If you ever find yourself at a literary loose end – perhaps shortly after you’ve exhausted all of your Dostoevsky and your Mills and Boon – you could turn your hand to the less-than-riveting read of the Civil Contingencies Act 2004. I will admit: it’s not really a page-turner and there’s no interesting plot twist toward the end, but you’ll learn some amazing things. Having learned them, you’ll probably then spending some time thinking about your police force or your NHS trust and wonder.
Imagine this —– a police force finds that a police station is taken out of commission and cannot meaningfully operate, for whatever reason. Let’s imagine a security alert that means the whole place is evacuated for safety reasons because of concerns of an explosive device. The custody block with 12 prisoners in it needs to be evacuated; the 999 response teams cannot operate there any longer so they cannot access the computers report crimes, update incident logs and build prosecution files; the radio batteries can’t be accessed to ensure radio communications can be sustained; the control room can no longer receive phone calls from the public and the controllers can’t use computers or the police radio system.
So what happens?! Well, the police could just pack up and head home early for a few extra days off, right?! Obviously not – things still need policing.
Imagine this —– a mental health trust finds that a specialist psychiatric hospital is taken out of commission and cannot meaningfully operate, for whatever reason. Let’s imagine there has been a fire that means the whole building had to be evacuated. There are several different wards in the building, with different groups of patients of differing need. Some of the patients are Part II patients, but others are there under Part III: in hospital subsequent to criminal proceedings and including violent and sexual offenders. The hospital is not going to be useable until significant repair work has been completed.
So what happens?! — well, could the trust just send the patients home for a few days, until the work is done?! Obviously not. Care still needs to be provided.
Each of these situations is a civil emergency, as defined by the 2004 Act. This legislation places a duty upon police forces and NHS trusts, amongst other public bodies, to ensure that they have planned and prepared for these kinds of things. The above examples are not hypothetical. Several police stations have been shut down at zero notice for security reasons. Chace Farm Hospital in north London, a medium secure unit, partially burned down in 2008, resulting in many of the 60 patients sleeping on mattresses in a gymnasium.
The Act itself defines what an emergency is, it defines which public authorities are covered by the Act and outlines very clear expectations in section 2 that those organisations will “assess, plan and advise” with respect to the potential for emergencies, which is exhaustively defined in section 1.
There is a duty to undertake periodic reviews about the potential for emergencies and to maintain plans that have the effect of —
- preventing the emergency
- reducing, controlling or mitigating its effects, or
- taking other action in connection with it.
So if you work in the public sector in organisations like policing or mental health, you should be able to ask your boss if you can see the “business continuity plans” for what would happen if your building ceased to be operable. Obviously there are other kinds of emergency, but these serve the purpose.
MENTAL HEALTH BEDS AND POLICE CUSTODY
I have written previously about the difference in approach between policing and mental health to the management respectively, of cells space and mental health beds. I have just checked the custody computer at work at the cell block is currently 25% in use, 75% of its capacity is spare and we view this as a positive thing. It is (very rare!) respite to the custody staff who 24hrs ago had a full cell block and were run off their feet, but it means if my officers arrest a large number of people at a pub fight or out of a stolen car, they can easily be accommodated. It also means that if neighbouring police areas are having an especially busy time and they fill their custody space, we have capacity tonight to help them, just as they helped us last night.
By contrast, many NHS organisations run their hospitals at near 100% capacity. I’m told that in some areas the contracts between CCGs and the ‘provider’ trusts mean that unless hospitals beds are 95% in use, the provider can’t cover their costs. This is perceived as efficient because it means the beds we’re paying for and the staff we’re paying to provide care are used almost to the maximum degree, most of the time. I’ve always looked upon it as inherently inefficient, because if the local police detained three people under s136 MHA, it may mean there is no local bed to admit them to. It means that we’d start looking at other hospitals and nearby areas, who are also running their hospitals at 95%+.
So what happens if something burns down or suffers catastrophic electrical failure? Well, if my cell block shut down right now, I’d transfer the prisoners to one or two nearby custody blocks. Every surrounding custody block in my force right now, has capacity to accommodate all of the prisoners from my cell block. Even if this happened last night when we were literally full, they would have been able to be spread around a number of cell blocks and there is one other possibility. There are three police stations near to my area with cell blocks that are not routinely used. We could just open one of them up, put the custody staff from my station into the other station and use a different building. If the station where the 999 response officers worked was out of commission, they would use computers elsewhere, get batteries from other main stations and so on. If there was a difficult period answering 999 calls during the first hour or so after the emergency being realised, surrounding police areas would help to police mine. Just as we have done for them, when they have major incidents and emergencies.
What happens if a medium secure hospital with 60 patients like Chase Farm is taken out? We don’t have spare medium secure units standing empty ‘just in case’ – to be fair, the Act doesn’t impose such a strict duty to have a spare building. But neither do we ensure that all medium secure units maintain an empty ward, so that they could accept an additional 10% of patients to their normally commissioned numbers at short-notice, should business continuity plans be invoked following an ’emergency’. If this were the case, patients from one medium secure unit could be dispersed around the nearest five or six surrounding units – but again, such a particular requirement is not in the Act itself. So how should it be managed? Some medium secure units accommodate 90 men – where would they go, if that unit were taken out and how would they get there? It is probably for all these reasons that when I was once involved in a major incident, desktop-style exercise that was modelled on the 2008 Chace Farm incident, it didn’t take long before I was asked whether the detained MHA patients could be moved to police custody as a temporary step and would the police take them there? Little knowledge of this Act emerged when I asked what their business continuity plans were?
The point here is this —there is a legal duty on police forces, mental health trusts and others to have business continuity plans in place for most reasonably forseeable contingencies, including the less-likely but obvious major problems like the loss of your main building to natural events or security breaches. These plans should be maintained and reviewed at regular intervals and where necessary published. I simply ask the question, in light of the realignment of all our public services over the last two years: do we have revised business continuity plans and how would we handle the sudden inability of a major building to function, especially where that building accommodates legally detained people like mental health patients?
Do we have joint plans in place with police, fire and ambulance for how we would react in reality and dare I ask, have we practised for it?
Winner of the Mind Digital Media Award.