Abstract
BackgroundEmergency planning in the UK has grown considerably in recent years, galvanised by the threat of terrorism. However, deficiencies in NHS emergency planning were identified and the evidence-base that underpins it is questionable. Inconsistencies in terminologies and concepts also exist. Different models of emergency management exist internationally but the optimal system is unknown. This study examines the evidence-base and evidence requirements for emergency planning in the UK health context.MethodsThe study involved semi-structured interviews with key stakeholders and opinion leaders. Purposive sampling was used to obtain a breadth of views from various agencies involved in emergency planning and response. Interviews were then analysed using a grounded approach using standard framework analysis techniques.ResultsWe conducted 17 key informant interviews. Interviewees identified greater gaps in operational than technical aspects of emergency planning. Social and behavioural knowledge gaps were highlighted with regards to how individuals and organisations deal with risk and behave in emergencies. Evidence-based approaches to public engagement and for developing community resilience to disasters are lacking. Other gaps included how knowledge was developed and used. Conflicting views with regards to the optimal configuration and operation of the emergency management system were voiced.ConclusionsFour thematic categories for future research emerged:(i) Knowledge-base for emergency management: Further exploration is needed of how knowledge is acquired, valued, disseminated, adopted and retained.(ii) Social and behavioural issues: Greater understanding of how individuals approach risk and behave in emergencies is required.(iii) Organisational issues in emergencies: Several conflicting organisational issues were identified; value of planning versus plans, flexible versus standardized procedures, top-down versus bottom-up engagement, generic versus specific planning, and reactive versus proactive approaches to emergencies.(iv) Emergency management system: More study is required of system-wide issues relating to system configuration and operation, public engagement, and how emergency planning is assessed.
Highlights
Emergency planning in the United Kingdom (UK) has grown considerably in recent years, galvanised by the threat of terrorism
In its broadest sense it is synonymous with emergency planning and encompasses a spectrum of activities from business continuity management and planning, training and preparedness, as well as the response to, and recovery from emergencies. (Figure 1) [4,5] This was further codified in the Civil Contingencies Act, 2004 that set out for the various health agencies key responsibilities to prepare for major incidents that included the assessment of local hazards and risks, planning, training and testing activities [6,7]
We present the results from a study commissioned by the National Institute for Health Research Service Development Organisation to determine the evidencebase for emergency planning, for the UK health context [13]
Summary
Emergency planning in the UK has grown considerably in recent years, galvanised by the threat of terrorism. The UK experiences around 11 major incidents per year [1]. These often require coordinated multi-agency responses including from the National Health Service (NHS). Emergency management is often erroneously understood as only those activities pertaining to the response to an emergency situation. In its broadest sense it is synonymous with emergency planning and encompasses a spectrum of activities from business continuity management and planning, training and preparedness, as well as the response to, and recovery from emergencies. (Figure 1) [4,5] This was further codified in the Civil Contingencies Act, 2004 that set out for the various health agencies key responsibilities to prepare for major incidents that included the assessment of local hazards and risks, planning, training and testing activities [6,7] In its broadest sense it is synonymous with emergency planning and encompasses a spectrum of activities from business continuity management and planning, training and preparedness, as well as the response to, and recovery from emergencies. (Figure 1) [4,5] This was further codified in the Civil Contingencies Act, 2004 that set out for the various health agencies key responsibilities to prepare for major incidents that included the assessment of local hazards and risks, planning, training and testing activities [6,7]
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