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Emergency Preparedness, Resilience and Response (EPRR)

The NHS needs to plan for, and respond to, a wide range of incidents and emergencies that could affect health or patient care. These could be anything from extreme weather conditions to an outbreak of an infectious disease or a major transport accident. The Civil Contingencies Act (2004) requires NHS organisations, and providers of NHS-funded services, to show that they can deal with such incidents while maintaining services.

This programme of work is referred to in the health community as emergency preparedness, resilience and response (EPRR). New arrangements for local health EPRR form some of the changes the Health and Care Act 2022 is making to the health system in England.

The ICB is a Category 1 responder organisation, as defined in the Civil Contingencies Act (2004). In April 2023, the ICBs have also taken over the facilitation of the Local Health Resilience Partnership (LHRP) and Health Emergency Preparedness Operational Group (HEPOG) from NHS England. The role of the LHRP is to provide strategic leadership on EPRR for the health organisations and communities of the Local Resilience Forum (LRF) area.

Local Resilience Forums (LRF) are partnerships of member agencies, including those defined under the Civil Contingencies Act (CCA) 2004  by responder 'categories':

  • Category 1 responders are organisations that are directly involved in the response to an emergency. These responders are subject to a number of civil protection obligations.
  • Category 2 responders are those who have a role to play in response but are less directly involved. The Act does not place such stringent duties on these responders but does require that they share information appropriate to managing emergencies and cooperate fully with the LRF.

Coventry and Warwickshire Integrated Care Board is a member of both the West Midlands LRF and the Warwickshire LRF and we are proud to work together with partner agencies to ensure that if, and when, an emergency occurs, we are prepared to respond together and minimise any impact.

In the event of an incident, the partnership agencies that form the LRF join forces to:

  • Consider the hazards that feature in the LRF area, assessing the impacts of the risk and providing this information to the public in a Community Risk Register.
  • Create plans to help make the risks safer, setting out how we will come together to respond should an emergency happen, and how we can help people get back to normal afterwards.
  • Ensure our response is coordinated when things do go wrong.
  • Carry out training and testing to make sure we are ready.
  • Identify lessons from incidents and exercises, learning as we go along to improve how we respond in the future.

Every Local Resilience Forum has a Community Risk Register (CRR) which describes risks for the community and assesses how likely they are to lead to an emergency and the potential impact they would have. The register is created through a risk assessment, and the information is used by the LRF to plan and prepare for emergencies that may occur.

The CRR focuses on serious risks that could result in an emergency, defined as:

  • An event or situation which threatens serious damage to human welfare in a place in the United Kingdom.
  • An event or situation which threatens serious damage to the environment of a place in the United Kingdom.
  • War or terrorism which threatens serious damage to the security of the United Kingdom.

Source: Civil Contingencies Act (2004)

The West Midlands CRR puts the national risks in a local context and whilst it doesn’t describe all risk it highlights those which could affect our routine day-to-day lives. 

You can view the West Midlands Community Risk Register here.

The Top Risks to Warwickshire can be found here.

The potential for national emergencies is determined by Government in its National Risk Register.  

The annual NHSE Core Standards for EPRR review process was undertaken in line with the updated NHS framework. The ICB has achieved a rating of partially compliant, an improvement of +36% against the Core Standards from the previous year’s non-compliant outcome. Significant work has been undertaken to improve compliance in the light of the revised standards and Coventry and Warwickshire ICB is working towards becoming fully compliant with the NHS Core Standards for EPRR.

Progress against compliance has also been made across the system, with an average change of +16%. According to the annual NHSE assurance regional report, this has placed CWICB as one of the top performing systems in the region.

Further detail on the EPRR activity can be found in the ICB Annual EPRR Report to board via this link.

The ICS has EPRR and Business Continuity Policies in place as well as an Incident Response Plan for major incidents, and business continuity plans to deal with significant issues that may face the organisation.

Our EPRR role is to:

  • Ensure contracts with provider organisations contain relevant emergency preparedness, resilience (including business continuity) and response elements
  • Support NHS England in discharging its EPRR functions and duties locally
  • Provide a route of escalation for the Local Health Resilience Partnership (LHRP) should a provider fail to maintain necessary EPRR capacity and capability
  • Fulfil the responsibilities as a Category two responder under the Civil Contingencies Act 2004 and support NHS England and NHS Improvement to deliver their Category one duties
  • Maintain business continuity plans
  • Be represented on the LHRP
  • Seek assurance provider organisations are delivering their contractual obligations.

We do this by:

  • Working with the LHRP to develop strategic multi-agency plans for responding to emergencies
  • Participating in training and exercises which are used to review multi-agency plans
  • Assisting with the local co-ordination of the response to emergencies in partnership with NHS England and NHS Improvement
  • Working with the LHRP to ensure the capacity, skills and competencies required are in place to co-ordinate the local health response to an emergency
  • Undertaking regular performance monitoring of ICS-commissioned and NHS funded services
  • Co-operating with the multi-agency planning and response network in accordance with the Civil Contingencies Act 2004 (as amended) requirements as a category two responder
  • Ensuring a 24 hour a day, seven day a week on-call system
  • Ensuring compliance with the national core standards for EPRR for the ICS and NHS funded healthcare providers
  • Maintaining business continuity plans to ensure ICS service delivery is maintained.