actions Required?	Issues you can’t resolve that need cascading upwards & to whom	
BLOCK TWO
The number of cases of H1N1v are starting to increase again as we enter a second wave.	Distribution of antiviral treatment

How will patients be screened, assessed and issued with antivirals as numbers increase heading into the second wave?

				
	How will this be communicated to the public and the media? 

	How will hard to reach groups get access to antivirals?  

Give examples of hard to reach groups that will require special consideration for access.

	What role might your organisation have in supporting the antiviral distribution process?

	What plans are in place in your organisation to handle flu-related calls from the public?

				
	Where can health professionals get advice on flu? 

Scenario	Exercise Questions	Where evidenced in your own Plan(s)	Further Actions Required?	Issues you can’t resolve that need cascading upwards & to whom	
BLOCK TWO
The number of cases of H1N1v are starting to increase again as we enter a second wave.	Vaccination

A pandemic vaccine should be available before the winter, but only in limited quantities.  Have you considered procurement and prioritisation within your region?

	Who is a priority to receive early batches of vaccine deliveries, once health care workers and at risk groups have been vaccinated?

				
	How will you ensure the vaccines are secure?

				
	How will mass vaccination be organised once larger supplies become available?

				
	Will you still advocate the seasonal flu vaccine?

				

Scenario	Exercise Questions	Where evidenced in your own Plan(s)	Further Actions Required?	Issues you can’t resolve that need cascading upwards & to whom	
BLOCK TWO
The number of cases of H1N1v are starting to increase again as we enter a second wave.	Use of Personal Protective Equipment (PPE) and infection control guidance

Have you carried out a risk assessment on your staff?

				
	Which of your staff may need PPE?

				
	What PPE would you require and in what quantity?

				
	Does this reflect National (DH & HSE) guidance?

				
	How would you ensure access to PPE and sufficient quantity?

				
	Are plans in place to store PPE?

				
	Have you trained staff in use of PPE?

				

Scenario	Exercise Questions	Where evidenced in your own Plan(s)	Further Actions Required?	Issues you can’t resolve that need cascading upwards & to whom	
BLOCK TWO
The number of cases of H1N1v are starting to increase again as we enter a second wave.
.	What measures are you planning locally?

What are the implications on your organisation of the increased demands caused by the impacts of pandemic influenza?
				
	What resources do you consider to be in short supply? How will you manage the increased demand for these resources?

	Have you identified your essential services and how have you planned to maintain them?

				
	What plans are in place to maintain out of hours service?
				
	What special measures are required for vulnerable groups, eg children, elderly, mental health patients, homeless, drug addicts, travelling communities, others?

	What more should the LRF being doing to coordinate the local response?

				

Scenario	Exercise Questions	Where evidenced in your own Plan(s)	Further Actions Required?	Issues you can’t resolve that need cascading upwards & to whom	
BLOCK TWO
The number of cases of H1N1v are starting to increase again as we enter a second wave.	Resilience of the emergency services

What arrangements have been developed to maintain core response to emergencies across the patch?

				
	Are there arrangements in place to utilise the VAS (Voluntary Aid Services) and what briefings, support and preparation would be required for these personnel?

				
	Social distancing measures/Schools/Travel advice

Would there be good reason to restrict mass gatherings during the second wave?

				
	What social distancing measures could be put in place locally?

				

Scenario	Exercise Questions	Where evidenced in your own Plan(s)	Further Actions Required?	Issues you can’t resolve that need cascading upwards & to whom	
BLOCK TWO
The number of cases of H1N1v are starting to increase again as we enter a second wave.	During the spring/summer school closures were implemented as part of the control measures. Do you envisage school closures during the second wave and for what reason? 

				
	What extra advice and precautions will be needed for special schools and the vulnerable population?  

				
	Do you envisage travel advice being recommended during the second wave?

				

Scenario	Exercise Questions	Where evidenced in your own Plan(s)	Further Actions Required?	Issues you can’t resolve that need cascading upwards & to whom	
BLOCK THREE
The pandemic is close to the peak of the second wave. This wave is far more severe than the first with a much higher clinical attack rate and case fatality rate. Staff absence is creating major problems.	Resilience Arrangements

What arrangements have been developed to maintain a core response to emergencies occurring across the Local Resilience Forum (LRF) area?

				
	What Resilience arrangements are in place to ensure that consistent public health advice is given across the region?

				
	What arrangements do you have in place to utilise the voluntary agencies? 

				
	Staff Shortages/Resources

Where would your organisation look for additional resources and how would you maximise staff resources?

				
	What steps may be taken to accommodate employees who have difficulties with childcare / sick family members?

				

Scenario	Exercise Questions	Where evidenced in your own Plan(s)	Further Actions Required?	Issues you can’t resolve that need cascading upwards & to whom	
BLOCK THREE
The pandemic is close to the peak of the second wave. This wave is far more severe than the first with a much higher clinical attack rate and case fatality rate. Staff absence is creating major problems.	Have you considered clinical governance implications of reduced staffing levels?

				
	If you have responsibility for 1 man businesses (eg single handed GP practices) how are they going to operate with staff sickness?

	How will you ensure the flow of information to the public continues?

				
	Business Continuity

What role would the SCG have in monitoring manpower and ensuring essential services are maintained?

	What activities could you stop and which activities must be maintained?

				
	How would any disruption in utility services (transport, fuel, power, water) affect your organisation?

				

Scenario	Exercise Questions	Where evidenced in your own Plan(s)	Further Actions Required?	Issues you can’t resolve that need cascading upwards & to whom	
BLOCK THREE
The pandemic is close to the peak of the second wave. This wave is far more severe than the first with a much higher clinical attack rate and case fatality rate. Staff absence is creating major problems.	What would be the implications of reduced levels of waste (including clinical waste) collections on your organisations?
				
	What actions can you take to minimise this disruption?

	Management of deaths

What arrangements are in place to ensure suitable body holding facilities and adequate mortuary provision?

	What support do you have in place for bereaved relatives?

				
	Antiviral distribution

How would you continue to monitor the distribution of antivirals?

				
	How are you planning to review the process of antiviral distribution and maintain adequate supplies given the extremely high demand?  

				

Scenario	Exercise Questions	Where evidenced in your own Plan(s)	Further Actions Required?	Issues you can’t resolve that need cascading upwards & to whom	
BLOCK FOUR
The second wave has now peaked and the number of new cases has started to decline.  The press are already declaring the pandemic over, raising public expectations of an immediate return to normality.	Recovery

Do you have a recovery plan?

				
	When will you start to consider recovery planning?

				
	What would you estimate the timescales for return to the new normality?

				
	What is your communications strategy during recovery? 

What would your key messages to the public and the media be at this stage?

				

Scenario	Exercise Questions	Where evidenced in your own Plan(s)	Further Actions Required?	Issues you can’t resolve that need cascading upwards & to whom	
BLOCK FOUR
The second wave has now peaked and the number of new cases has started to decline.  The press are already declaring the pandemic over, raising public expectations of an immediate return to normality.	What are the main recovery issues and how would you seek to resolve them for:-
•	Staff (eg accumulation of leave, time in lieu; exhaustion and low morale; managing expectation etc.)

•	Facilities (return of facilities to “normal use”, prioritisation, coordination across a health economy; cleaning and decontamination – who, when, how?) 

•	Equipment/supplies (shortage of key components/spare parts, lack of key equipment; low or minimal supplies of consumables, rationing, coordination and sharing across a health economy – how?) 

•	how and when targets are re-introduced
				
	•	What services would you re-introduce first? 
•	How would you decide? 
•	Whom would you need to consult? 
•	What is the mechanism for this? 
•	How would you co-ordinate with other similar organisations? 
•	How would you communicate your plan to reintroduce services with your staff and the public?  
•	What would be the main lines to take?

Scenario	Exercise Questions	Where evidenced in your own Plan(s)	Further Actions Required?	Issues you can’t resolve that need cascading upwards & to whom	
BLOCK FOUR
The second wave has now peaked and the number of new cases has started to decline.  The press are already declaring the pandemic over, raising public expectations of an immediate return to normality.	Voluntary Services

How would you make best use of the voluntary services? 

	What MOUs do you have in place? 

	Are voluntary organisations appropriately trained? Could they be and how would this happen?

	What help would you be able to ask patients’ families to assist the support of return to normality?

				
	Bereavement

If there are a large number of fatalities as a result of the pandemic, what actions will be taken to provide support and counselling for the bereaved in your organisation? 

				
	What impact will the loss of colleagues have on your organisation and how will this be managed?  

				

Scenario	Exercise Questions	Where evidenced in your own Plan(s)	Further Actions Required?	Issues you can’t resolve that need cascading upwards & to whom	
BLOCK FOUR
The second wave has now peaked and the number of new cases has started to decline.  The press are already declaring the pandemic over, raising public expectations of an immediate return to normality.	What steps are in place now for the eventuality of losing key staff within your organisation eg succession planning?

				
	Lessons Learned

What will be your process for capturing lessons learned during the pandemic?

				
	How will you share these lessons;

•	Within your organisation?

•	With other organisations?