Appendix one HNZ00089739.pdf

Reviewed June 2017
1982
Act
Regional Health Emergency Plan
For the
Information
Bay of Plenty, Lakes, Tairawhiti,
Official
Taranaki and Waikato District
The
Health Boards
under
Released
Reviewed April 2017
Review 2020
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Memorandum of Understanding (MOU) for Emergency
Management:

Midland DHBs
Parties:
•  Bay of Plenty District Health Board
•  Lakes District Health Board
•  Tairawhiti District Health Board
•  Taranaki District Health Board
•  Waikato District Health Board

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Agreement:
1.        That the DHB emergency management staff of the Midland Region engage in
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emergency planning activities, share resources, services, plans,  people and
knowledge wherever possible to enhance emergency preparedness and
collaboration within the region.
2.
In the event of a major incident or emergency, the parties agree to support each
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other, where possible, with the provision of facilities, equipment, supplies, laboratory
and radiology services, and relevant skilled staff.
2.
Each organisation has the ability to track costs associated with this MOU.  Due to the
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urgency of a situation, it may be necessary to negotiate payment after support has
been provided.
The
3.
Agreement to use each other’s services including facilities wil  be between managers
of those services and/or facilities named, or the respective incident controllers. The
under
parties will:
a.)
treat each other’s facilities and/or equipment with the care and respect and to
a standard reasonably expected in the circumstances.
b.)
comply with all relevant law and professional standards when using another’s
Released
facilities and/or equipment, and/or staffing resource(s).
c.)
assist each other through regular, exchange of information during the
management of the incident
4.
In the event of a Civil Defence emergency the parties agree to fulfil their obligations
pursuant to the Civil Defence Emergency Management Act 2002.

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Signed on behalf of the contributing District Health Boards:

Signature

Name

Designation

DHB
Bay of Plenty
Lakes
Tairawhiti
Date

1982
Signature

Act
Name

Designation

DHB
Taranaki
Waikato

Information
Date

Official
The
under
Released
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Glossary

Term or
Explanation
Abbreviation
CDEMG
Civil Defence and Emergency Management Group
CIMS
Coordinated  Incident  Management  System.    A  structure,  used  by  all
emergency services, to systematically manage emergency incidents.
Critical Supplies
Critical supplies will be determined by the incident. It is those supplies
that are in short supply and without the DHB / health service provider
cannot provide essential services.
DHB Single Point  The  person/position  nominated  by  DHBs  as  a  7x24  contact,  as
of Contact
required by the NHEP
1982
(SPOC)
Single Point of Contact
Act
Duty Response
A  Midland  Region  emergency  manager  rostered  to  monitor  all
Coordinator
incidents  in  the  region  and  when  appropriate  convene  an  early
communication call for DHB  single point of contacts
EACC
Emergency Ambulance Communications Centre
Information
EMERGENCY
For the purpose of this plan, an emergency is a situation that poses an
immediate risk to life, health property, or the environment that requires
a coordinated response.
Official
EMIS
Emergency Management Information System. The agreed primary tool
for  the  management  of  significant  incidents  and  emergencies  at  a
The
local,  regional  and  national  level  is  the  web-based  emergency
management information system.
HEMG
Health Emergency Management Group
under
MHEMG
Midland Health Emergency Management Group.
MoH
Ministry of Health
Incident
An  event,  from  which  the  impact  cannot  be  handled  within  routine
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service  arrangements  and  requires  the  implementation  of  special
procedures by one or more agencies.
Incident Action
A  statement  of  the  objectives,  strategies  and  critical  functions  to  be
Plan
taken to respond to a specific Regional Incident and/or Incident.
IT
Information Technology
NHEP
National Health Emergency Plan
PHO
Primary Health Organisation
PHU
Public Health Unit
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PIM
Public Information Management
Regional Incident  A  Regional  Incident  is  an  Incident  or  number  of  Incidents  whose
spread, or potential spread requires responses by more than one DHB,
or is of a magnitude that a coordinated regional response is, or may be
required.
REMA
Regional Emergency Management Advisor
TAG
Technical Advisory Group.  This is an advisory group convened when
a Coordinated technical response is required for a Regional Incident.
The TAG supports the HEMG during a Regional Incident.
1982
Act
Information
Official
The
under
Released
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Part One:  Introduction

1.1
Purpose
The  vision  for  health  emergency  management  planning  in  the  Midland  DHBs  is  ‘resilient
health  services  in  the  Midland  region’.    This  emphasises  the  importance  of  an  integrated
approach  to  emergency  management  planning,  and  the  need  for  a  shared  approach  to
coordination, cooperation and communication across the Midland DHBs.
Under  the  National  Health  Emergency  Plan  (NHEP),  each  DHB,  in  consultation  with  the
other  DHBs  in  their  region,  is  responsible  for  the  preparation  of  a  regional  incident
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coordination plan.  The plan is to set out a generic process for managing regional incidents
(irrespective  of  origin)  with  task  assignments,  assignment  of  roles  and  responsibilities,
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standard forms and other relevant guidance.  The Plan will support decision-making by the
regional coordination team in the event of a national, health-led emergency.
The  Midland  Regional  Health  Emergency  Plan  (MRHEP)  outlines  the  processes  to  be
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implemented  should  the  health  response  to  an  incident,  or  potential  incident,  need  to  be
coordinated  across  all  or  part  of  the  Midland  region.    It  provides  a  generic  process  for  the
management of regional incidents, irrespective of origin and whether they are declared (civil
Official
defence)  emergencies  or  not,  and  provides  for  a  consistent  approach  to  coordination,
cooperation and communication across the Midland region DHBs when they are responding
The
to an incident.
The MRHEP meets the requirements of the National Health Emergency Plan, the Ministry of
under
Health Operations Policy Framework and the CDEM Act 2002.

1.2
Area to which this Plan applies
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The Midland DHBs consist of:
Map 1
•  Tairawhiti DHB
Midland
•  Taranaki DHB
Region:
•
Area to
  Lakes DHB
which this
•  Bay of Plenty DHB
plan
•
applies
  Waikato DHB

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1.3
Planning partners
•  Midland DHBs

(MRHEP owners)
•  St John

(associate)
•  Ministry of Health (MoH)
(associate)
•  Public Health Units

1.4
Activation of the MRHEP:
A regional health response may be activated, but is not limited to, any of the following:
•  If assistance is required with the management of hospital patients (eg regional bed
management)
•  For regional management of critical supplies
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•  If regional coordination is mandated during a national emergency (eg an influenza
Act
pandemic)
•  To ascertain if a DHB affected by an incident in their area needs assistance from
neighbouring DHBs
•  At the request of the Midland CEOs
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•  At the request of the Ministry of Health
•  For pre-planning for a major event that is going to impact on the region.

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All Midland Region DHBs are to ensure they have a Single Point of Contact (SPOC) in their
DHB  to  allow  initial  contact  and  any  later  follow  up.  These  are  reconfirmed  at  regular
The
intervals and the relevant individuals kept up to date with how they are required to respond.
Any changes to the SPOC shall be notified to the other DHBs in the region, MoH  Regional
under
Emergency Management Advisor and the Ministry of Health.
Depending on the nature or potential nature of the incident the requesting DHB or the EACC
manager  may  also  include  a  message  to  0800  GET  MoH  to  ensure  that  the  MoH  are
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advised  of  the  incident  or  a  ‘No  surprise’  situation  and/or  to  have  a  representative  of  the
MoH participate in the teleconference.

Notes:
•  Whilst  this  process  is  in  place  for  operational  requirements,  other  teleconferences
and  meetings  may  be  called  regionally  to  discuss  administration  matters  and/or  in
response to MoH code alerts as described in the NHEP..
•  The preferred information sharing and reporting tool will be EMIS.
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1.5
Planning assumptions

A number of assumptions underlie this plan:
i.
The Ministry of Health will provide national coordination, support and leadership.
ii.
The Ministry of Health will produce national plans,  which this plan will be consistent
with.1
iii.
This plan is aligned with intent, philosophy and terminology of the Health Emergency
Plan of each DHB.  This plan depends upon individual DHB plans to provide
operational detail and the location of resources.
iv.  Coordinated Incident Management Systems (CIMS) is used by the DHBs, emergency
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services and other response agencies within the region to  manage the response
activities through common incident management rules.
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v.  Each DHB already has plans in place to:
•  Provide public health advice and support
•  Coordinate PHOs and GPs
•  Support early-discharge patients in the community (i.e. if hospitals have to empty
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out beds)
•  Support community residential health services (eg rest homes, disability services)
•  Support community health services supporting people in their own homes
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•  Coordinate and work with welfare agencies to provide psychological support
The
•  Continue business as usual to the greatest extent possible
•  Work with other DHBs and other emergency services in the Midland region in
order to provide a coordinated response
under
•  Each DHB exercises their plans in accordance with the Operation Policy
Framework.
•  Each DHB participates in local, regional and national exercises
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•  Each DHB maintains, tests and updates their Single Point of Contact.

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1.6 National Context

Abbreviations: DG = Director General; ELT = Executive Leadership Team; ODESC = Office of the Domestic and External
Security Committee; NCMC = National Crisis Management Centre
DIRECTOR
GENERAL &
EXECUTIVE
LEADERSHIP
TEAM
Note: National Coordinator delegated
authority/resources within strategic
DG representative
Briefing and Support
goals of the incidents. DG & ELT
at ODESC
remain responsible for the wider
Ministry of Health functions.
NATIONAL HEALTH
1982
COORDINATION
KEY ADVISOR
NATIONAL
CENTRE
KEY ADVISOR
TECHNICAL
COORDINATOR
ADVISORY
GROUP
Act
PUBLIC
PLANNING &
INFORMATION
LOGISTICS
OPERATIONS
LIAISON
INTELLIGENCE
MANAGEMENT
Note: CIMS functions further broken
Ambulance
down into functional areas dependant
Liaison Officer
on incident
Information
NCMC Liaison
Officer
Northern
Central
Southern
Midland
Region
Region
Region
Region
National Welfare
Official
Coordinator
Recovery Group
Liaison Officer
CIMS
structure
Watch Group
The
determined by
Representative
Region
Other
Intersectoral
under
DHB Incident
DHB Incident
DHB Incident
DHB Incident
groups as
Controller
Controller
Controller
Controller
req’d
CIMS
structure
determined
DHB
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Part Two  Strategic component

2.1
Regional Hazards and Risks in the Midland area
These include:
•  Flooding
•  Earthquake
•  Tsunami
•  Fire
•  Human epidemic
•  Influenza pandemic
1982
•  Volcanic/Lahar activity at the Central Volcanic Plateau and Mt Taranaki
Act
•  Sea surge
•  Beach erosion
•  Drought
•  Cyclones/Tornadoes
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•  Hazardous chemical spills
•  Utility failure
•  Mass casualty incident
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•  Land/mud slide
•  Maritime Incident.
The

The MRHEP uses an ‘all hazards’ approach to planning.
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2.2  Reduction
Risk identification and reduction takes place within each DHB:
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i)
as part of their internal risk management and emergency management
programmes, and
ii)
through their liaison and planning with external agencies, eg Regional/District
Councils and emergency services.

AS/NZS4360: Risk Management (1999) is the standard used by Health

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2.3    Readiness
Readiness activities carried out by the Midland DHB Planners include, but are not limited to:
•  Monthly meetings (see Terms of Reference, Appendix Four)
•  Regular communications tests, including phone, text, satellite phone, e-texts
•  Participation in regional exercises (Middle Earth EMIS exercises)
•  Peer review of plans
•  Standardised ‘Midland’ planning templates
•  Standardised training and education packages
•  Monthly ‘on-call’ roster (DHB Emergency Planners, MoH Regional Emergency
Management Advisor)
•  Circulation of and discussion on Incident Reports from individual DHBs, outlining the
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outcomes, experience and learning gained
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•  Development of risk-specific plans as required, eg the MR Mental Health Emergency
Plan
•  Meeting with Volcanic Plateau group and related services
•  Joint Emergency Management Information Systems (EMIS) exercises.

Information

2.4  Response
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This plan will provide for a Midland-wide response to any incident that threatens the
wellbeing of patients/service users, staff or the public, for example:
The
•  A health emergency (eg a mass casualty event, or an infectious disease outbreak in
the community)
•
under
  An incident or event that may impact on the ability of health providers to deliver their
usual services (eg floods, earthquake).

It may also be activated at the request of any of the Midland DHBs, Ambulance Services
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or the Ministry of Health for coordination of a regional response.

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2.5    Recovery
A regional recovery planning template has been developed and is included in the suite of
Midland Region Health Emergency Plans.



Health supports CDEM and other key

agencies with welfare initiatives
Health’s Psychosocial Co-ordinator leads

psychosocial recovery with support from:
•
Ministry Social Development

•
Ministry for Primary Industries

•
Te Puni Kokiri

•
Ministry of Education
•
NZ Red Cross

•
Salvation Army

•
1982

Victim Support

Act

Social
Environment
Coordinating activity to

restore buildings to a

state suitable for

continuing delivery of
health services

Natural
Community
Built
Environment
Environment
•  Hospitals

•  GP Surgeries etc
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•

  Aged residential
care

•  Pharmacies
Economic

•  Other health
Environment
premises
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The

Restoring / managing;  financial
control infrastructure to support

continuity of health services
under

Public Health Units
suppor t initiatives directed
Released
at rest  oring the natural
environment to an

acceptable state.
•   Sewerage systems
•   Waste disposal
•
Water purity

•
Biodiversity
•   and ecosystems
•   Air clarity etc

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Part Three:
Operational Component

3.1
Criteria for activation of the MRHEP
The Plan may be activated if an incident in any part of the Midland region looks like it may
progress to the point where:
•  The local DHB may need assistance
•  Regional coordination of services (including Ambulance services) may be required
•  The incident will become nationally significant.
Or if:
•  The CEOs or delegate request it
•
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  The MoH requests it.

Act
3.2  Means of activation
Any DHB, the MoH or St John can initiate activation of the Regional Health Emergency Plan.
This can be done to DHBs’ single point of contact (SPOC) via email, group text, phone or via
the  Emergency  Ambulance  Communications  Centre  (EACC).    All  participants  have
Information
teleconference numbers prepared for this purpose.

See   Figure 1 (over page) for process.
Official

The
An initial teleconference or meeting will be arranged.  See Appendix One for a checklist for
use at the initial conference.
under
3.4  Regional Coordination
The principal tasks of Regional Coordination is to coordinate the most effective use of
regional health resources during a regional and/or national emergency and provide
strategic direction, support and coordination to Midland DHBs.
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The  Regional Coordinator (see Appendix Two) leads this function, and is appointed and
endorsed by the Midland CEOs or delegates at the first incident management meeting.

The Regional Coordinator will manage and oversee the achievement of the following:
▫
Collection and assessment of information;
▫
Establishment  of  specialised  regional  sections  as  required,  eg  Public
Information/media  management;  Technical  Advisory  Group(s)  (see  Appendix
Three) etc.
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▫
Regional reporting and updating via EMIS;
▫
Establishment of regional priorities, aims and objectives;
▫
The review and amendment (as appropriate) of Regional Incident Action Plans and
▫
Reporting to the Ministry of Health.

The Regional Coordinator may be appointed from the DHB best placed to provide this
function at the time. There is an expectation that the person appointed as Regional Co-
ordinator will be trained to CIMS Level 4.

The attendees of the group teleconferences will constitute the Regional Coordination
Team.

1982

Act

Information
Official
The
under
Released
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Figure 1: Midland Regional Health Emergency Plan Activation Process

DHBs or the MoH decide to

Notify
request activation of the Regional

0800GETMOH
Health emergency plan

Notify Single Points
Notify REMA
of Contact
Either:
-  group text
-  phone
-  email
1982
-  via EACC
(process to be
Act
arranged)
‘Midland Regional
Response activation.
Teleconference at
>>time<<.
083033/>>pin no << #’
Information
Meeting (use detailed checklist in
Appendix One):
  Role call
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  Situation report
  Appoint Regional Coordinator
The
  Identify risks and issues
  Identify potential support
agencies and services

under
  Identify approach
  Identify potential recovery
issues
Ongoing activity as
  Develop plan/assign tasks
agreed by Group
  Decide which agencies are to
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be notified
  Assign tasks/responsibilities
Stand
  Agree communications
down/recovery
methods/processes
  Time of next meeting/group
discussion

Debrief/Event
  Develop and distribute action
review
plan and meeting notes
Develop and
disseminate
final report
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3.5  Information Management

3.5.1 Communication
Initial communication will be through the SPOCs.

During an incident there are number of communication processes available to the
Midland HEMG:
•  EMIS (see 3.5.2)
•  Telephone (land-line, mobile, fax)
•  Satellite Phone
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•  Text messaging (txt-mail or mobile phone)
•
Act
  Email
•  Ambulance radio networks
•  Civil Defence networks.

The preferred/available method will be confirmed at the initial group meeting.

Information

3.5.2 Health sector emergency management information system:
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EMIS
The  agreed  primary  tool  for  the  management  of  significant  incidents  and
The
emergencies  at  a  local,  regional  and  national  level  is  the  web-based  emergency
management information system – EMIS.
under

EMIS provides a robust system to manage and log information produced during an
incident.  It  provides  each  DHB,  PHU  and  other  key  health  responders  such  as
Ambulance with a logging and task tracking system, in order to manage their local
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response to an incident.  The system has the ability to log requests for information
or  action,  and  a  mechanism  to  track  progress  on  these  requests.  In  addition,  the
system  also  includes  standardised  templates  for  situation  reports  and  reporting  of
key intelligence information.

Information in EMIS is visible to all organisations involved in the response that have
access  rights  to  EMIS.  Other  government  agencies  may  be  provided  with  access
rights to view the system, to enhance visibility of the health sector response.  EMIS
does not replace verbal communications between agencies.

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The  system  is  managed  and  hosted  by  the  Ministry  of  Health.  The  Ministry  has
ensured that appropriate disaster recovery systems are in place to minimise the risk
that EMIS will be unavailable due to an information technology (IT) outage.
3.5.3 Alternative information-sharing processes
If,  for  any  reason,  EMIS  cannot  be  utilised,  computer  based  templates  stored  on
memory sticks may be used prior to the use of  paper-based templates, to capture
information. Alternative communication links, such as satellite phones and or radio
links may be used to convey this information.

Paper-based  templates  will  be  used  for  record  keeping,  situation
1982 reports,
intelligence  reports  and  requests  for  information  and  action.    Dissemination  of  the
Act
completed  templates  will  be  via  the  SPOC  system  using  email,  fax,  satellite  or
radio.    DHBs  are  responsible  for  developing  their  own  alternative  mechanism  for
logging information and tracking of tasks locally. Utilisation of the templates ensures
that where information has to be communicated verbally it can be done so quickly
Information
and succinctly and with common templates information is easier for the receiver to
collate.  EMIS Situation Report and Incident Action Planning templates are attached
as Appendix Five
Official

3.5.4 Public Information/med
The  ia management
The  public  Information/media  management  strategy  will  be  guided  by  the
requirements  of  the  situation  and  the  affected  organisation(s).    Where  possible,
under
regional  public  information  management  (PIM)/media  management  strategies  will
be implemented.

The  lead  DHB  IC  will  advise  the  Midland  DHB  ICs  regarding  coordination  of
Released
messages  within  the  region,  each  DHB  will  be  responsible  for  delivery  of  the
messages  within  their  own  region  unless  other  arrangements  are  agreed  at  the
time.
The regional information plan may include, but is not limited to:
•  A list of the key stakeholders affected by the regional Incident
•  Key messages
•  The process for distributing key messages
•  The  likelihood  of  the  regional  incident  affecting  stakeholders  (not  already

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affected), either directly or indirectly
•  The scope of the regional incident in terms of public health, access to health
services and/or public confidence, national or international interest
•  Technical and operational information.
•  Likely  communications  issues  and  escalations  in  all  scenarios  (worst-case
planning).
•  Internal communications requirements:
•  CEOs and DHB Board members
•  Call centre staff
•  DHB, Health Provider staff, visitors and volunteers
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•  Staff and patients families/next of kin.
•
Act
  Ministry of Health via EMIS
•  Other  organisations  (e.g.  Emergency  Services,  Civil  Defence  Health
Providers.)
•  The allocation of resources and task responsibilities.
•
Information
  Guidelines for the documentation of communication.

It is recognised that the individual DHB(s) may need to include information specific
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to  their  area  of  jurisdiction,  or  rephrase  the  agreed  communications  to  meet  their
unique needs.
The

Copies  of  all  official  DHB  media  releases  should  be  forwarded  to  the  Ministry  of
under
Health preferably before but always after release.
In a national health emergency:
•  The Ministry of Health will be responsible for communicating with the media
on national
Released health issues during a national health-related emergency. It shall
retain oversight of all health related media communications;
•  The Ministry will use information obtained from situation reports provided from
the  sector  as  the  basis  for  developing  media  briefings  and  briefing  other
government agencies;

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3.6  Stand-down of regional response
The decision to end a regional incident will be the responsibility of the regional coordinator,
after consultation with the DHB representatives/Lead CEO if one is appointed.  The original
reasons  for  escalating  to  a  regional  incident  should  be  reviewed  and  considered  in  this
process.

The  DHBs  with  due  consideration  of  TAG  advice  and  the  specifics  of  the  regional  incident
may  agree  to  establish  heightened  levels  of  monitoring  for  a  period  immediately  after  a
regional incident.

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3.7  Debriefing/incident review
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3.7.1 Initial Debrief
The  initial  debrief  should  occur  within  72  hours  of  an  end  to  the  coordinated
response to a regional incident.  Its primary purpose is to capture fresh impressions
and to identify significant issues for later review.
Information
3.7.2 Review of Coordinated Response and Improvements
The review should be held once all records have been collated and assessed.  All
Official
respondents should provide a written report outlining:
•  their involvement,   The
•  significant issues identified and
•  possible solutions or amendments to be made to the existing arrangements.
under

The  Midland  Health  Emergency  Group  (MHEMG)  should  ensure  that  all
recommendations  are  followed  up,  assessed  and  approval  given  by  DHB
emergency management staff/CEOs for amendments to the MRHEP.
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3.7.3 Plan Update
Following  debrief  and  incident  review  the  MHEMG  will  review  and  update  the
MRHEP.

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Part Four: Administrative Arrangements

4.1
Maintenance of the MRHEP and document control

Copies of this document
Copies  of  this  document  are  held  by  the  designated  Midland  HEMG  member(s)  for  each
DHB.    It  is  their responsibility  to  identify  and  control  superseded  documents  and to  ensure
amendments are inserted in to hard copies and any intranet versions are updated.

During non-incident periods the MHEMG is responsible for coordinating the maintenance of
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this document.  These responsibilities include:
•  Making amendments (as agreed by the MHEMG – see below)  Act
•  Distributing copies
•  Maintaining version control of all documents
•  Ensuring  a  full  review  and  update  of  the  Plan  every  three  years  or  following  any
activation
Information
•  Keeping CEOs up to date with regional planning and getting their sign-off.

4.2  Funding Arrangements
Official
Each organisation will track costs associated with activating their Health Emergency Plans.
The
Due to the urgency of a situation, it may be necessary to negotiate payment after support
has been provided.
under
4.3  Supporting Documents
Supporting documents are as follows:
•  National Health Emergency Plan and relevant sub-plans and guidance documents
(http://www.moh.govt.nz/moh.nsf/indexmh/emergencymanagement-nhep)
Released
•  New Zealand Influenza Pandemic Action Plan (NZIPAP)
http://www.health.govt.nz/system/files/documents/publications/nzipap-framework-for-
action-apr2010.pdf

•  National Civil Defence Emergency Plan and Order
(http://www.civildefence.govt.nz/memwebsite.NSF/wpg_URL/For-the-CDEM-Sector-
Publications-Index?OpenDocument)
•  DHB Health Emergency Plans

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o  Bay of Plenty DHB
http://www.bopdhb.govt.nz/media/58093/bopdhb-health-emergency-plan-
2015-2018.pdf
o  Lakes DHB
Couldn’t find link
o  Hauora Tairawhiti
Couldn’t find link
o  Taranaki DHB
http://www.tdhb.org.nz/misc/documents/health_emergency_plan_2013-
16.pdf
1982
o  Waikato DHB
Act
https://www.waikatodhb.health.nz/assets/public-health-advice/public-health-
topics/emergency-management/Waiora-Waikato-Campus-site-plan.2.pdf

Information
Official
The
under
Released

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Reviewed June 2017

Part Five:  Appendices

Appendix One:
Convening the initial MHEMG meeting

Appendix Two:
Regional Coordinator Duty Card

Appendix Three:
Technical Advisory Group(s)

Appendix Four:
  Midland Health Emergency Management Group (MHEMG) Terms of
Reference (2013)

Appendix Five:
Forms (Situation Report/Incident Action Plan)
1982

Act

Information
Official
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Appendix One:  Convening the initial HEMG meeting

•  Ensure that someone is designated to take and distribute minutes.
•  Initial discussion may cover (depending on the size, scope and projected
development of the incident):
  What has happened and where?

  What is the cause of the possible Incident (if known)?
  What is the known and likely (if known) impact?
  What are the risks and issues?
  How is the possible incident likely to develop (if known)?
  Has a Civil Defence declaration been made?
  What resources are likely to be required to manage the incident?
  What is the current capacity of the group?
  What is the potential for the incident (worst case scenario)?
  What is being done to address the possible incident?
1982
  Who needs to be notified (MOH, internal/external stakeholders)
  Who can be contacted for further information?
Act
  Does the response need to escalate?
  How and at what intervals, will the Group communicate throughout the incident?
 What are the back-up communications processes (see 3.5.1 )?
  When is the next discussion?
  If the HEMG thinks it is necessary the response will be escalated and the
following will be decided:
  Who will be the Regional Coordinator?
Information
  Who will be the Lead Midland CEO?
  Is a Technical Advisory Group (TAG) required?  (See Appendix Four for
role and function of a TAG)
  Clarification of tasks and responsibilities.
Official
  Situation report
  Appoint Regional Health Coordinator
The
  Identify risks and issues
  Identify potential support agencies and services
  Identify approach
under
  Identify potential recovery issues
  Develop plan/assign tasks
  Decide which agencies are to be notified
  Agree communications methods/processes
 Released
  Time of next meeting/group discussion
  Develop and distribute action plan and meeting notes

25

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Appendix Two:    Regional Coordinator Duty Card

POSITION:

To be appointed by the Midland CEO Group
LOCATION:

To be confirmed at the time
RESPONSIBLE TO:
Chair of Midland CEO Group.
FUNCTION:  Provides strategic direction, support and coordination to Midland DHB
Incident Management Teams (IMTs).
NB:
Coordination strategies should be developed in conjunction with DHBs, considering
the policies, politics, and other factors that influence the situation.

KEY TASKS (✓)
  Assess the situation. Initiate regional risk assessment and develop regional situation report
Consider: What is the problem? How is the situation likely to develop? What resources will be
required, who needs to know?

1982
  Coordinate, collate & disseminate relevant information eg:
o  Hospital bed state.
o  Availability of personal protective equipment (hospitals and community).
Act
o  Ability of primary and community health services to function
o  Status of allied health professional services
o  Availability of appropriately skilled staff.
o  Ambulance/transport capacity/issues.
  Deliver the responsibilities required of the regional coordination team2
  Liaise with the national coordination team
  Implement regional clinical escalation pathways  Information
  Coordinate regional health services’ response
  Monitor the use of resources and distribution thereof
  Oversee all communications with the national coordinator.
  Arrange for regular briefing and consultation with DHB Incident Controllers.
  Brief the chair of the Midland CEO Group
Official
  Identify regional response structure and key roles and develop a communications plan.
  Set priorities and allocate resources

The
  Prioritise resource allocation to all DHBs.
  Ensure effective strategies are adopted
  Oversee development of an Incident Action Plan
The Incident action Plan should reflect the objectives, strategies, communication and
under
resource needs of the DHB’ s Incident Action Plans.
  Ensure information is well managed and timely.
  Provide personnel with clear directions on their al ocated role, an understanding of the ‘big
picture’ and how they relate to it, and a source for updated status reports. Maintain proper
information flow.
  Ensure coordination of public information.
  A large incident may require the appointment of a Regional Spokesperson to manage public
Released
information. A policy on who can make statements should be clearly articulated.  There
should be regular media briefings.
  Organise changeovers.
  The briefing of the incoming Incident Coordinator will include details of:
o  The incident control structure presently in place
o  An up-to-date situation report on the overall situation and current planning
o  Critical or unresolved issues
o  Key authorities and organisations to be consulted
  Maintain a log of activities, issues and decisions via EMIS or manually
  Keep Ministry of Health informed of status of regional capacity via EMIS or other means.

2 As per the New Zealand Influenza Pandemic Action Plan: http://www.moh.govt.nz/moh.nsf/indexmh/nz-
influenza-pandemic-action-plan-2006

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Reviewed April 2017

Appendix Three:   Technical Advisory Group(s)

Membership and Authority of Attendees
In  an  Incident  the  TAG  will  draw  its  membership  from  the  affected  DHBs  and,  where
appropriate, co-opt others with specialist expertise relevant for the incident. All other DHBs
will be informed of the convening of the TAG.  .
Representation  at  meetings  of  the  TAG  will  be  at  the  most  appropriate  operational  level
available.

Responsibilities in a Regional Incident
In  a  regional  Incident  the  TAG  will  provide  technical,  logistical  and  planning  support  to  the
1982
Regional Coordinator.  Under the CIMS structure, it fills the Intelligence function.
Act
A senior person, with appropriate skills or responsibilities for the particular Incident, will lead
the TAG and will report to the Regional Coordinator.
When  appropriate,  the  TAG  may  form  sub  groups  to  examine  specific  technical/clinical
issues in detail.
In the coordinated technical response to an Incident the key roles of the TAG are to provide:
Information
o  A continuous technical/clinical, operational and public health perspective.
o  Rapid  coordinated  technical/clinical  response  to  assist  in  the  preparation  of  an
Incident Action Plan (IAP).
Official
The IAP should include provision to cooperate on such things as:
The
o  Operational responses
o  Monitoring, and reporting requirements
o  Information sharing under
o  Critical supplies and services
o  Clinical protocols
o  Staffing requirements
Released
o  Capacity of facilities in the region
o  A forum for technical and operational liaison between Affected DHBs
o  A flow of information to Affected DHBs.
Specific actions of the TAG will include:
o  Liaison with national and local committees / experts e.g. Public Health Directorate at
Ministry of Health, Hazard Substance Technical Liaison Committee or others deemed
necessary
o  An immediate review of whether the Incident has, or has the potential to impact on
public health or public confidence

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Reviewed April 2017

o  Documentation of all actions undertaken
o  Isolation of sub-zones
o  Consideration of alternative supply options.

Progress Reporting
The  TAG  will  report  to  the  Regional  Coordinator  on  progress  throughout  a
Regional  Incident.    The  Regional  Coordinator  will  set  reporting  frequency  and
expectation.
1982
Act
Information
Official
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Appendix Four:  Midland Health Emergency Management Group
(MHEMG) Terms of Reference 2013

Preamble:  The  Midland  DHBs,  St  John,  and  The  Ministry  of  Health  are  committed  to
enabling  health  providers  to  respond  and  recover  effectively  and  efficiently  to  emergency
incidents,  whilst,  as  far  as  possible,  continuing  to  maintain  services  and  meet  legislative
requirements.

The overarching purpose of the Group is the development of resilient health services in the
Midland  region,  by  the  provision  of  consistent  and  coordinated  emergency  management
1982
information, advice, training, and planning.

Act
Goals: The MHEMG will:
•  Agree, review, update and facilitate the implementation of a health coordination plan for
the Midland Region
•  Establish  a  region-wide,  consistent  approach  to  the  enabling  of  wider  health  provider
Information
participation in emergency management activities
•  Participate
in
regular
Midland
Regional
Health
Emergency
Planning
meetings/teleconferences
Official
•  Keep Midland CEOs apprised of activities, seek their sign-off for joint plans, ensure they
The
are aware of their responsibilities in local, regional and national health emergencies
•  Develop  and  implement  a  consistent  region-wide  approach  to  management  of  shared
regional risks and hazards
under
•  Promote continuing, coordinated and consistent professional development in emergency
management planning
•  Participate in regional exercises and workshops
Released
•  Support each other with the facilitation of DHB/health provider emergency management
training and exercises
•  Participate in regular communications tests
•  Enhance  the  ability  of  health  providers  to  manage  the  Recovery  process  by  providing
information, education and exercises
•  Promote collaborative Recovery activities between DHBs and other Recovery agencies
across the Region
•  Share emergency management developments and provide linkages between DHBs, St
John, wider health providers and the MoH

29

link to page 30 Reviewed April 2017

•  Providing  immediate  support  to  any  DHB  Emergency  Coordinator  following  any
emergency event in a particular DHB area.
Goals will be achieved by:
•  Maintaining a minute and action point process
•  The establishment of a Midland Health Emergency Coordination Plan, tested biennially
and reviewed every three years or following a regional activation
•  The  participation  of  each  member  organisation  in  monthly  meetings,    exercises  and
workshops.
Composition of MHEMG:
•  Bay of Plenty DHB
•  Tairawhiti DHB
1982
•  Taranaki DHB
Act
•  Lakes DHB
•  Waikato DHB
•  St John   Support/advisory capacity only
•  Public Health Rep



•
Information
  MoH  Regional  Emergency  Management  Advisor  (Midland)  support/advisory  capacity
only

Official
Membership  of  other  services  or  organisations  will  be  by  the  agreement  of  the  DHBs.
Outside  representatives  /  speakers  can  be  seconded  to  any  meeting  on  an  as  required
The
basis.
Meetings:
under
•  Held monthly in Rotorua unless decided otherwise by the Group
•  6 monthly Midland Region will combine with Northern Region in Hamilton
Specific Midland business will be dealt with at the conclusion of the combined meeting
•  Chair will change 30th Ju
Released  ne each year.   DHB reps will fill the Chairperson role
•  The Chair will decide how minutes will be recorded and who will be responsible for that
role.
•  Rotorua meetings will be catered for by Waikato, Lakes, Bay of Plenty DHBs on a
rotational basis3.

3 Taranaki and Tairawhiti DHBs have the highest travel costs in order to attend the meeting, so the Group agreed that
they should not have to contribute to catering costs.

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Reviewed April 2017

Appendix Five:   Forms

CIMS Situation Report/Action Plan

Incident Name Date
Situation Report

Incident Name:
Date:
Time:
Sitrep No:

Prepared By:
Contact telephone:
Contact email:

Next Sitrep to be issued at:
Time:
Date:

1982
Organisation or Team Name:
Incident Controller:

Act
EOC Location:
EOC Telephone:
EOC email:

Situation Report Released to:

Event details:
Information

Situation Summary:
A  brief  overview  of  the  incident,  for  use  during  briefings.    The  summary  should  provide  an  overview  the
Official
development  of  the  incident,  resources  available  and  deployed,  actions  taken,  casualties,  spread  of  disease,
property damage, and progress since last IAP. May also include predicted development of the incident. State of
emergency declaration or lifted – Recovery phase start.
The

Overall Goal:
A goal statement indicating the desired outcome of the incident. The overall goal guides the development of the
under
IAP  and  must  reflect  the  policies  of  the  DHB,  MoH,  PHU,  lead  and  supporting  agencies.    The  goal  should
include a time frame.

Assessment:
Released

Critical issues, progress made, assumptions and predicted incident development, ADVERSE EVENT.

Reminder: Seek balance between speed and quantity/quality/source of the information
Checklist:
•
Geographical area affected
•
Access
•
Health facilities status (total damages – partial damages – level of care provided – services lost
•
Local health personnel status
•
Gaps identified (due to events)
•
Victims figure and sources (dead, missed, injured)
•
Figures, sources. Location, environmental health conditions, level of health service
•
Shelter, food and water access/availability
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Reviewed April 2017

•
Action being taken in the health sector (MOH, UN, Red Cross, MSF, Oxfam and other international and
local NGOs
•
Lead agency and list of Health related clusters
•
Priority areas for intervention – type of intervention
•
Quality of the coordination
•
MFAT/NZAid prioritised areas
•
ATTACH FULL ASSESSMENT FORMS

Actions Taken
Planning and Intelligence:

An  overall  summary  of  the  situation  to  date,  plus  a  summary  from  a  Planning  and  Intelligence  perspective
including  risks,  considerations  and  assumptions.    Actions  being  taken  or  planned  and  progress  made.  Times
for activation events and further activities to be included.

Checklist:
1982
•
Major current health issues (trauma, primary, paediatrics, mental health)
•
Potential development (positive or negative)
Act
•
Mitigating actions taken by the team or other organisations
•
List of agencies involved in health and key focus areas during the response and recovery.
•
Water supply quality and status / Access to distribution sites / Estimated time for partial/full restoration
•
Vector  control  –  Epidemiology  -  Environmental  health  condition  –  sanitation  –  drainage  –  human  and
solid waste disposal
•
Food safety update (source)

Information
Actions Taken
Operations:

Official
A  summary  of  the  operational  responses  and  activities  undertaken,  in  progress  or  planned.    Also  include  a
record of risks, considerations and assumptions.

The
Actions Taken
Logistics:
A summary of logistic activities including risks, considerations and assumptions.
under

Checklist:
•
Status of the health supply chain within the affected country
•
Status of the health supply chain coming from NZ and system implemented locally to manage imports
and donations
•
Released

Status of key medical equipment
•
Storage and warehousing capacity and condition
•
Transport issue or not for goods and personnel

Actions Taken
Liaison:

A summary of liaison activities, liaison supplied elsewhere or supplied to your own EOC or required.

Actions Taken
Communications:
Details of communications released under preparation or planned and how and to whom provided.
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Reviewed April 2017

Resources:

Resources In place:
Details of resources in place, those in reserve and where deployed or located. Included those resources being
sourced and likely times for availability.

Resources that may be required:
Details of resources that may be required, why and where and possible sources.

Actions Taken:

Factors:
1982
Critical elements, security/safety issues, weather and other factors or limitations that are impacting or likely to
impact on the development of this incident and the response.
Act

Predicted Incident Development:
How the situation is expected to evolve, including spread of disease, patient numbers, staff and resource
availability.

Information
Proposed Activities:

Proposed activity general:
Plans to respond to predicted incident development, resourcing issues, communications strategies, etc.
Official

Proposed activity and strategy:
The
The proposed strategic development to meet any predicted changes.

under
Information Flow:

A summary of the departments, agencies, teams and individuals who may have information needed and/or
need to be kept informed of actions taken and planned. Includes contact lists of specialists and briefing times
and locations.
Released

Communications Plan:

Includes telephone and cell phone numbers, email addresses, radio call signs and frequencies also calling
schedules if required.

Checklist:
•
More reliable communication at the moment
•
What is available, what has been restored and what is still unavailable

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Reviewed April 2017
Public Information (Includes information for staff):
Details of communications released, under preparation or planned for. Record how, when and to whom the
information has and will be provided. Also include details of key media contacts.
Other relevant information:
Situation Report Approved by:
Name & Position:
Time:
Date:
under The Official Information Act 1982
Released
34

Facility Name:
Assessment valid as at:
INFRASTRUCTURE ASSESSMENT
PERSONNEL ASSESSMENT
(tick only where appropriate)
(tick only where appropriate)

Critical Shortage
No damage; all utilities fully functional:
28.
ED Doctors
  ☐
True    False
29.
Intensivists
  ☐

☐
☐
30.
General Surgeons
  ☐
If false:
31.
Orthopaedic Surgeons
  ☐

Severe   Moderate  Isolated  None
32.
Specialist Surgeons
  ☐
1.
Structural Damage
☐
☐
☐
☐
33.
Operating Theatre Staff
  ☐
2.
Fire
☐
☐
☐
☐
34.
Physicians
  ☐
3.
Flooding
☐
☐
☐
☐
35.
Registered Nurses (specify type)
  ☐

  ☐

Ful y     Partial y      Not

  Functional

  ☐
1982
4.
Power
☐
☐
☐

  ☐
5.
Generators
☐
☐
☐
36
Health Care Assistants
  ☐
Act
6.
Water Supply
☐
☐
☐
37.
X-ray Staff
  ☐
7.
Sewage
☐
☐
☐
38.
Lab Staff
  ☐
8.
Communications
☐
☐
☐
39.
Clerical Staff
  ☐
9.
Gas Supply
☐
☐
☐
40.
Other:

10.
Other Utility (please identify):

  ☐
Information

  ☐

  ☐

  Ful y     Partial y      Not

  Functional
BED AVAILABILITY
Official
11.
Overall Operational Status is:
☐
☐
☐
Available (Can Admit)   Critical
Shortage

The  41.  ICU

☐

42.
Medical

☐
43.
Surgical

☐
SERVICE AVAILABILITY (column continues overleaf)
under
(tick only where appropriate)
44.
Maternity

☐
All services fully functional:

45.
Burns

☐
       True    False
46.
Paediatric

☐

☐
☐
47.
Other:

☐
If false:


Released  Fuly   Partialy      Not

  Functional
CASUALTY INFORMATION

12.
Emergency Department
☐
☐
☐
(in last 24 hours)
13.
Satellite ED
☐
☐
☐

14.
Operating Theatres
☐
☐
☐
48.
Patients Treated as Outpatients

15.
Recovery
☐
☐
☐
49.
Patients Admitted

16.
Radiology
☐
☐
☐
50.
Patients Awaiting Treatment

17.
Laboratory
☐
☐
☐
51.
Patients Discharged

18.
Pharmacy
☐
☐
☐
52.
Deaths


19.
Decontamination
☐
☐
☐
CAN THIS HOSPITAL RECEIVE AND TREAT PATIENTS WITH?
35

Facility Name:
Assessment valid as at:
20.
Vehicles / Transport
☐
☐
☐



Yes
No
21.
Mortuary
☐
☐
☐
53.
Injuries

☐
☐
22.
Pathology
☐
☐
☐
54.
Infectious Diseases

☐
☐
23.
Catering
☐
☐
☐

24.
Laundry
☐
☐
☐
If Yes please Specify Below
25.
Sterilisation
☐
☐
☐
26.
Blood Products
☐
☐
☐
27.
Other Services
Service Name
☐
☐
☐
Service Name
☐
☐
☐
Service Name
☐
☐
☐

Additional Information (elaborate or comment on any of the above)
1982

Act


Information
Official
The
under
Released
36