Major Incidents
Provision of Mutual Aid between
South Western Ambulance Service NHS Foundation Trust
St John Ambulance and Rescue Service (Guernsey)
The States of Jersey Ambulance Service
Memorandum of Understanding
July 2016
Major Incidents
Provision of Mutual Aid between
South Western Ambulance Service NHS Foundation Trust
The St John Ambulance and Rescue Service (Guernsey)
The States of Jersey Ambulance Service
Memorandum of Understanding
1. Introduction
This Memorandum of Understanding (MOU) is between the South Western Ambulance Service NHS Foundation Trust, The St John Ambulance and Rescue Service (Guernsey) and the States of Jersey Ambulance Service. It provides a basis for the provision of mutual aid between Services in the event of a Major Incident and should be read in conjunction with the ‘Concept of Operations underpinning the Memorandum of Understanding’ document (Appendix-C).
The contents of the Memorandum have been circulated to the Association of Ambulance Chief Executives.
The Memorandum would be implemented on an extra-statutory basis, rather than pursuant to specific statutory powers, or to comply with legislative requirements.
2. Information
This MOU provides details of the arrangements to be invoked in circumstances where the Ambulance Services in 1. above require Mutual Aid from the other Service, in order to support the response to a Major Incident.
3. Intention
The intention of this MOU is to provide a framework in which to:
- Request Mutual Aid in support of a Major Incident;
- Arrange assets in response to a request;
- Manage the reception of Mutual Aid.
4. Definitions
A Major Incident is any emergency (including known or suspected acts of terrorism) that requires the implementation of special arrangements by one or all of the Emergency
Services and will generally include the involvement, either directly or indirectly, of large
numbers of people. To avoid any misunderstanding, the Host Service/Trust requesting aid will declare a Major Incident, prior to making the request to invoke the Mutual Aid Agreement.
5. Principles
This Memorandum of Understanding is governed by four principles:
- Mutual Aid
Mutual Aid to a Major Incident will be provided by the named Ambulance Services at the request of the Service/Trust in whose geographic area the incident occurs, (hereafter referred to as the Host Service/Trust).
- Authority and Responsibility
In the event of a Major Incident the Host Service/Trust will have the responsibility
to requisition resources from other Services/Trusts. It follows therefore that any Service/Trust receiving such a request will have a duty to supply mutual aid on request, subject to the maintenance of a safe level of cover. The Host Service/Trust shall make any request for assistance through the use of a request form (appendix B). The request for aid must be made by the Host Service/Trust Gold Commander and the request form signed by the same.
- Primacy
The Host Service/Trust will have primacy at the scene and all resources deployed in
pursuance of mutual aid and will at all times act under the command and control of that
Service/Trust.
- Self Activation
Self activation by Services/Trusts or individual members of staff must not take
place under any circumstances.
6. Capacity for Mutual Aid
Deploying resources on mutual aid to another Service will inevitably reduce the ability of the Service supplying aid to deal with its own core activity. This may generate circumstances where the Service supplying aid may wish to consider declaring a Major Incident in its own right and manage the consequences accordingly.
7. Performance Standards
Department of Health and Channel Island Health Departments performance standards will be suspended for the duration of a Major Incident, from the outset until the restoration of normality, both for the Host Trust and those Services/Trusts providing mutual aid.
8. Command and Control
Following the National Ambulance Resilience Unit (NARU) Command and Control Guidelines the Host Trust will nominate Gold, Silver and Bronze in accordance with their Major Incident plan. Operational Officers/Managers from the Service/Trust supplying aid can be used in relevant command positions, commensurate with their experience/rank.
9. Command Teams
Services/Trusts providing mutual aid will nominate members of staff to join the host command and control team as and when required at all or any of the following levels:
- Gold – Strategic
- Silver – Tactical
- Bronze – Operational
10. Form Up Point(s) (FUP’s)
The Service/Trust supplying mutual aid will nominate FUP(s) to which all Mutual Aid
resources will be deployed in the first instance to be held there prior to deployment as on the instructions of the Host Service/Trust.
Each Service/Trust will nominate an officer to manage the arrangements at the FUP.
11. Other Resources
There are specialist resources available within Services/Trusts which may be requested.
Host Trusts should indicate what specialist resources are required, i.e. CBRN, control, air support, medical incident officer, marine support.
The Host Service/Trust will have access to the other agencies National Inter-Agency Liaison Officer/s (NILO) and/or their Radiation Protection Supervisor/s.
12. Voluntary Aid Service (VAS)
Support from VAS will be retained locally to augment core response.
13. Communications
Primary incident management communications and control will be under the direction of the Host Service/Trust.
14. Closing Actions
Supporting Services/Trusts should be notified of “Major Incident Stand Down” by the Host Service/Trust.
Host Service/Trust to initiate the decision to return Mutual Aid assets to supporting Services/Trusts.
Should the Host Service/Trust wish to cancel a Mutual Aid request the supporting Service/Trust will be notified without delay. The Service/Trust supplying aid has the right to withdraw resources if the need of the organisation requires them back.
15. Conditions of Service
- The supporting Service/Trust supplying aid will remain responsible for the employment terms and conditions, insurance of employees and payment of salaries during the period that they are deployed to the Host Service/Trust.
ii. Additional expenses incurred for travel, insurance premiums, operational cover and items arising from deployment of staff or equipment will be payable by the Host Service/Trust upon receipt of an invoice for said expenses, subject to reasonable criteria.
iii. The Host Service/Trust will provide suitable accommodation and food/subsistence for employees from the supporting Service/Trust for the duration of the deployment.
- There is no obligation on the Service/Trust supplying aid to ensure the same staff for the total period.
v. Host Service/Trust must ensure paramedics are lawfully allowed to practice within their geographical area.
16. Terms of Agreement
This agreement shall have immediate effect and run indefinitely unless terminated by either party in writing of 6 months notice.
Date…………………………….. Signature……………………………………
Name………………………………………..
Position……………………………………..
For South Western Ambulance Service NHS Foundation Trust
Date…………………………….. Signature……………………………………
Name………………………………………..
Position……………………………………..
For St John Ambulance and Rescue Service
Date……………………………….. Signature…………………………………….
Name…………………………………………
Position …………………………………..…
For the States of Jersey Ambulance Service
APPENDIX A
MUTUAL AID Ambulance resources supplied at the request of an Ambulance
Service to assist that Service in the support of a Major Incident.
MUTUAL ASSISTANCE Ambulance resources supplied at the request of an Ambulance
Service to assist in situations of high level of domestic demand.
SUPPORTING SERVICE Any Ambulance Service supplying resources under the terms of the Mutual Aid Plan.
HOST SERVICE The Ambulance Service in whose operational area the Major Incident has occurred, and who requires support to deal with it.
FORM-UP POINT A designated area within the borders of the operational area of a
supporting Ambulance Service that would be suitable for parking and organisation of ambulance vehicles, prior to deployment to a Host Ambulance Service.
RENDEZVOUS POINT The reporting point for all attending vehicles and other resources
from supporting Ambulance Services responding to the Host Service request. The Rendezvous Point should ideally be at, or close to, the external borders of the operational area of the Host Service.
APPENDIX B
MAJOR INCIDENT MUTUAL AID REQUEST
Date and Time of request | Date: Time: |
Requesting Organisation | From: |
Name of lead officer requesting Organisation | |
Supporting Organisation | To: |
Jersey DOH / SW PCT /Guernsey DOH informed | |
Name of lead officer Supporting organisation | |
Mutual aid being requested. - This must be explicit, including exact quantities required for how long, and for what purpose
- If equipment consider leads
attachments etc | |
Where the Mutual Aid is to be sent. - Exact location where they/it
will be greeted and by whom | |
Transport arrangements - Will the requesting organisation
be providing transport or requesting this as well | |
Contact arrangements between lead officers - An agreed contact for each party
to be used throughout the emergency | |
Signature of requesting lead officer | |
Complete this form as far as possible prior to contact with the supporting Organisation being asked for mutual aid.
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APPENDIX C
Concept of Operations underpinning the Memorandum of Understanding between
South Western Ambulance Service NHS Foundation Trust
St John Ambulance and Rescue Service (Guernsey)
The States of Jersey Ambulance Service
July 2016
Introduction
This Concept of Operations (CONOPS) document provides the operational framework to support the Memorandum of Understanding between the South Western Ambulance NHS Foundation Trust, St John Ambulance & Rescue (Guernsey) Service and the States of Jersey Ambulance Service - herein referred to as the Agreement.
The purpose of this paper is to clearly identify the agreed parameters of the Agreement, modus operandi and procedures for implementation.
The CONOPS will be an Appendix to the Major Incident Plan of the signatory organisations.
This CONOPS will be reviewed annually and after each deployment or exercise.
Background
The South Western Ambulance Service Foundation Trust provides pre-hospital medical cover to the strategic area of Devon, Cornwall, Dorset, Somerset and Wiltshire The Trust has approximately 1500 frontline operational staff working in Minor Injuries Units, General Practice Surgeries and on a diverse fleet comprising rapid response cars, four wheel drive utility vehicles, road ambulances, motorcycles, air ambulances and a marine unit.
The St John Ambulance & Rescue Service provides emergency and high dependency care and transport for the people of Guernsey. The Service has approximately sixty staff providing ambulance and rescue services to the resident population of 65,600 distributed across the island. The Service operates a unique facility which combines professional ambulance operations with specialist land and sea rescue teams. Although independent of the UK National Health Service, the Service actively contributes to the Association of Ambulance Chief Executives and maintains the same clinical and operational standards as Trusts in mainland Britain.
The States of Jersey Ambulance Service provides emergency and high dependency care and transport for the people of Jersey. The Service has approximately seventy six staff providing Ambulance and related services to the 99,000 resident population distributed across a total land area of 28,716 acres (45 square miles). Although independent of the UK National Health Service, the Service actively contributes to the Association of Ambulance Chief Executives and maintains the same clinical and operational standards as Trusts in mainland Britain.
Purpose and Function of the Agreement
The intention of the Agreement is to formalise arrangements for the provision of assistance in the event of a Major Incident which significantly disrupts or overwhelms the operating capabilities of one or other service. For the purposes of the Agreement, a Major Incident is defined as:
Any emergency (including known or suspected acts of terrorism) that requires the implementation of special arrangements by one or all of the Emergency Services and will generally include the involvement, either directly or indirectly, of large numbers of people.
A Major Incident will always be declared by the Host service prior to invoking the Agreement.
Principles
The Agreement is governed by four principles:
- Mutual Aid
Mutual Aid to a Major Incident will be provided by the named Ambulance Service at the request of the Service/ Trust in whose geographic area the incident occurs (the host service).
The scale of assistance provided will depend on the nature of the Incident, available resources and transport facilities. It is recognised that all organisations would depend on access to appropriate transport provided by other organisations.
The tables below illustrate the anticipated typical level of support, and timetable of provision, between South Western Ambulance, St John Ambulance & Rescue Service (Guernsey) and the States of Jersey Ambulance Service.
Table 1 SWASFT Resources
Time from Request | Number of Personnel | Scale | Vehicle / Assets | Transport |
4-6 hours | 6-10 | Commanders (including NILO/s), Paramedics and Technicians | None | Scheduled flight from Exeter, Bournemouth and /or Southampton. Chartered flight using existing contractors |
6- 24 hours | 4- 10 | Paramedics and Technicians | 2- 4 Equipped emergency ambulances. Equipment Support Vehicles | Condor Ferries Commodore Shipping |
The South Western Ambulance Service NHS Foundation Trust remains a signatory to the AACE Memorandum of Understanding for the Provision of Mutual Aid between Ambulance Services in the event of Major and Catastrophic Incidents.
Table 2 Guernsey Resources
Time from Request | Resource | Number | Vehicle / Assets | Transport |
1-3 hours | Gold Silver Bronze Paramedic EMT’s AR | 1 1 1 1-2 2-4 | None | Scheduled flight from Guernsey. Chartered flight using existing contractors |
6-12 hours | Gold Silver Bronze Paramedic EMT’s AR | 1 1 2 1-2 | 1-2 Equipped emergency ambulances. Equipment Support Vehicles | Condor Ferries Commodore Shipping |
Table 3 Jersey Resources
Time from Request | Resource | Number | Vehicle / Assets | Transport |
1-3 hours | Gold Silver Bronze NILO/RPS Paramedic Technician ASU | 1 1 1 1 2-4 2-4 6-10 | None | Scheduled flight from Jersey. Chartered flight using existing contractors |
6-12 hours | Gold Silver Bronze Paramedic Technician ASU | 1 1 2 4-6 2-4 2-6 | 1-2 Equipped emergency ambulances. Equipment Support Vehicles | Condor Ferries Commodore Shipping |
It is recognised that the St John Ambulance & Rescue Service (Guernsey) and States of Jersey Ambulance Service are limited in ability to provide manpower and material in support of a Major Incident. However, the Services do have a strong cadre of experienced Commanders which would be available to supplement or relieve those of the South Western Ambulance Service engaged in managing a protracted incident.
- Authority and Responsibility
In the event of a Major Incident the Host Service/ Trust will have the responsibility to requisition resources from other Services/ Trusts. It follows therefore that any Service/ Trust receiving such a request will have a duty to supply mutual aid on request, subject to the maintenance of a safe level of cover.
The Host Service/ Trust shall make any request for assistance through use of a request form (Appendix B of the Agreement). The request for aid must be made by the Host Service/ Trust Gold Commander and the request form signed by the same.
South Western Ambulance Service NHS Foundation Trust contact:
Duty Control Officer East Communication Centre tel: 01202 851329
Fax: 01202 870511
This officer will alert the Chief Executive, Director of Operations (office hours) or Duty Director (out-of-hours)
States of Jersey Ambulance Service contact:
Combined Control Centre tel: 01534 444700
tel: 01534 444701
Fax: 01534 444731
(The Control Centre will contact the Ambulance Duty Silver Manager or in their absence the Duty Gold Commander
Guernsey St John Ambulance & Rescue Service contact:
Guernsey Joint Emergency Services Control Centre tel: 01481 756996
Fax: 01481 714963
(The Control Centre will alert the Ambulance Duty Silver Officer or in his absence the Duty Gold Officer)
iii. Primacy
The Host Service/Trust will have primacy at the scene and all resources deployed in pursuance of mutual aid will at all times act under the command and control of that Service/Trust.
An operational officer will always accompany any personnel deployed under the Agreement to act as Liaison Officer. The Liaison Officer will ensure continued effective communication between Services/Trusts.
iv. Self Activation
Self activation by Services/ trusts or individual members of staff must not take place under any circumstances. The Agreement will only be invoked after communication between the appropriate Gold Commanders of the retrospective Services/Trusts.
Chemical, biological, Radiological and Nuclear Incidents
It is not envisaged that the Agreement will be invoked as a result of a CBRN incident, except where available resources have been overwhelmed. Existing arrangements for ambulance decontamination and mass decontamination are in place in all strategic areas.
National Inter-Agency Liaison Officer / Radiation Protection Supervisor
In the event the Host Service/Trust’s NILO/RPS is not available, they will have access to the other Service/Trust’s duty NILO/RPS for advice only. It is acknowledged the South Western Ambulance NHS Foundation Trust will only be able to provide UK guidance but both St John Ambulance & Rescue (Guernsey) and the States of Jersey Ambulance Service follow NARU guidance for most events but may also have local procedures to consider.
The NILO/RDS can advise on the following:
- Suspected or actual CBRN, HAZMAT (chemical) incidents
- Suspected or actual Terrorist Incidents
- Suspected/actual incidents involving a radiation source
- Unidentified suspected package incidents (suspected contaminant or suspected IED)
- Criminal or domestic siege or hostage incidents
- Incidents with 5 or more casualties
- Other Police led incidents
- Other multi agency incidents
- Pre-planned stages of other Police led incidents on request
- Major Incidents as defined in Major Incident Plans
- Complex or protracted Dual Agency or Multi Agency incidents
- Strategic and Tactical Advisor for Business Continuity Incidents
- Severe weather events effecting service delivery
Contact numbers for NILO/RPS:
South Western Ambulance NHS Foundation Trust
0300 303 8608
States of Jersey Ambulance Service
01534 444701
Conditions of Service
It is recognised that considerable costs will be incurred through the invocation of the Agreement. Expenses incurred will be payable by the Host Service/Trust upon receipt of an invoice subject to reasonable criteria. The Resilience Department of all three Services will be responsible for ensuring that the Gold Commanders are provided with a daily report and estimation of expenditure attributed to the Agreement.
Closing Actions
Supporting Services/ Trusts will be notified of “Major Incident- Stand Down” by the Host Services/ Trust.
Host Service/ Trust to initiate the decision to return Mutual Aid assets to supporting Services/ Trusts in consultation with Gold Commanders.
Should the Host Service/Trust wish to cancel a Mutual Aid request, the supporting Service/Trust will be notified without delay.
The Service/ Trust supplying aid has the right to withdraw resources if the need of the organisation requires them back.
Review of Agreement and CONOPS
The Resilience Department of all three Services will be responsible for initiating review of the Agreement and CONOPS after a period of one year, post incident or after testing of the Plan by Live or Table-top/ Command Post Exercise.
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