Agenda item

            (Mr. W. Francey, Director of Health and Environmental Services, attended in connection with this item.)

 

            The Committee considered the undernoted report:

 

“Relevant Background Information

 

      The Committee has over the last 6 months received a number of reports regarding Pandemic Flu, detailing the Council’s planning processes for ensuring continuity of critical services, implications for staff absence procedures and information to be issued to all staff and managers.

 

      The number of new cases of Swine Flu in Northern Ireland has been generally showing an increase over the last few months, although the levels are not as high as predicted earlier in the year and there is not yet a sustained week on week increase.  It must also be noted that clinical diagnosis is now being used to confirm swine flu in most cases, as opposed to laboratory testing and so the figures reported are considered as estimates.  .

 

      Since 2007 the council has had in place a specific corporate contingency plan (Strategic Pandemic Plan) to cope with a pandemic situation.  It is supported by individual pandemic contingency plans for critical services such as refuse collection, burials and cremations and some environmental health functions.  All Services also have more general business continuity plans.  All of these plans have recently been reviewed and subjected to appropriate desk?top testing.

 

      Information has also been issued to all staff and managers on swine flu, detailing how to minimise the spread of infection, sickness procedures, special leave arrangements, etc.  Improved cleaning procedures have also been put in place.

 

Key Issues

 

      The Department of Health is still planning for further more severe waves of this illness in the very near future and the Government has issued revised planning assumptions based on the estimated worst case situation, to enable authorities to plan for this eventuality.  It is expected that there will be a peak period sometime in the next two months which will have an impact not only on the health service, but also on the business continuity of public services.

 

      Antiviral drugs such as Tamiflu are being offered to those who have contracted the illness, but it is a matter of clinical discretion as to whether they are being prescribed in individual cases, although a number of high risk groups have been identified for early priority access to antiviral medicines.  

 

      In Northern Ireland, the responsibility for ensuring effective supplies of antiviral medicines rests with the Health and Social Care Board (HSCB).  At present the drug is being dispensed via community pharmacists in the normal way.   However, as part of the Board’s contingency arrangements for a major second or third wave of the virus, it has asked district councils for support with the distribution of antiviral medicines during the peak period (likely to last for 2 – 3 weeks), should the normal methods of distribution be overwhelmed.  In periods of higher demand, large scale access to antivirals may be required.  When this critical stage is reached the Board may be required to quickly mobilise a number of additional Antiviral Collection Points (ACPs).

 

      The Board has been working through the Local Government Emergency Management Group (LGEMG) to develop a Memorandum of Understanding (MOU) between it and district councils to agree the support which might be called upon from councils in respect of ACPs.    A copy of this MOU is provided in the Appendix, along with a covering letter.  The MOU envisages that, where pharmacies are overwhelmed during a peak period, temporary ACPs will be set up in Council premises with the support of Council staff.   A workshop has also been held for some key members of staff and a number of community and leisure centres have been identified as possible locations.

 

      The Principal Solicitor in Legal Services has had sight of the MOU and is satisfied with the legal framework to enable the Council to perform this role and also the level of risk to the Council in terms of its role and the level of indemnity stated. 

 

      The MOU outlines the Council role as being to identify and provide appropriate facilities for the provision of ACPs.  The Council will, where possible, identify staff to support the service and as their employer, manage any human resource elements.   All costs to the Council associated with this work can be reclaimed from the Board.

 

      One concern regarding this arrangement for Belfast will be the ability of the Council to provide the required numbers of staff for this purpose should there be high absence levels and a focus on the delivery of its own critical services.  However the MOU allows for this, in that it states:

 

      Councils will endeavour to provide agreed levels of service to HSCB in support of the distribution of anti-virals, but any support provided will be conditional upon the ability of the individual council to make staff available having regard to prevailing circumstances:

 

      Council Officers will be meeting with the Board officials in the next few weeks to discuss in detail the arrangements for Belfast and the expectations in terms of buildings and staff.

 

Resource Implications

 

      Human

 

      Further training of staff will be needed.  Communication is also ongoing with the Unions.

 

      Financial

 

      All costs will be recoverable from the HSCB. Additional funding has now been agreed by the Assembly for dealing with swine flu.

 

Recommendations

 

      The Committee is recommended to authorise the Chief Executive to sign the MOU with the Health and Social Care Board.

 

Key to Abbreviations

 

MOU:    Memorandum of Understanding

HSCB:   Health and Social care Board

LGEMG:  Local Government Emergency Management Group

ACP: Antiviral Collection Point

 

Decision Tracking

 

      The Head of Environmental Health will report back on any further developments with the MOU and will provide updates to Committee as required.

 

Appendix 1

 

Memorandum of Understanding between

the Health and Social Care (HSC) Board and

Local Government District Councils in Northern Ireland

 

September 2009

 

Index

 

1    Purpose

2    Background

3    Circumstances of initiation

4    Role and Responsibility of HSC Board

5    Role and Responsibility of District Councils

6    Communication

7    Resource Implications

 

      Signatures of authorising officers

 

      Annex

 

1    Purpose

 

      In times of national emergency such as Pandemic Flu there may be exceptional demands on health and social care services which may require co-operation and support from other public service organisations to deliver vital services to the community. This document describes the circumstances under which such support may be sought by the HSC Board from District Councils and addresses the management of such arrangements, the risks for both parties and the need for resources.

 

2    Background

 

      There is a legislative provision which permits local government to offer support in to other organisations in emergencies. Section 105 of the Local Government Act (Northern Ireland) 1972 allows for arrangements to be entered into for the supply of goods and services or the interchange of staff. A district council may make arrangements with another council, public body or government department, inter alia, for the provision by one party of support to another for any for administrative, professional or technical services.

 

      There are pre-existing relationships between District Councils and Health and Social Care in the field of emergency planning including agreements for the provision of rest centres. This is helpful in building arrangements in preparation for a flu pandemic.

 

      A flu pandemic (level 6) was declared by the World Health Organisation in June 2009 and countries throughout the world are activating plans to manage outbreaks as they emerge. The Health Service in Northern Ireland must gear up to ensure that all appropriate elements of care are in place in anticipation of the first and subsequent waves of pandemic flu cases. It is expected that with each wave, there will be strain placed upon all elements of the service. It is important therefore to consider contingencies and to have planned and appropriate resources identified in order to ensure continuity of service alongside the management of flu. The strategic context for the development of antiviral distribution arrangements is set out in the Annex.

 

3    Circumstances of initiation

 

      It is anticipated that there may be a large surge of demand on the health system in response to Pandemic Flu in Northern Ireland in November 2009. An important component of the health service response will be to ensure there is ready access to antiviral medicines. In periods of higher demand, large scale access to antivirals may be required.  When this critical stage is reached the Board may be required to quickly mobilise a number of Antiviral Collection Points (ACPs).

 

      It is a fundamental intent within this large scale mitigation strategy that the person with flu should stays at home and that antivirals are collected on their behalf from a designated local Antiviral Collection Point (ACP) by a ‘Flu Friend’. 

 

      Antivirals will be issued from the ACP to Flu Friends, following assessment of the patient by the National Flu Service or a GP, on submission of an authorisation number which has been provided by the flu line or an authorisation form issued by a GP. 

 

      This stage of initiation will be introduced  in a situation where normal supply mechanisms via community pharmacies can no longer meet the demand. The extent of this need will vary in each locality and will be informed by flu status reporting in each locality.

 

4    Role and Responsibility of HSC Board

 

      The Board is responsible for ensuring the appropriate availability of antiviral medicines for the population of Northern Ireland. It will provide guidance on the development of ACPs, deliver training, ensure access to a stock management system, provide daily professional support in the management of ACPs. It will ensure appropriate delivery of stock. It will provide advice and training on infection control and the necessary equipment required for personal protection as appropriate. All public information including centre signage will be provided by the HSC Board.

 

      The Board will liaise closely with Councils in the initial set-up of ACPs and in standing down these venues. Communication is set out in section below.

 

      The Board will indemnify the Councils against any claim made by a Third Party for damages for any damage, loss, injury (including death) arising out of any act or omission in relation to any activities or obligations covered by this agreement, subject to the Councils accepting liability for any acts or omissions of their employees, servants or agents, which may give rise to such claims.

 

5    Role and Responsibility of Councils

 

      The Council will identify and provide appropriate facilities for the provision of the service. It will, where possible, identify council staff to support the service and as their employer manage any human resource elements including liabilities.

 

      Councils will endeavour to provide agreed levels of service to HSCB in support of the distribution of anti-virals, but any support provided will be conditional upon the ability of the individual council to make staff available having regard to prevailing circumstances.

 

6    Communication

 

      District councils and the HSCB local offices will nominate lead officers so that communication can be initiated promptly to:

 

·         Implement the antiviral distribution plan locally

·         Ensure there is day to day supervision and management

·         Manage any operational aspects

·         Take decision to stand down

 

7    Resource Implications

 

      It is anticipated that there will be resource implications should District Council facilities and staff be required to support the implementation of any emergency response situation. Resources are currently being sought and the HSCB is awaiting interdepartmental approval. Until the Executive approves funding for Pandemic Flu, the HSCB cannot yet stand over the resource envelope required.

 

      The HSCB will reimburse Councils in respect of the costs of any staff deployed to provide support to the Antiviral Collection Points and any ancillary costs associated with the provision of this service. Both parties will ensure that their respective payments and receipts are recorded and accounted for under agreed relevant organisational procedures.

 

8    Effective Date

 

      This Agreement will come into effect on ----------------- and will be subject to review as appropriate on 31st March 2010 and thereafter annually.

 

      Signed and Dated

 

________________    Chief Executive ________________ Council

 

_______________      Mr John Compton, Chief Executive, HSCB”

 

            The Committee adopted the recommendations.