1. Capital Insight Pty Limited ABN 76 056 297 100 77 Berry Street North Sydney NSW 2060 t02 9955 2300 f02 9955 5574 www.capitalinsight.com.au Strategic Risk Mitigation Planning for Engineering Infrastructure Failure (power supply interruption) May 2014

2. Overview Background Scope of Services Operational Criteria Investigation Methodology Outcomes

3. Background: Westmead Hospital Site

4. Background: Substation Upgrade Endeavour Energy cutover planned for Saturday 10 May (4am) Loss of redundancy at Zone Substation during upgrade work 8 hours maximum potential exposure to total loss of mains power should an incident occur on the other feed during cutover

5. Scope of Service Identify relative criticality of clinical and non-clinical services, and service interdependencies Confirm application of disaster management plans Interviews to confirm risk exposure and mitigation options Identify historical events that inform risk mitigation options Develop matrix of services showing the impact of risk events Define risk mitigation options, and required actions Provide commentary regarding governance arrangements Deliver report within 8 business days

6. Operational Criteria: General NSW Health Incident Management Policy (PD2014_004) NSW Health Disaster Risk Management Guidelines (GL2009_004) Emergency Management Arrangements for NSW Health (PD2012_067) AS4083-2010: Planning for Emergencies – Health Care Facilities NSW Health Department Plan (HEALTHPLAN) Western Sydney LHD HEALTHPLAN Westmead Hospital Emergency Management Plan (WESTPLAN), 2013 Westmead Hospital Business Continuity Plan, 2013

7. Operational Criteria: TS11 Engineering Services and Sustainable Development Guidelines Essential power is to be provided for Critical Care Services, and for other areas as determined by the LHD. TS11 defines minimum power supply requirements for Critical Care Service areas, including: Resuscitation Bays in the Emergency Department Treatment Bays in the Emergency Department in Level 5 and 6 facilities Operating Rooms, Anaesthetic Bays and Recovery Area Day Procedures Rooms Coronary Care Unit Intensive Care Unit Neonatal Intensive Care Unit Cardiac catheterisation Rooms selected areas of Medical Imaging Unit.

8. Investigation Methodology

9. Outcomes Strategic Risk Mitigation Plan Scope Definitions Limitations and exclusions Operational risk profile Recommendations (risk mitigation strategies) Next steps

10. Outcomes Service Groups Critical care and medicine Medicine and cancer services Clinical support functions Other health services Food services Engineering support services

11. Outcomes Service Groups (continued) Engineering and ICT infrastructure – a/c and ventilation systems – +ve and –ve pressure – General lighting – Phone system – Duress – Nurse call – Data centre – Distributed communications – Software applications – Oxygen – Medical air – Lifts – Pneumatic tube – Potable water – Hot water – Fire detection – Fire suppression – Security and locks

13. Outcomes Risk mitigation strategies identified across four categories: 1.Investigations and/or tests: –identify risk treatments –cost/benefit analysis for risk treatments –obtain more detailed information 2.Specific opportunities for infrastructure improvements (short term and strategic) 3.Protocols for incident response 4.Contractual obligations and liabilities

14. Outcomes Investigations and Tests 1.Scheduled supply failure condition testing 2.Review of communications infrastructure 3.Review of standby generator capacity 4.Review of nurses monitoring stations 5.Review of lift operations under power failure scenario 6.Review of procedural lighting 7.Review of fridges, freezers and cool rooms

15. Outcomes Investigations and Tests (continued) 8.Review of software application hosting arrangements 9.Data room fire protection (sprinklers!) 10.Review of miscellaneous servers 11.Review of asset services capacity to respond (+ equipment) 12.Alternative supply arrangements for NETS 13.Review of access security 14.Risk assessment for extended standby generator deployment

16. Outcomes Specific Infrastructure Improvements 1.Eliminate "work arounds“ used in the past 2.Provide essential power to tissue pathology laboratories 3.Provide essential power to Zouki 4.Provide temporary standby generator service for radiology 5.Provide essential power to biomedical equipment area

17. Outcomes Protocols for Incident Response 1.Protocols for infrastructure failure scenarios 2.Protocols for recording lessons learned 3.Protocols for management of Pathology West Critical Facilities 4.Protocols for CSSU and DSSU (incl. private hospital) 5.Obtain and coordinate tenant Business Continuity Plans (BCPs) 6.Update Westmead BCP and WESTPLAN

18. Outcomes Contractual Obligations 1.Endeavour Energy notification obligations 2.Maintenance of uninterruptible power supplies (UPS) 3.Identify lease liabilities

19. Outcomes Client Before After !

20. Conclusion Outputs Scope of investigations: – to improve business continuity outcomes – as input to facility expansion planning/design Recommendations to improve maintenance, inspections and testing Recommendations to improve disaster response capabilities Opportunities to minimise financial losses.

21. Conclusion Opportunities for discussion.......... What other similar or complementary experience do we possess? Opportunity to develop new advisory service? Opportunities to add value to our PM service? Potential clients?