The Audit and Assessment Framework for Major Incident Planning

The Audit and Assessment Framework for Major Incident Planning supports the development, maintenance and reviewing/testing of NHS major incident plans. It complements the other parts of the "Operational Doctrine" and should be used to review and improve major incident plans in light of up to date advice.

The Audit and Assessment Framework is made up of organisation, causal and scenario specific major incident planning audit tools. The organisational audit tools cover responsibilities of SHAs, acute trusts, ambulance trusts, PCTs and specialist trusts eg those providing mental health and learning disabilities services. These are designed to be adaptable for other NHS organisations. The causal audit tools cover incidents resulting from Chemical, Biological, Radiological and Nuclear (CBRN) sources as well as infectious diseases. The "scenario specific" one covers mass casualties.

All the audit tools have a "yes/no" format with space to add comments to assist with subsequent reviews and updates. The organisational audit tools are similar to encourage an environment of joint working and mutual support in the development of major incident plans. This close co-operation is essential if the NHS is to play its part in reducing the likelihood of a major incident occurring or, if one does, its impact especially when many of the risks now faced have not been experienced before in the UK. Under the leadership of each SHA, NHS organisations should work together ensuring that while they improve internal arrangements, overall plans dovetail and everyone is clear who is responsible for what if a major incident happened.

Assigning lead responsibilities for major incident planning is clearly important to avoid unnecessary duplication of effort. Some lead roles will be clear, others less so. For example, the local ambulance trust will lead on patient transport, the acute trust on provision of emergency care and decontamination. However, the impact of a major incident may mean alternative arrangements are required so all NHS organisations need to be able to contribute personnel or other assistance to unfamiliar functions which means everyone needs a working knowledge of such arrangements which should be regularly tested. These should be outlined in Major Incident Plans.

While there has been consultation with the NHS about these audit tools, they are new and further testing will be required. To that end, if you have any concerns about the Framework and/or ideas as to how we can improve it, please do not hesitate to contact DH’s Emergency Preparedness Division.

The Audit and Assessment Framework for Major Incident Planning is not specifically a new approach but it is hoped that it will assist NHS organisations develop, in conjunction with partners and other stakeholders, robust major incident plans that raise public confidence in the NHS ability to deal with major incidents.