GP mythbuster 69: Business continuity - arrangements for emergencies and major incidents

GP practices need to plan for and respond to a number of wide ranging incidents that could affect health or patient care.

Pandemic influenza remains one of the top risks for the UK and any outbreak will have significant implications for primary care. Therefore all practices should plan for pandemic influenza as part of their business continuity arrangements. Practices should ensure they have identified core, essential services and can maintain these when faced with an increase in patients with influenza-like symptoms whilst possibly experiencing staffing disruptions arising from the outbreak.

Other incidents and emergencies could be extreme weather conditions, a major traffic accident, industrial action or loss of premises. Planning ahead should enable your practice to recover more quickly and continue to provide a service to the population you serve.

The Civil Contingencies Act (2004) provides a framework for what tasks should be performed in the event of a civil emergency and how organisations should cooperate. Some NHS organisations are identified as ’category one‘ responders who have a legal duty to develop robust continuity management arrangements to help them maintain their critical functions in a major emergency or disruption. Practices are not in ’category one’, but it is good practice for all providers of NHS funded care to act as if they were and to develop robust business continuity management arrangements.

Business continuity plans

When planning, practices may find it useful to collaborate with other users of their premises or with neighbouring practices. This can be particularly important for services that operate from a single location or when the issue affects multiple services (such as bad weather or influenza).

Arrangements should be responsive to incidents that have a short, medium or long term impact on the running of the practice. Some scenarios to consider when developing a business continuity plan are:

• Significant numbers of staff could not come into work
• IT systems were disrupted significantly
• You could not use your premises for a period of time
• Paper records were destroyed or damaged beyond use
• A supplier was unable to deliver essential goods or services.

A robust plan should:

• Name a person responsible for delivering business continuity
• Reflect local risk registers and NHS England’s Core Standards for Emergency Preparedness, Resilience and Response
• Set out key functions needed to deliver services
• State a maximum acceptable disruption time for these functions
• Describe how the key functions will be restored within the maximum acceptable disruption time
• Identify key materials, external services or staff required to maintain patient care

Exemplar plans may incorporate:

• Key roles and tasks to be undertaken to respond to an incident
• Prompts (for example action cards) to support an individual undertaking a role or task
• Key information needed to restore practice function (account/contract details, contact numbers etc.)
• Processes for collaboration with other services and across a health community
• Systems for ensuring that the most up to date plan is available on and off site at all times
• Systems to test key elements of the plan and identify lessons learned
• Communication plans for:
  • patients
  • staff
  • local health service providers
  • key stakeholders including NHS England, CCG and CQC (see GP mythbuster 21: Statutory notifications to CQC).

Our inspections

Key line of enquiry S5 considers how well a practice anticipates and plans for potential risks to the service. During an inspection we will look at what arrangements are in place to respond to emergencies and major incidents.

Further resources

NHS England has produced a management toolkit with examples for practices to consider - NHS England Business continuity toolkit

Practices may wish to contact their CCGs or local area teams – some have developed template business continuity plans.