EN CCG Severe Weather Response Plan...conditions resulting in transport difficulties or threat to life. The National Severe Weather Warning Service provides two levels of warning for

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SEVERE WEATHER RESPONSE PLAN

Author:

Sharn Elton, Director of Operations

Date of Implementation:

1st February 2015

Reviewed:

Version

Issue 1

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FREEDOM OF INFORMATION

The contents of this plan are assumed to be accessible to the public and to staff, unless an exemption under the Freedom of Information Act 2000 has been identified during the drafting process.

Please indicate opposite any exemptions you are claiming. Remember that some exemptions can be overridden if it is in the public interest to disclose – as decided by the FOI multi- disciplinary team. Exemptions normally apply for a limited time and the information may be released once the exemption lapses.

This plan contains information;

Please insert an “x” if relevant

1. That is personal data

2. Provided in confidence

3. Intended for future publication X

4. Related to criminal proceedings

5. That might prejudice law enforcement

6. That might prejudice ongoing external audit investigations

7. That could prejudice the conduct of public affairs

8. Information that could endanger an individual’s health & safety

9. That is subject to legal privilege

10. That is commercially confidential

11. That may not be disclosed by law

12. Other Please describe

Remember to destroy all unnecessary drafts and unneeded correspondence, once the final version of this plan is agreed.

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CONTENTS

FREEDOM OF INFORMATION ....................................................................................... 2 CONTENTS ..................................................................................................................... 3 DISTRIBUTION ................................................................................................................ 5 GLOSSARY ..................................................................................................................... 6 INTRODUCTION .............................................................................................................. 7 1. AIM .......................................................................................................................... 8 2. OBJECTIVES .......................................................................................................... 8 3. RISK ........................................................................................................................ 8 6. ALERTING AND ACTIVATION OF EMERGENCY RESPONSE .......................... 14 8. ROLES AND RESPONSIBILITIES ........................................................................ 16 9. WARNING AND INFORMING ............................................................................... 19 10. RECOVERY .......................................................................................................... 20 12. TRAINING ............................................................................................................. 20 13. EQUIPMENT ......................................................................................................... 20 14. HEALTH AND SAFETY ......................................................................................... 20 15. FINANCE ............................................................................................................... 20 ANNEX A SEVERE WEATHER ALERT LEVELS AND RESPONSE ACTIONS ....... 21 ANNEX B WEATHER ACTIVITY TABLE FOR EMERGENCY RESPONDERS ........ 22 ANNEX C WARNING AND INFORMING – EXEMPLAR PUBLIC MESSAGES ........ 27 ANNEX D PROVIDERS - LEVELS 0-4 …………………………………………………..30 ANNEX E KEY TRIGGER TEMPERATURES …………………………………………..31 ANNEX F ACTION CARDS PUBLIC HEALTH ENGLAND …………………………….32

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AMENDMENTS

AMENDMENT DATE OF ORIGINAL

AMENDED CHANGE

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DISTRIBUTION

East and North Herts Trust Hertfordshire Urgent Care Health and Community Services Hertfordshire Partnership Foundation Trust Hertfordshire Community Services Hertfordshire County Council Hertfordshire Borough Council Hertfordshire Fire & Rescue NHS England - East Anglia Area Team Hertfordshire CCGs East of England Ambulance Service NHS Trust Environment Agency Public Health England - Anglia Public Health Team

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GLOSSARY

Abbreviation Description

ACS Hertfordshire County Council Adult and Community Services Di t tCCGs Clinical Commissioning Groups

CYP Hertfordshire County Council Children’s and Young People’s Di t tDCLG Department for Communities and Local Government

EPRR Emergency Preparedness, Resilience and Response

HA Highways Agency

HWB Health and Wellbeing Boards

HWS Health and Wellbeing Strategy

LA Local Authority

LHRP Local Health Resilience Partnership

MIU Minor Injuries Unit

NRC Network Response Centre

NSWWS National Severe Weather Warning Service

OGD Other Government Department

PHE Public Health England

RED Resilience and Emergencies Division, DCLG

The Cabinet Office has produced the Civil Protection Lexicon. This is a single point of reference for terminology used in UK civil protection. The lexicon provides a common, agreed set of definitions for terms used across the range of Integrated Emergency Management activities.

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INTRODUCTION This plan is the multi-agency response plan for severe weather events in Hertfordshire and provides outline information on the response, management and roles and responsibilities of individual agencies. This plan was devised and written by Sharn Elton, Director of Operations.

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1. AIM The aim of this plan is to provide a multi-agency emergency response framework for all agencies responding to a severe weather event in Hertfordshire. 2. OBJECTIVES

a. Identify the risks and provide advice and information to communities and individuals to enable them to be prepared for the effects of a severe weather event.

b. To provide a clear and concise procedure for the assessment of weather

warnings, together with a corresponding escalation procedure and plan activation process.

c. Agree specific roles, responsibilities and actions for all agencies involved in the

response to a severe weather event.

d. Identify key response issues that should be considered at both strategic and tactical levels in responding to a severe weather event.

e. Determine activities to reduce disruption to the communities, utilities,

businesses, and to protect the environment.

f. Lead recovery activity to support the recovery of communities and businesses.

3. RISK

a. Overview. The nature of Hertfordshire is such that in the past it has been subject to a wide variety of severe weather events. These have included heavy snowfall in 2003, 2009 and 2010 which caused widespread disruption, heat waves in 2003 and 2006 and damage caused by the high winds in 1987 and 1990. The county will continue to be susceptible to severe weather conditions which are likely to change as the effects of climate change will present new challenges or effects of greater consequences.

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b. Community Risk Register. A variety of severe weather risks have been rated as to their likelihood and potential effects on the county in the Hertfordshire Community Risk Register. http://m.hertsdirect.org/services/commsafe/commprotect/emeresilience/hertsrespartnership/

Risk Rating Hazard Description

HIGH

Low Temperatures and Heavy Snow

Snow falling and lying over most of the county for at least one week. After an initial fall of snow there is further snow fall on and off for at least 7 days. Most areas experience some falls in excess of 10cm, some drifts in excess of 30cm and a period of at least 7 consecutive days with daily mean temperature below -3ºC. There is likely to be some disruption to transport networks, businesses, power supply and water supply, and also school closures.

HIGH

Storms and Gales

Storm force winds affecting most of a county for at least 6 hours. Most areas experience mean speeds in excess of 55mph with gusts in excess of 85mph. Short term disruption to infrastructure including power, transport networks, homes and businesses.

HIGH

Heatwave

Daily maximum temperatures in excess of 32°C and minimum temperatures in excess of 15°C over most of a county for at least 5 consecutive days. There is likely to be disruption to power supply and transport infrastructure.

• Severe Weather and Climate Change. Climate change forecasts indicate that Hertfordshire is likely to experience:

• Blocked weather patterns leading to prolonged periods of similar, possibly

extreme, weather. • Greater winter rainfall leading to an increase in flooding. • Reduction in summer rainfall amounts. • Increases in summer rainfall intensities. • More severe storm events – windstorms and extreme rainstorms • Overall increases in annual mean temperatures. • Increases in the number of very hot days. • Increase in fire risk due to changes in biodiversity for upland areas.

The Recovery Plan will need to be flexible in its approach and be responsive to severe weather as the climate changes and adapt its plans in an appropriate manner.

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4. VULNERABLE PEOPLE

a. During a significant severe weather event anyone has the potential to become vulnerable due to the factors in disaster-related incidents. However, for a significant number of people the experience can be serious as it has the potential to remove them from established support mechanisms or expose particular vulnerabilities.

b. Vulnerable groups within the community will need special provision both in implementing any preparatory and precautionary measures for a potential severe weather event, and also in response to an incident. There are 3 categories of individuals that may fall into a ‘vulnerable group’:

• People who are generally independent, albeit with a structured support

environment, in their normal daily circumstances, i.e. residential health / social home, or similar circumstances, or;

• People who due to an event or situation, such as illness, operation or accident who are now dependent upon others to support and care for them to survive independently within the community or;

• People who through individual circumstances (age, disability, or language barriers) may require extra support and care to deal with the consequences of being involved in an emergency.

c. Separate plans and guidance are being devised to assist in the identification of vulnerable groups and individuals. These provide a flexible process for collating and sharing information between responders whilst maintaining confidentiality, and detail additional support measures or actions that may be required to assist these groups or individuals during an incident. Individuals from the following key groups are considered to be particularly at-risk in the event of severe weather event:

• Older people (over 75 years old). • People assessed as being at risk of, or having had, recurrent falls. • Elderly people who live alone and do not have additional social services

support people who are housebound or otherwise low mobility. • Frail elderly. • Children under the age of five or with disabilities. • Homeless or people sleeping rough. • People who have had operations – temporary. • People with pre-existing or long term serious medical conditions medical

conditions, especially those requiring medical support equipment or regular medication.

• People with long term mental health problems or learning difficulties that reduces individual’s ability to self-care (including dementia).

• Pregnant women and new-born children. • People living in isolated rural villages. • People living in deprived circumstances or who are fuel poor • Other marginalised groups

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5. WEATHER AND INFORMATION SERVICES

The trigger for the activation of this plan will be by notification to responder agencies from:

a. Met Office National Severe Weather Warning Service1. This service notifies agencies through the provision of warnings of severe or hazardous weather which can cause problems ranging from widespread disruption of communications to conditions resulting in transport difficulties or threat to life. The National Severe Weather Warning Service provides two levels of warning for the following types of weather conditions and these will be reinforced using the following icons:

• rain; • ice;

• wind; • fog.

• snow;

The two levels of warning are:

(i) Alerts: These are issued more than 24 hours ahead.

(ii) Warnings: These are issued up to 24 hours ahead.

Weather warnings will be assigned a colour indicating a combination of the level of impact and the likelihood of the severe weather. The colours will be assigned according to a matrix (Fig 1) to give each warning a colour:

Fig 1:

High Likelihood

Medium Likelihood

Low Likelihood

Very Low Likelihood

Very Low Impact

Low Impact Medium Impact High Impact

The tables on the Met Office website provide examples of the level of disruption which might be found at each of the impact levels and for each weather element (rain, snow etc.). Note weather assessed as having a “Very Low” impact may still have some minor impacts.

The basic messages associated with each of the colour states are:

1 http://www.metoffice.gov.uk/publicsector/nswws

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No Severe Weather

Be Aware Be Prepared Take Action

In addition, the Chief Forecaster’s assessment explains why the warning has been issued and the likely impacts as well as indicating where any uncertainties lie.

Further advice on any warnings issued can be obtained from the duty forecasters at the Met Office, or from the regional Public Weather Service (PWS) Advisor2. The PWS Advisor for the Eastern Region can provide more localised interpretation of forecasts. They can also be called upon to provide advice at multi-agency or Strategic Coordinating Group (SCG) meetings.

b. Hazard Manager3. Hazard Manager is a one-stop information source for the emergency response community. It is designed to supplement the role of the PWS Advisors in providing consistent weather-related information and interpretation of severe weather events. The services currently available on Hazard Manager are:

• Interactive Map Viewer with weather information. • Flood Guidance Statements. • Weather warnings. • Hazard Advice. • FireMet and CHEMET services.

c. Heat-Health Watch System.4 The Heat-Health Watch system is operated by the Met Office and the Department of Health from the 1st of June until the 15th of September each year. The Met Office issues weekly notifications by email during this period. All agencies ensure they are signed up to receive these notifications and will act in accordance with the activity levels shown in Annex B. The Met Office may forecast a heatwave where regional trigger threshold temperatures are met or exceeded. The system operates with five levels – Blue, Green, Yellow, Amber and Red – full details can be found in Annex A of this plan. The JEPU and Hertfordshire Clinical Commissioning Groups (CCGs) receive email forecasts / alerts from the Met Office along similar lines of warnings received through the National Severe Weather Warning Service (NSWWS).

d. Cold Watch System. A Cold Watch system will operate from 1st November to 31st March each year. During this period, the Met Office may forecast extreme winter weather, as defined by forecasts of temperatures, snow and ice formation and their duration. There will be consultation between the Met Office and the Department of Health to raise alerts at appropriate level in view of the weather forecasts and their likely impacts. There are five levels of alert – 0 to 4 – full details can be found in Annex A of this plan.

2 http://www.metoffice.gov.uk/publicsector/PWSA 3 http://www.metoffice.gov.uk/publicsector/hazardmanager/access - please note: this service is not publicly available 4 http://www.metoffice.gov.uk/weather/uk/heathealth

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e. Highways. Hertfordshire County Council receives daily forecasts from which service decisions are made by the HCC Winter Service – Senior Decision Maker. When severe weather is predicted or in place, then direct contact can be made with the forecasters to discuss and plan accordingly. f. Highways Agency. A Highways Agency Winter Service is operated from the 1st

October to the 31st April each year. A daily road weather forecast enables winter decisions to be made. The Highways Agency Emergency Planning Team also has access to the Met Office weather updates from embedded forecasters at their National Traffic Control Centre.

g. Other Means of Notification. Any Hertfordshire Category 1 or 2 Responder can use the Hertfordshire Alerting Directory to initiate the generation of all or part of the Hertfordshire crisis management structure, in response to a severe weather warning. Notification may also be made to activate the plan due to the consequential issues that have arisen due to a severe weather event. Information may also be provided by members of the public contacting individual emergency services or other Hertfordshire partners in response to specific severe weather related events.

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Individual agencies conduct Risk Assessment

(Consider range of factors ‐ other prevailing conditions, recent weather

conditions)

6. ALERTING AND ACTIVATION OF EMERGENCY RESPONSE

Receive NSWWS Alert / Warning

Met Off PWS Advisor email Intelligence from Cat 1/2 responder

Monitor Situation

Multi‐agency No Teleconference

required?

Yes

Insufficient resources for single

No agency response? Coordinated

activity required?

Yes

Establish TCG and / or SCG, as appropriate

Implement Multi‐agency Response

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7. GENERIC CONCEPT OF EMERGENCY RESPONSE TO AN SEVERE WEATHER EVENT Emergency Management The process of declaring a Multi-agency or Major Incident will follow procedures laid down in the Hertfordshire Generic Response and Recovery Plan. The management of severe weather events is split into 4 levels; these mirror the alert levels for the specific response plans:

a. Level 0 – Long-term planning

- Identify Emergency Services and other multi-agency partners likely to be affected by severe weather event.

- Review plans, contingency arrangements and responsibilities in the pre- seasonal period.

b. Level 2 – Prevention

- At start of appropriate severe weather season, review public information and advice.

- Issue general preparation messages to public and multi-agency partners.

c. Level 3 – Response

- On receipt of specific severe weather warnings, Emergency Managers conduct risk assessments and either monitor situation or: - Implement response plan activities. - Issue messages to public and other multi-agency partners.

d. Level 4 – Emergency Response

- As appropriate, implement multi-agency coordination or Major Incident command and control when services are being severely affected (power failure, major transport disruption, etc.).

The multi-agency action plan for severe weather events is at Annex B. Further details on specific agency response actions are included in individual organisation’s response plans.

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8. ROLES AND RESPONSIBILITIES The following roles and responsibilities are more specifically envisaged in a Hertfordshire response to a severe weather event: Hertfordshire Resilience Forum (HRF):

• Monitor the situation for significant weather changes or new warnings being issued;

• Consider declaration of Multi-Agency Incident or Major Incident, as appropriate • Identify requirements for any cross-agency staff or resources from Multi-Agency

partners; • Provision of coordinated public warnings and advice in response to hazardous

situations. DCLG RED:

• Support the co-ordination of the response where the emergency crosses a number of counties within the region and brokerage of mutual aid across the region and between regions;

• Co-ordinate regional response activity with national response activity including coordination of resource requests.

East of England Ambulance Service NHS Trust (EEAST):

• Identify, in conjunction with partners, those persons who will require evacuation or special care measures from the ‘At Risk Register’;

• Coordinate the use of the voluntary and private sector in health emergency response.

Environment Agency (EA):

• Prevent/control and monitor the input of pollutants to the environment; • Provide advice and technical support to other partners on the disposal of waste; • Provide advice and technical support to partners on the environmental issues; • Monitor water resource situation and put in place appropriate measures if

required. Hertfordshire Constabulary:

• Lead and co-ordinate the evacuation of a given area if considered appropriate; • Traffic management, assisted by Highways Agency and Hertfordshire

Highways, as appropriate; • Closure of roads as appropriate; • Control of movement in areas where hazards are present.

Hertfordshire Fire and Rescue Service:

• In conjunction with other agencies, assist with rescue operations.

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Hertfordshire Local Authorities:

Hertfordshire County Council: • Disseminate warning messages to service providers; • Provide business continuity advice to businesses and voluntary

organisations to enable them to mitigate the effects of severe weather; • Provision of emergency transport if required; • Provide specialist advice on the safety of roads/bridges; • Social care support for vulnerable or displaced people; • Assist traffic management through provision of highways support - roads &

signs, road clearance; • Treatment of roads to clear snow and ice; • Mitigation of any environmental hazards (e.g. Closure of countryside parks or

Rights of Way); • Management of environmental, food and water safety, pollution issues; • Liaison and coordination of support to and from community resilience groups.

District / Borough:

• Provision of emergency welfare for people, pets and livestock who become unavoidably detained and stranded;

• Provision of temporary emergency accommodation; • Liaise with Town/Parish councils resilience groups; • Provision of emergency transport (IBC only); • Monitor/repair coastal protection structures; • Local management of environmental, food and water safety, pollution issues; • Confirm building structural safety and suitability for human occupation; • Assist in the clearance of debris; • Coordinate and provide advice on waste disposal and collection.

Public Health England and Director of Public Health:

• Provide clear and unambiguous advice on the health implications of a severe weather event;

• Provide health guidance and advice where necessary directly Hertfordshire Clinical Commissioning Groups (CCGs):

• The CCG is responsible for leading the system and co-ordinating the system response. At the declaration of alert level 3 (p15) the CCG must take the lead in ensuring that key providers and partners have taken appropriate action, including:

• Conducting risk assessments • Implementing response plans and ensuring message to the public and other

multi agency partners, as required Highways Agency:

• Provide temporary traffic management at any incident in support of the Police; • Set strategic and tactical Vehicle Management Signs to support road closures; • Provision of timely advice to the public on route availability and any diversion routes; • Restore the highway to operational use, by snow clearance, treatment of the road /

making the surface safe, removal of debris as a result of the conditions or incidents.

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Military:

• Provision of specialist advice and support, as available under the Military Aid to the Civil Authorities (MACA) arrangements.

Utilities: Major utilities such as National Grid (Gas) and National Grid (Electricity), UK Power Networks, Anglian Water, Essex & Hertfordshire Water, British Telecom have their own contingency plans, which would be activated as required. Companies will be required to liaise closely with emergency services and local authorities during the response and recovery phase, including linking in with Hertfordshire crisis management structures. Voluntary Sector: • The numerous voluntary organisations, nationally, regionally and in Hertfordshire,

have the potential to provide additional capacity and specialist capability for any incident response or during the recovery phase;

• Responsibility for coordinating the response of voluntary groups is likely to rest with the Local Authority, through Hertfordshire Voluntary Organisations Group (HVOG).

Community Resilience

A number of Parish, Town Councils and other community groups, have developed Community Emergency Plans for their areas. The County Council and District Council Community Teams will liaise with and coordinate Community Emergency Teams to enable a coordinated and supported response of communities with the Emergency Services.

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9. WARNING AND INFORMING

a. Warning and Informing the Public

One of the key aspects of any preparation and response to a severe weather event is the timely dissemination of accurate information, advice and warnings to the public. As severe weather tends to be seasonal, advice and preparatory information will be circulated as part of a coordinated strategy, linked to the 4 preparedness and response levels. This strategy is aimed at raising awareness and escalating from advice to warnings on notification of specific severe weather. Hertfordshire District Council will lead on the planning and development of generic media advice in respect of warning / information. This will consider key messages (normally no more than 4), who the information is targeted at, what methods should be used for dissemination and what detailed information should be given (supplied by emergency planners). These messages should be pre-prepared and reviewed at Level 1 and available for release from Level 2 onwards in the appropriate annexes to this plan.

General advice to the public on preparing for and action to take in the event of severe weather is available from a number of sources listed below:

- Hertfordshire Resilience - general severe weather preparation information -http://m.hertsdirect.org/services/commsafe/commprotect/emeresilience/hertsrespartnership/

- Hertfordshire Community Emergency Preparedness - advice and information -http://m.hertsdirect.org/importantnews/

- The Met Office website - general severe weather preparation information - Met Office: What to do in severe weather.

- Department of Health, Public Health England websites – provide health-related information, guidance and advice.

- Department for Education - provide advice to educational establishments on preparation for severe weather.

- The Highways Agency provides information on routes and travel disruptions on their website Traffic England. UK wide travel information is available from Transport Direct.

- AA Roadwatch will also be used to broadcast warnings - http://www.theaa.com/travelwatch/travel_news.jsp.

- Regional or national television may broadcast weather warning information during major events.

- Local radio stations.

An outline of the likely advice, information and warnings that will be compiled by Communicate Hertfordshire is at Annex C.

b. Media

The media interest in any significant severe weather event, based upon historical evidence, is likely to be very high. The management of the Hertfordshire media response will be guided by Hertfordshire District Council

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10. RECOVERY At, or shortly after the declaration of a Multi-Agency or Major Incident, the County Council will convene a Recovery Working Group (RWG) to prepare for the management of the post response activity aimed at restoring and rebuilding affected communities in the aftermath of a major severe weather event.

12. TRAINING Any additional staff brought in to augment Hertfordshire responders may require to be trained and equipped to complete assigned tasks. Training of responders will take place either by individual agencies or multi-agency to ensure people can conduct the required response role and operate collectively.

13. EQUIPMENT Procurement of equipment and supplies during an emergency response should wherever possible follow existing agency procedures. However, the multi-agency County Council Logistics Cell may co-ordinate the procurement and distribution of additional or specialist emergency supplies during a major incident

14. HEALTH AND SAFETY All organisations referred to in this plan will have relevant risk assessments in place to carry out their organisation’s responsibilities. 15. FINANCE Initially the provision of support to an emergency response is provided at the cost to the providing organisation. Where costs are significant, applications can be submitted by local authorities via the Bellwin Scheme which provides details on who is eligible for financial support

Annexes Annex A – Severe Weather Alert Levels and Response Actions.

Annex B - Weather Activity Table for Emergency Responders

Annex C - Warning and Informing – Exemplar Public Messages

Annex D – Health and social care staff in all settings (community, hospitals and care homes)

Annex E – Key Trigger Temperatures

Annex F – Action Cards from Public Health England

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ANNEX A SEVERE WEATHER ALERT LEVELS AND RESPONSE ACTIONS 1. HEATWAVE

The Heat-Health Watch system operates from 1 June to 15 September each year. The Met Office uses this system to trigger heatwave warnings where the regional threshold temperatures are met or exceeded. The average threshold temperatures for this region are:

• Day time temperature of 30°C or more. • Night time minimum threshold temperature of 15°C or more.

Level 0 Long-term planningAll year

Level 1 Heatwave and Summer preparedness programme1 June – 15 September

Level 2 Heatwave is forecast – Alert and readiness 60% risk of heatwave in the next 2–3 days

Level 3

Heatwave ActionTemperature reached in one or more Met Office National Severe Weather Warning Service regions

Level 4

Major incident – Emergency responseCentral Government will declare a Level 4 alert in the event of severe or prolonged heatwave affecting sectors other than health

2. COLD WATCH

A Cold Watch system will operate in England and Wales from 1st November to 31st March each year. During this period, the Met Office consults with the Department of Health, the Cabinet Office and other experts to raise alerts at appropriate level in response to the weather forecasts and their likely impacts.

Level 0 Long-term planningAll year

Level 1 Winter preparedness and action programme1 November to 31 March

Level 2

Severe winter weather is forecast – Alert and readiness Mean temperature of 2°C and/or widespread ice and heavy snow are predicted within 48 hours, with 60% confidence.

Level 3

Response to severe winter weather – Severe weather action Severe winter weather is now occurring: mean temperature of 2°C or less and/or widespread ice and heavy snow.

Level 4

Major incident – Emergency responseCentral Government will declare a Level 4 alert in the event of severe or prolonged cold weather affecting sectors other than health

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ANNEX B WEATHER ACTIVITY TABLE FOR EMERGENCY RESPONDERS

Activity Level Level 0 Level 1 Level 2 Level 3 Level 4

Generic activity levels for ALL SEVERE WEATHER for emergency responder organisations

LONG TERM PLANNING

All year

PREPAREDNESS ALERT AND READINESS

ACTION MAJOR INCIDENT - EMERGENCY RESPONSE

Warning and Informing activity

Develop communications strategies to encourage resilience and preparedness.

Prepare core messages to be broadcast alongside national, PHE messages aligned to warnings and weather forecasts.

Appropriate agencies register to receive weekly Heat-Health Watch and Cold Weather Plan notifications and alerts.

Consider issue of general media messages.

Post advice links on agency’s websites.

Appropriate agencies receive weekly Heat- Health Watch and Cold Weather Plan notifications and alerts

Issue media messages – especially ‘hard to reach groups’.

Agencies to receive Met Office weekly notifications

Update Community Resilience partners and encourage review of community emergency plans.

Agencies to receive Met Office weekly notifications

Update Community Resilience partners and ask them to activate their community emergency plans

Specific activity levels associated with Heatwave

All Agencies

Make environmental improvements to provide a safe environment for clients in the event of a heatwave.

Prepare business continuity plans to cover the event of a heatwave (e.g. storage of medicines, computer resilience, etc.).

Work with partners and staff to raise awareness of the impacts of severe heat and on risk reduction awareness

All Agencies

Coordinate individual agency heatwave contingency plans & business continuity arrangements.

Liaise with partners on joint preparedness arrangements.

Circulate National heatwave guidance and advice – schools, care settings, prisons, and voluntary organisations.

All Agencies

Liaise and confirm status of heatwave response, logistics and monitoring mechanisms (Cat 2 responders as appropriate).

Communicate alerts to staff and make sure that they are aware of heatwave plans

Increase advice to health and social care workers working in community, care homes and hospitals

All Agencies

Convene Hertfordshire teleconference to identify particular heatwave related issues and potential mitigation strategies (NHS lead).

Review safety of public events.

Issue warning information and media alerts.

NHS & Local Authority (ACS & CYP)

Continue to distribute DH advice / guidance to…

All Agencies

Convene TCG/SCG to coordinate implementation of mitigation measures and national guidance (NHS lead).

Update warnings, information and media alerts.

NHS & Local Authority

Coordinate the implementation of DH advice / guidance

…cont…

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Hertfordshire District Council

Engaging the community & voluntary sector to support development of local community emergency plans

Encourage development of community emergency plans to identify and support vulnerable neighbours.

PHE / NHS England

Issue general advice to the public and professionals.

Health / Care providers

Identify high risk individuals and monitor care settings.

PHE / NHS England

Provide guidance to professional partners and advice to Public.

Routinely monitor syndromic and mortality surveillance

Health / Care providers

Communicate alerts to staff

Implement heatwave measures and arrangements to monitor those identified at high risk.

PHE / NHS England

Issue Level 2 alert to professional partners and advice to Public.

Continue to monitor syndromic and mortality surveillance

people at risk, residential care managers and carers.

Commission additional care and support, involving at least daily contact, as necessary for at risk individuals living at home. This may involve informal carers, volunteers and care workers.

Continue to distribute guidance to head teachers.

guidance to residential care managers, carers and head teachers.

Specific activity levels associated with WIND

All Agencies


All Agencies

Confirm individual agency contingency & business continuity plans.

Cat 1 and 2 agencies liaise on joint preparedness arrangements.

Review pre-prepared general information and guidance.

All Agencies

Cat 1 EP practitioners liaise and confirm status of response, logistics and monitoring mechanisms (Cat 2 responders as appropriate).

Identify public events likely to be affected.

Issue public information advice and guidance.

All Agencies

Convene Hertfordshire teleconference to identify particular issues and potential mitigation strategies (LA lead).



Police, LA & HA

Manage disruption to transport infrastructure

All Agencies

Convene TCG / SCG to coordinate implementation of mitigation measures and national guidance (LA lead).


LA & HA

Coordinate and prioritise route maintenance operations.

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Specific activity levels associated with RAIN

All Agencies

Business as usual

Activity as per WIND (above).

All Agencies

Business as usual


All Agencies5

Convene Hertfordshire Flood Advisory Telecon to identify particular issues and potential mitigation strategies (LA lead).

Inform partners of identified risk area(s).

Consider establishing TCG / SCG

Consider implementing Operational Flood Plan actions.

Review supporting Emergency Plans.

Consider mobilisations of resources – personnel, plant, flood protection, voluntary organisations

Consider / Implement activation of evacuation plans and arrange for rest centres to be set up.

All Agencies10

Convene Hertfordshire

TCG / SCG to coordinate implementation of mitigation measures and national guidance (LA lead).

Identify risk / effected areas.

Consider wider flood risks and refer to the Hertfordshire Flood Plan Activate Operational Flood Plan actions.

Consider / Implement activation of evacuation plans and arrange for rest centres to be set up.

5 Medium and High activity as detailed in the HERTFORDSHIRE Flood Plan v.5

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Specific activity levels associated with SNOW & ICE

All Agencies

Review actions and guidance from PHE Cold Weather Plan.

Work with partner agencies to ensure that cold weather planning features within wider winter resilience planning.

Work with partners and staff on risk reduction awareness (e.g. flu vaccinations, signposting for winter warmth initiatives.


Engage with local statutory partners to agree how voluntary organisations can contribute to local community resilience arrangements.

PHE and NHS England

Issue general advice to the public and professionals and work closely with other government departments

All Agencies

Confirm individual agency winter contingency & business continuity plans.

Cat 1 and 2 agencies liaise on joint preparedness arrangements.

Identify categories of vulnerable individuals & groups.

Review pre-prepared general information and guidance.

LA in consultation with HA

Review winter service plans (Snow clearance and gritting) strategy.


Identify measures to reduce effects of cold on at risk groups - vulnerable adults and young people.

All Agencies

Cat 1 EP practitioners liaise and confirm status of winter response, logistics and monitoring mechanisms (Cat 2 responders as appropriate).

Identify public events likely to be affected.

Issue public information advice and guidance.


Distribution of DH & DfE guidance to residential care managers and carers, schools, Sure Start centres and children’s nurseries.

LA

Deliver winter service plan, which includes actions for severe weather situation.

All Agencies

Convene Hertfordshire teleconference to identify particular snow-related issues and potential mitigation strategies (LA or NHS lead).




Continue to distribute DH & DfE guidance and advice.

Identify and provide any specific support requirements for at risk individuals or groups.

LA and HCC

Implement snow clearance and gritting contingency plans.

Police and HCC

Manage disruption to transport infrastructure.

Coordinate route information.

All Agencies

Convene TCG / SCG to coordinate implementation of mitigation measures and national guidance (LA lead).



Liaise on implementation of DH advice / guidance.

Continue distribution of guidance to residential care managers, carers and head teachers.

LA & HCS

Establish severe weather desk to manage and coordinate winter service activities.

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Activity Level Level 0 Level 1 Level 2 Level 3 Level 4 and other national

organisations that produce winter warmth advice.

Specific activity levels associated with FOG

All Agencies

Business as usual


All Agencies

Business as usual


All Agencies

Consider media messages

Police and HA

Manage transport disruptions

Activate matrix signs

All Agencies

N/A

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ANNEX C WARNING AND INFORMING – EXEMPLAR PUBLIC MESSAGES HEATWAVE

GUIDANCE MESSAGES FOR PUBLIC WARNING & INFORMING

These are the core messages that will be broadcast as ‘official Department of Health warnings’ alongside national and regional weather forecasts. They may be expanded or otherwise refined in discussion with broadcasters and weather presenters. The implementation of the Health and Social Care Act 2012 has seen the abolition of Primary Care Trusts and Strategic Health Authorities and the creation of a number of new bodies including Public Health England (PHE), NHS England and Clinical Commissioning Groups (CCGs). At a local level, responsibility for public health has transferred to local authorities.

The Department of Health (DH) is responsible for strategic leadership of both health and social care systems, but no longer has direct management of most NHS systems. NHS England provides national leadership for improving health care outcomes, directly commissions general practice services, some specialist services, and oversees Clinical Commissioning Groups. CCGs now commission planned hospital care, rehabilitative care, urgent and emergency care, most community health services and mental health and learning disability services. Directors of Public Health in Local Authorities are responsible for population health outcomes, supported by Public Health England (PHE), which provides national leadership and expert services to support public health

• Advising hospitals and care, residential and nursing homes to provide cool areas and monitor indoor temperatures to reduce the risk of heat-related illness and death in the most vulnerable populations.

• Helping GPs and district nurses and social workers to identify vulnerable patients and clients on their practice lists by providing them with heatwave information and good practice.

• Ensuring that health and social care organisations and voluntary groups implement measures to protect people in their care and reduce heat-related illness and death in those most at risk.

• Recommending health visitors and school nurses provide advice to parents and childcare providers and schools and young people respectively regarding behaviours to protect health during hot weather (e.g. fluid intake, reducing excessive sun exposure, avoiding diving into cold water).

Level 1 – Heatwave and Summer preparedness

No warning required unless there is a 60 per cent probability of the situation reaching Level 2 somewhere in the UK within the next three days, then something along the lines of:

“If this does turn out to be a heatwave, we will try to give you as much warning as possible. But in the meantime, if you are worried about what to do, either for yourself or somebody you know who you think might be at risk, for advice go to NHS Choices at NHS Summer Health programme Alternatively ring NHS 111.”

Level 2 - Alert and readiness

The Met Office, in conjunction with PHE, is issuing the following heatwave warning for [regions identified]:

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“Heatwaves can be dangerous, especially for the very young or very old or those with chronic disease. Advice on how to reduce the risk either for yourself or somebody you know can be obtained from NHS Choices at NHS Summer Health programme NHS 111, or from your local chemist.”

Level 3 and 4 - Heatwave action/Emergency

The Met Office, in conjunction with PHE, is issuing the following heatwave advice for [regions identified]:

“Stay out of the sun. Keep your home as cool as possible - shading windows and shutting them during the day may help. Open them when it is cooler at night. Keep drinking fluids. If there is anybody you know, for example an older person living on their own, who might be at special risk, make sure they know what to do.”

More advice is available from the Met Office website: Met Office: What to do in severe weather

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LOW TEMPERATURES AND HEAVY SNOW

HELPING HERTFORDSHIRE STAY SAFE IN BAD WEATHER

Members of the Hertfordshire Resilience Forum, including Hertfordshire County Council, Hertfordshire Constabulary, Hertfordshire Clinical Commissioning Groups and district and borough councils, are working together once again to ensure the county’s residents stay safe during the current severe weather conditions.

The Forum is issuing a series of key messages and top tips to let people in the county know what’s being done to deal with the bad weather and how they can keep safe in the snow and ice:

Hertfordshire Constabulary • Advice on winter driving and potential travel disruption.

Local Authorities

• Information on road treatment regime and self-help gritting arrangements.

• School closures – Advice on where information is provided.

• Advice on changes to refuse collection schedules / frequency

• Hertfordshire Clinical Commissioning Groups

• Director Public Health

• Wellbeing advice, particularly for older people and consideration of vulnerable members of the community.

East of England Ambulance Service NHS Trust • Reminder of the appropriate use of the 999 system.

Hertfordshire Fire and Rescue Service

• Fire safety precautions – advice on use of portable heaters, open fires, candles, etc.

More advice is available from the Met Office website: Met Office: What to do in severe weather

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Annexe D

Figure 3.2: Providers – health and social care staff in all settings (community, hospitals and care homes)

Level 0

Level 1 Level 2 Level 3 Level 4

Long-term planning

All year

See accompanying document ‘Making the Case’ for more detail

Heatwave and Summer preparedness programme

1 June – 15 September

Heatwave is forecast – Alert and readiness

60% risk of heatwave in the next 2–3 days

Heatwave Action

Temperature reached in one or more Met Office National Severe Weather Warning Service regions

Major incident – Emergency response

Central Government will declare a Level 4 alert in the event of severe or prolonged heatwave affecting sectors other than health

Professional Staff (all settings):

Develop systems to identify and improve resilience of high-risk individuals

Encourage cycling/walking where possible to reduce heat levels and poor air quality in urban areas.

Care Homes and Hospitals

Work with commissioners to develop longer term plans to prepare for heatwaves

Make environmental improvements to provide a safe environment for clients in the event of a heatwave

Prepare business continuity plans to cover the event of a heatwave (e.g. storage of medicines, computer resilience, etc)

Work with partners and staff to raise awareness of the impacts of severe heat and on risk reduction awareness (key public health messages – box 1)

Professional Staff (all settings)

Identify high-risk individuals on your caseload and raise awareness of heat illnesses and their prevention among clients and carers.

Include risk in care records and consider whether changes might be necessary to care plans in the event of a heatwave (e.g. initiating daily visits by formal or informal care givers for those living alone)


Ensure business continuity plans are in place and implement as required; ensure appropriate contact details are provided to LA/NHS emergency planning officers to facilitate transfer of emergency information

Identify or create cool rooms/areas (able to be maintained below 26°C)

Install thermometers where vulnerable individuals spend substantial time

Professional staff (all settings):

Check high-risk people have visitor/ phone call arrangements in place

Reconfirm key public health messages to clients

Check client’s room temperature if visiting


Check indoor temperatures are recorded regularly during the hottest periods for all areas where patients reside

Ensure cool areas are below 26°C

Review and prioritise high-risk people

Ensure sufficient cold water and ice

Consider weighing clients regularly to identify dehydration and rescheduling physio to cooler hours

Communicate alerts to staff and make sure that they are aware of heatwave plans

Ensure sufficient staffing

Implement business continuity

Professional staff (all settings):

Visit/phone high-risk people

Reconfirm key public health messages to clients

Advise carers to contact GP if concerns re health


Activate plans to maintain business continuity – including a possible surge in demand

Check indoor temperatures are recorded regularly during the hottest periods for all areas where patients reside

Ensure staff can help and advise clients including access to cool rooms, close monitoring of vulnerable individuals, reducing internal temperatures through shading, turning off unnecessary lights/equipment, cooling building at night, ensuring discharge planning takes home temperatures and support into account

NATIONAL EMERGENCY

Continue actions as per Level 3 unless advised to the contrary

Central government will declare a Level 4 alert in the event of severe or prolonged heatwave affecting sectors other than health and if requiring coordinated multi-agency response

High-risk Groups

Community: Over 75, female, living on own and isolated, severe physical or mental illness; urban areas, south-facing top flat; alcohol and/or drug dependency, homeless, babies and young children, multiple medications and over-exertion

Care home or hospital: over 75, female, frail, severe physical or mental illness; multiple medications; babies and young children (hospitals).

*Because Level 2 is based on a prediction, there may be jumps between levels. Following Level 3, wait until temperatures cool to Level 1 before stopping Level 3 actions.

** Level 4: A decision to issue a Level 4 alert at national level will be taken in light of a cross-government assessment of the weather conditions, co-ordinated by the Civil Contingencies Secretariat

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Annexe E

This figure summarises the key trigger temperatures during a heatwave. Although excess seasonal deaths start to occur at approximately 25°C, for practical reasons the Health Heatwave alert system is based upon temperature thresholds where the odds ratio is above 1.15–1.2 (a 15–20% increased risk). The different trigger temperatures for local areas are summarised below with regional

Figure 4. Trigger temperatures

variations due to relative adaptation to heat. However, a significant proportion of excess summer deaths occur before the Health Heatwave alert is triggered, which emphasises the importance of long-term planning actions by local authorities and the health sector.

52°C and 48°C – when train rails reach these temperatures a Temporary Speed Restriction (TSR) is introduced. Train speeds are reduced by 50% and 30% respectively

41.5°C and 36.2°C Temperatures recorded on the tube and on the platform during 2003 heatwave.

38.5°C Highest daytime temperature recorded in the UK

33°C Tarmac Roads may

begin to melt.

36°C Network Rail would be experiencing railhead temperatures of 50+°C when air temperatures of 36°C are reached. Extreme precautions would then be introduced.

24.5°C Temperature at which any excess deaths may first become apparent

24°C (for 3 days running) – London Underground deploy hot weather notices and supply bottled water. Maintenance workers begin work to stop rails buckling. Network rail also begin additional precautions to their track

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Annexe F Action Cards from Public Health England

Protecting and improving the nation’s health

Cold Weather Plan for England: Action cards for Cold Weather Alert Service

Commissioners (health and social care) and local authorities

1 Action cards for Cold Weather Alert Service: Commissioners (health and social care) and local authorities

Level 0: Year round planning• work with partner agencies to ensure that cold weather planning features within wider winter resilience planning• work with partners to ensure that a strategic approach to the reduction of excess winter deaths (EWDs) and fuel

poverty is taken across the local health and social care economy• work with partner agencies to:

– develop a shared understanding of EWDs and what partners can do to reduce them– identify those most at risk from seasonal variations– improve winter resilience of those at risk– ensure a local, joined-up programme is in place to support improved housing, heating and insulation,

including uptake of energy-efficient, low-carbon solutions– achieve a reduction in carbon emissions and assess the implications of climate change

• consider how your winter plans can help to reduce health inequalities, how they might target high-risk groups and address the wider determinants of health

• ensure that organisations and staff are prompted to signpost vulnerable clients onwards (eg for energy efficiency measures, benefits or related advice)

• work with partners and staff on risk reduction awareness (eg flu vaccination for staff in September/October), information and education

• engage with local VCS organisations for planning and implementation of all stages of the plan

Level 1: Winter preparedness and action programme – 1 November to 31 March• communicate public health media messages• work with partner agencies to coordinate locally appropriate cold weather plans• ensure key partners, including all managers of care, residential and nursing homes are aware of the alert system

and can access advice• review the distribution of the cold weather alerts across the system and ensure staff are aware of winter plans

and advice• ensure that local organisations and professionals are taking appropriate actions in light of the cold weather

alerts in accordance with the local and national Cold Weather Plan• ensure that organisations and staff are prompted to signpost vulnerable clients onwards (eg for energy

efficiency measures, benefits or related advice)• liaise with providers of emergency shelter for homeless people to agree plans for severe weather and ensure

capacity to scale up provision• support communities to help those at risk. Support the development of community emergency plans• identify which local health, social care and voluntary and community sector organisations are most vulnerable

to the effects of winter weather. Agree plans for winter surge in demand for services. Make sure emergency contacts are up to date


2 Action cards for Cold Weather Alert Service: Commissioners (health and social care) and local authorities PHE publications gateway number: 2014380

Level 2: Severe winter weather is forecast - Alert and readiness

Mean temperature of 2°C and/or widespread ice and heavy snow are predicted within 48 hours, with 60% confidence • continue to communicate public health media messages• communicate alerts to staff and make sure that they can take appropriate actions• ensure key partners, including all managers of care, residential and nursing homes, are aware of the alerts and can access Department of Health and other advice• ensure that organisations and staff are prompted to signpost vulnerable clients onwards (eg for energy efficiency measures, benefits or related advice)• support local community organisations to activate community emergency plans• activate business continuity arrangements and emergency plans as required• consider how to make best use of available capacity, for example by using community beds for at-risk patients who do not need an acute bed and enabling access to step-down care and reablement• work with partner agencies (eg transport) to ensure road/ pavement gritting preparations are in place to allow access to critical services and pedestrian hotspots

Level 3: Response to severe winter weather – Severe weather action

Severe winter weather is now occurring: mean temperature of 2°C or less and/or widespread ice and heavy snow • continue to communicate public health media messages• communicate alerts to staff and make sure that winter plans are in operation• ensure key partners are undertaking action in response to alerts• support local community organisations to mobilise community emergency plans• ensure continuity arrangements are working with provider organisations• work with partner agencies (eg transport) to ensure road and pavement gritting arrangements are in effect to allow access to critical services and pedestrian hotspots

Level 4: Major incident - Emergency response

Central government will declare a level 4 alert in the event of severe or prolonged cold weather affecting sectors other than health • continue actions as per level 3 unless advised to the contrary• implementation of national emergency response arrangements by central government

The Cold Weather Plan for England 201 and associated documents can be accessed at: www.gov.uk/government/publications/cold-weather-plan-for-england



Provider organisations: health and social care (community services, hospitals, care homes and prisons)

1 Action cards for Cold Weather Alert Service: Voluntary and community sector

Level 0: Year round planning – All year

• ensure that you are engaged with local emergency preparedness response and recovery and other strategic arrangements – especially for winter planning

• ensure your organisation can identify those most vulnerable to cold weather and draw up plans for joined-up support with partner organisations. Agree data-sharing arrangements within information governance principles

• assess the longer-term implications of climate change, reduction in carbon emissions, and sustainability for longer-term business continuity

• consider how best to mobilise and engage community organisations and support the development of community emergency plans

• make sure that staff members have identified all those vulnerable to cold weather and that arrangements are in place to support and protect them appropriately

• work with staff on risk reduction awareness, information and education. Encourage staff to be vaccinated against flu before winter starts

• ensure that the business continuity plan includes severe winter weather. Plan for a winter surge in demand for services

• consider carers’ needs and support they can continue to give• work with environmental health officers on Housing Health and Safety Rating System hazard identification

Level 1: Winter preparedness and action programme – 1 November to 31 March

• undertake internal reviews to ensure that cold weather alerts are going to the right staff and that appropriate actions are agreed and able to be implemented when received, especially to protect vulnerable service users

• make sure that staff members have identified all those vulnerable to cold weather and that arrangements are in place to support and protect them appropriately

• ensure staff members are undertaking appropriate home checks when visiting clients, eg room temperature (which should be at least 18°C to minimise risk to health), medications and food supplies

• hospitals and care, residential and nursing homes: ensure that rooms, particularly living rooms and bedrooms are kept warm (at least 18°C to minimise risk to health) and that staff are taking appropriate action to protect residents from cold weather

• work with partner agencies to co-ordinate cold weather plans; ensure data sharing and referral arrangements are in place

• continue to work with staff on risk reduction awareness, information and education. Encourage staff to be vaccinated against flu, if not already

• work with local authority teams to identify accident hotspots on pavements or roads, advise on gritting priorities to prevent accidents, and ensure access by utilities and other essential services

• ensure staff are aware of the business continuity plan for winter weather; plan for a winter surge in demand• ensure carers are receiving advice and support


2 Action cards for Cold Weather Alert Service: Provider organisations: health and social care (community services, hospitals, care homes and prisons) PHE publications gateway number: 2014380

Level 2: Severe winter weather is forecast – Alert and readiness

Mean temperature of 2°C and/or widespread ice and heavy snow are predicted within 48 hours, with 60% confidence • communicate alerts to staff and ensure that locally agreed Cold Weather Plan actions take place, especially

those to protect vulnerable service users• continue to ensure local actions for the vulnerable such as:

– arranging daily contacts/visits– ensuring staff are undertaking appropriate home checks when visiting clients, eg room temperature (which

should be at least 18°C to minimise risk to health); medications and food supplies– ensuring carers are receiving appropriate advice and support

• hospitals and care, residential and nursing homes: ensure that rooms, particularly living rooms and bedrooms, are kept warm

• activate business continuity arrangements and emergency plans as required. Activate plans to deal with a surge in demand for services


Severe winter weather is now occurring: mean temperature of 2°C or less and/or widespread ice and heavy snow • communicate alerts to staff and ensure that locally agreed actions take place, especially those to protect

vulnerable service users• implement local plans for contacting the vulnerable. Consider daily visits/phone calls for high-risk individuals

living on their own who have no regular contacts• ensure carers are receiving appropriate advice and support• implement plans to deal with surge in demand• implement business continuity arrangements

Level 4: Major incident – Emergency response


The Cold Weather Plan for England and associated documents can be accessed at: www.gov.uk/government/publications/cold-weather-plan-for-england



Voluntary and community sector

1 Action cards for Cold Weather Alert Service: Voluntary and community sector

Level 0: Year round planning

• engage with local statutory partners to agree how the community and voluntary sector can contribute to the local community resilience arrangements

• develop a community emergency plan to:- identify and support vulnerable neighbours in the winter- assess the impact severe weather might have on the provision and use of usual community venues- ensure that pavements and public walkways are cleared of snow and ice in the local community- agree support, resources and training to maximise effective use of volunteers- support recruitment of volunteers- agree mechanisms for distributing food, fuel, emergency heating, health, social care and other provision to

vulnerable people- review emergency housing and hostel provision- agree arrangements with other community groups to maximise contact with vulnerable people- identify available services for vulnerable people and agree signposting arrangements with providers


• test the community emergency plan to ensure that roles and responsibilities and actions are clear• set up rotas of willing volunteers to keep the community safe during inclement weather and to check on

vulnerable people and neighbours• support the provision of appropriate advice about the health risks of cold weather/ cold housing especially with

vulnerable people• ensure that there is a business continuity plan for severe winter weather to ensure support can continue to be

given to vulnerable people• actively engage vulnerable people known to be at risk and check on welfare regularly and support them to seek

help if necessary

Cold Weather Plan for England 2014Action cards for Cold Weather Alert Service

2 Action cards for Cold Weather Alert Service: Voluntary and community sector PHE publications gateway number: 2014380


Mean temperature of 2°C and/or widespread ice and heavy snow are predicted within 48 hours, with 60% confidence • activate the community emergency plan• activate the business continuity plan• continue to actively engage vulnerable people known to be at risk and check on welfare

regularly and support them to seek help if necessary• stay tuned to the weather forecast


Severe winter weather is now occurring: mean temperature of 2°C or less and/or widespread ice and heavy snow • implement community emergency plan• contact vulnerable people to ensure they are safe and well, and support them to seek

help if necessary• ensure volunteers are appropriately supported


Central government will declare a level 4 alert in the event of severe or prolonged cold weather affecting sectors other than health • continue actions as per level 3 unless advised to the contrary• implementation of national emergency response arrangements by central government• follow key public health and weather alert messages as broadcast on the media




GPs and practice staff

1 Action cards for Cold Weather Alert Service: GPs and practice staff

Level 0: year round planning

• be aware of emergency planning measures relevant to general practice. See www.england.nhs.uk/ourwork/gov/eprr

• promote flu immunisation to both staff and patients• ensure GPs and practice staff members are aware of local services to improve warmth in the home• consider training on seasonal weather and the identification of vulnerable individuals to help staff be more

aware of the effects of cold weather on health; those groups of patients likely to be most vulnerable; and how they can signpost patients on to other services

• consider use of tools to aid systematic identification of vulnerable individuals• consider using opportunistic approaches to signpost appropriate patients to other services when they

present for other reasons. For example, flu vaccination clinics can be an opportunity to promote core public health messages with vulnerable individuals


• staff training should include a specific session on the Cold Weather Plan and cold weather resilience where required, relevant and appropriate to local conditions

• consider how you can promote key public health messages in the surgery. For example, take advantage of clinical contacts to reinforce public health messages about cold weather and cold homes on health

• get a flu jab to help protect you and your patients• consider using a cold weather scenario as a table-top exercise to test your business continuity arrangements• be aware of systems to refer patients to appropriate services from other agencies• when making home visits, be aware of the room temperature in the household (which should be at least 18C

to minimise risk to health), and if required, know how to advise on levels that are of concern and as necessary, to signpost to other services

• consider using the Keep Warm, Keep Well booklet for up-to-date information and advice for patients


Mean temperature of 2°C and/or widespread ice and heavy snow are predicted within 48 hours, with 60% confidence

• take advantage of clinical contacts to reinforce public health messages about cold weather and cold homes on health

• when prioritising visits, consider vulnerability to cold as a factor in decision making


2 Action cards for Cold Weather Alert Service: GPs and practice staff PHE publications gateway number: 2014380


Severe winter weather is now occurring: mean temperature of 2°C or less and/or widespread ice and heavy snow • be aware of a possible surge in demand in the days following a cold spell• ensure that staff members are aware of cold weather risks and are able to advise patients appropriately






Individuals

1 Action cards for Cold Weather Alert Service: Individuals

Level 0: Long-term planning – All year • seek good advice about improving the energy efficiency of your home and staying warm in winter; undertake

energy efficiency improvements to your home or encourage your landlord to do so• seek advice from your local authority environmental health department if as a tenant your heating is defective

or you cannot affordably heat your home• check your entitlements and benefits; seek income maximisation advice to get benefits and other services;

seek advice from your fuel supplier or local advice provider if you have fuel debt or difficulties paying for or affording sufficient fuel

• ask your fuel supplier about their Priority Service Register for vulnerable customers, what this provides and if you are eligible

• check that your heating is working properly; make sure that you have access to sufficient fuel supplies for the winter period especially if you rely on oil, LPG or wood deliveries. Consider alternative heating measures if required

• have all gas, solid fuel and oil burning appliances (ie boilers, heaters and cookers) serviced by an appropriately registered engineer. Malfunctioning appliances can release carbon monoxide – a gas that can kill. Have flues and chimneys checked for blockages and swept if needed. Fit an audible carbon monoxide alarm (EN50291 compliant)

• get a flu vaccination if you are in a risk group (September/October)

Level 1: Winter preparedness and action programme – 1 November to 31 March • find good information about health risks. Try NHS choices at www.nhs.uk• if you are receiving social care or health services ask your GP, key worker or other contact about staying

healthy in winter and services available to you. Make sure you have a list of emergency numbers if you need to call for assistance or advice during cold weather

• check room temperatures – especially those rooms where disabled or vulnerable people spend most of their time. Homes should be heated to at least 18°C to minimise risk to health

• if you or someone else is likely to be restricted to one room during the winter period or during a cold spell make sure that it can be kept at or above recommended temperatures (which are at least 18°C to minimise risk to health) and that you plan what resources you/they need to keep them safe and warm – seek energy advice as necessary

• protect water pipes from freezing by insulating them• look out for vulnerable neighbours and help them prepare for winter (eg with key contact numbers for

emergency situations). Ensure they have access to warm food and drinks and are managing to heat their home adequately

• consider other preventive action you can take (eg perhaps volunteering to help implement the community emergency plan)

• consider using the Keep Warm, Keep Well booklet for up-to-date information and advice for patients


2 Action cards for Cold Weather Alert Service: Individuals PHE publications gateway number: 2014380


Mean temperature of 2°C and/or widespread ice and heavy snow are predicted within 48 hours, with 60% confidence • continue to have regular contact with vulnerable people and neighbours you know to be at risk in cold

weather – ensure they have access to warm food and drinks and are managing to heat their home adequately. Homes should be heated to at least 18°C to minimise risk to health

• stay tuned into the weather forecast, and ensure you are stocked with food and medications in advance (have deliveries or ask a friend to help)

• take the weather into account when planning your activity over the following days. Avoid exposing yourself to cold or icy outdoor conditions if you are at a higher risk of cold-related illness or falls

• discuss with friends and neighbours about clearing snow and ice from in front of your house and public walkways nearby, if you are unable to do this yourself


Severe winter weather is now occurring: mean temperature of 2°C or less and/or widespread ice and heavy snow • stay tuned into the weather forecast• heating your room to at least 18°C in winter poses minimal risk to your health when you are wearing

suitable clothing• if you have to go out, dress warmly and wear non-slip shoes. Tell someone where you are going and when

you will get back. Keep your mobile phone (if you have one) on you and charged• dress warmly, eat warm food and take warm drinks regularly; keep active• check on those you know are at risk• if you are concerned about your own health or that of other people, alert emergency services• clear pavements of ice or snow if you are able and it is essential


Central government will declare a level 4 alert in the event of severe or prolonged cold weather affecting sectors other than health • continue actions as per level 3 unless advised to the contrary• implementation of national emergency response arrangements by central government• follow key public health and weather alert messages as broadcast on the media




Frontline health and social care staff in community and institutions

1 Action cards for Cold Weather Alert Service: Frontline health and social care staff in community and institutions

Level 0: Year round planning• work with partner agencies to ensure that cold weather planning features within wider winter resilience planning• work with partners to ensure that a strategic approach to the reduction of excess winter deaths (EWDs) and

fuel poverty is taken across the local health and social care economy• work with partner agencies to:

– develop a shared understanding of EWDs and what partners can do to reduce them– identify those most at risk from seasonal variations– improve winter resilience of those at risk– ensure a local, joined-up programme is in place to support improved housing, heating and insulation,

including uptake of energy-efficient, low-carbon solutions– achieve a reduction in carbon emissions and assess the implications of climate change

• consider how your winter plans can help to reduce health inequalities, how they might target high-risk groups and address the wider determinants of health

• ensure that organisations and staff are prompted to signpost vulnerable clients onwards (eg for energy efficiency measures, benefits or related advice)

• work with partners and staff on risk reduction awareness (eg flu vaccination for staff in September/October), information and education

• engage with local VCS organisations for planning and implementation of all stages of the plan

Level 1: Winter preparedness and action programme – 1 November to 31 March• communicate public health media messages• work with partner agencies to coordinate locally appropriate cold weather plans• ensure key partners, including all managers of care, residential and nursing homes are aware of the alert

system and can access advice• review the distribution of the cold weather alerts across the system and ensure staff are aware of winter plans

and advice• ensure that local organisations and professionals are taking appropriate actions in light of the cold weather

alerts in accordance with the local and national Cold Weather Plan• ensure that organisations and staff are prompted to signpost vulnerable clients onwards (eg for energy

efficiency measures, benefits or related advice)• liaise with providers of emergency shelter for homeless people to agree plans for severe weather and ensure

capacity to scale up provision• support communities to help those at risk. Support the development of community emergency plans• identify which local health, social care and voluntary and community sector organisations are most vulnerable

to the effects of winter weather. Agree plans for winter surge in demand for services. Make sure emergency contacts are up to date


2 Action cards for Cold Weather Alert Service: Frontline health and social care staff in community and institutions PHE publications gateway number: 2014380


Mean temperature of 2°C and/or widespread ice and heavy snow are predicted within 48 hours, with 60% confidence • continue to communicate public health media messages• communicate alerts to staff and make sure that they can take appropriate actions• ensure key partners, including all managers of care, residential and nursing homes, are aware of the alerts and can access Department of Health and other advice• ensure that organisations and staff are prompted to signpost vulnerable clients onwards (eg for energy efficiency measures, benefits or related advice)• support local community organisations to activate community emergency plans• activate business continuity arrangements and emergency plans as required• consider how to make best use of available capacity, for example by using community beds for at-risk patients who do not need an acute bed and enabling access to step-down care and reablement• work with partner agencies (eg transport) to ensure road/ pavement gritting preparations are in place to allow access to critical services and pedestrian hotspots


Severe winter weather is now occurring: mean temperature of 2°C or less and/or widespread ice and heavy snow • continue to communicate public health media messages• communicate alerts to staff and make sure that winter plans are in operation• ensure key partners are undertaking action in response to alerts• support local community organisations to mobilise community emergency plans• ensure continuity arrangements are working with provider organisations• work with partner agencies (eg transport) to ensure road and pavement gritting arrangements are in effect to allow access to critical services and pedestrian hotspots

Level 4: Major incident- Emergency response



Documents

EN CCG Severe Weather Response Plan...conditions resulting in transport difficulties or threat to life. The National Severe Weather Warning Service provides two levels of warning for