Feidhmeannacht na Seirbhíse Sláinte Health Service Executive The Community, the HSE and Severe Weather Peter Daly, Chief Emergency Management Officer HSE South

The Community, the HSE and Severe Weather

RISK ANALYSIS PLANNING MITIGATION RESPONSE RECOVERY

There has to be a measure of personal responsibility** Weather emergencies are a fact of life and they should not come as a complete surprise! There has to be a measure of personal responsibility** RISK ANALYSIS

“But Papi always takes me skiing!!” In Ireland we are not set up for snow . “But Papi always takes me skiing!!”

Feidhmeannacht na Seirbhíse Sláinte Health Service Executive Four HSE Regions Feidhmeannacht na Seirbhíse Sláinte Health Service Executive EMERGENCY MANAGEMENT Severe Weather is LOCAL not matter how widespread the bad weather. The response may not be just local but it has to have a significant local input.

Major Emergency?? Severe Weather causes significant issues for the HSE in most of what it does. Impacts on Business Continuity

What can’t stop? Trauma [ the 999 system] Maternity Dialysis A lot more besides…… 24/7 Activity must continue Palliative/Hospice care Care of sick people in the community, including young chronically ill. Care of elderly Transplant

Types of Severe Weather Event Experience shows that Ireland is threatened by different types of severe weather including: • Flooding • Frost/Ice • Heavy Snow • Severe Winds • Thunderstorms Heatwaves have affected other countries in Europe in recent years and, with ongoing climate change, cannot be entirely discounted from the MEM Risk Assessment and Preparedness processes in Ireland. However, they are not covered in the body of this document.

The Eyjafjallajokull volcanic eruption

Dialysis 08 Mar 2012

Duration of the bad weather “Three week” Christmas From the Weekend before Christmas until the schools open in January Some things can be put off for week but not five weeks 10% Many patients in the community must get a visit every seven days

Prioritisation of scarce recourses Transport for: Form of Triage 999 Calls Essential Staff Acute Hospitals Essential Staff Community Hospitals Essential Staff Nursing Homes Dialysis Patients Specialist Palliative Care GP out-of-hours service Meals-on-wheels Public Health Nurses Mental Health Services Home Support Services Blood tests Form of Triage

Transport Difficulties Have we the right transport for this type of weather?

Transport Difficulties Have we the right transport for this type of weather? The HSE considered various traction systems and each system considered would require significant expenditure on both equipment and training. The HSE bought Estate Vehicles with All Wheel Drive capacity to replace some existing vehicles. This provides 4x4 type capability in a vehicle that will be operated daily. The cost of the vehicles are similar to traditional 2 wheel drive Estate cars representing improvements in road safety in severe weather and off road conditions without any additional expenditure over and above normal fleet replacement. As part of the NAS drive to improve road safety, the NAS has also taken delivery of three new purpose built Driver training Vehicles to support the national rollout of Driver training, initially for 180 new Student Paramedics.

‘We should have a list of the vulnerable’ us a list Identification of Vulnerable Those recently discharged from Hospital Those requiring urgent home based treatment Those with mobility problems Those living alone Those in remote/hard to reach areas Those requiring on-going medication, oxygen etc., Those who any disruption to their care plan would cause undue hardship ‘We should have a list of the vulnerable’ us a list Lists are dangerous! Especially to those who are NOT on the list! People who are normally not vulnerable can very quickly become very vulnerable indeed

Cumulative Effects Increase in Fractures Delayed presentation of fractures Reduced Staff Shortage of blood Interruption of essential supplies food laundry pharmacy Fuel WATER

Self –help! (“Help Yourself and Your Family”, ”Help your Neighbour”) Establish the real and most urgent needs of the community • Set priorities for the response and be prepared to defend these to the public and the media • Organise and maintain a protracted 24/7 response • Encourage and assist individuals and communities to respond themselves (“Help Yourself and Your Family”, ”Help your Neighbour”)

Stress of 24/7 versus 9 -5 VAT is not the only thing that is 21%! Every agency has this problem VAT is not the only thing that is 21%! And that does not include holidays – remember the ‘three- week’ Christmas Can be impossible to contact key staff out-of-hours – only advantage was that with the frost and snow they were at home. Unrealistic expectations on both sides

Self –help!

Highlight of the bad weather ? Individual acts of kindness and goodness. They way neighbours supported each other and looked out for those who were badly affected. The way in which HSE staff members of all parts of the HSE, who made what can only be described as heroic efforts to do their jobs.

Highlight of the bad weather ?