Chief Executive’s Message – Friday 7 January

January 7, 2022

In this week’s Friday message I reflect on the huge national publicity surrounding Trusts who have declared a “Critical Incident” in response to the combined triple whammy of staff absences, COVID admission pressures and winter/urgent care pressures and demand.  I have chosen to write about this because of the media scrutiny of this both nationally and locally, but also because I know some colleagues in our Trust have been asking why we haven’t declared such an incident ourselves this week.

Firstly, let me share with you the definitions of business continuity, critical and major incidents taken directly from the national, NHS guidance on emergency planning and resilience:

6.5.1 Business Continuity Incident A business continuity incident is an event or occurrence that disrupts, or might disrupt, an organisation’s normal service delivery, below acceptable predefined levels, where special arrangements are required to be implemented until services can return to an acceptable level. (This could be a surge in demand requiring resources to be temporarily redeployed)

6.5.2 Critical Incident A critical incident is any localised incident where the level of disruption results in the organisation temporarily or permanently losing its ability to deliver critical services, patients may have been harmed or the environment is not safe requiring special measures and support from other agencies, to restore normal operating functions.

6.5.3 Major Incident A major incident is any occurrence that presents serious threat to the health of the community or causes such numbers or types of casualties, as to require special arrangements to be implemented.

You will notice the subtle but important differences between these definitions. These do need taking into account before we declare any such incident within these categories because of the media scrutiny it receives and because, in governance terms, one cannot play fast and loose with expectations of both regulators and other organisations, whose mutual aid is required under a Major Incident or a Critical Incident scenario.

Whilst I know and accept that our COVID-19 inpatient levels are now over 20% of our bed base and while our staffing absences are at 13%, some of the highest in the NHS at present, nevertheless, they have not yet taken us to the point where we have temporarily lost our ability to provide core services or where mutual aid from other organisations is required.  Yes, we are providing sub-optimal services at present for our patients and this causes many of you, if not all of us, distress.  However, there are still other levers we can and will pull as a leadership team, around service suspension and staff redeployment yet, before we are in a genuine position of needing to declare such an incident.  Moreover, the declaration of a Critical Incident implies that you are isolated as a Trust in experiencing the challenge and can secure the mutual aid of other Trusts locally to get you out of the hole.  I need to be blunt with colleagues here – other, local Trusts are in just as much trouble as we are and cannot offer that support.

I hope this brief piece, no matter how sobering it may be to read, assists you in understanding this situation a little more.

Thank you for your continued efforts to keep our patients, and each other, safe.

Richard