1.1 Introduction

Nelson Marlborough Health has a Health Emergency plan which is used to provide overarching direction to the DHB in Emergency Management. The plan also outlines the structure of emergency management in Nelson Marlborough Health and how the health sector fits within this structure. The emergency plan will also outline the strategies to prepare the health sector for a response to a health emergency.

1.2 Name

This plan is the Nelson Marlborough Health Board, Health Emergency Plan (NMDHB HEP).

It replaces the NMDHB Major Incident Coordination Plan.

1.3 Background

Emergencies can happen anywhere and at any time. They can be as a result of severe weather, infectious disease, industrial accidents or intentional acts such as terrorism.

Emergency preparedness is progressive and ongoing management which leads towards greater resilience for Nelson Marlborough Health.

This resilience will allow the DHB to provide healthcare when it is needed in the time of a crisis. It is an ongoing and evolving process which requires planning, development of response actions and evaluation of these processes. Careful and considerate planning is critical to protecting the public and healthcare providers and safeguarding the healthcare system.

In 2002 the NZ government revised and repealed the Civil Defence Act 1983, replacing it with the Civil Defence Emergency Management Act 2002. This act stipulates that the roles and responsibilities that agencies have  (including Health). As a result the Ministry of Health (MOH) has now mandated all DHBs to have a Health Emergency Plan.

1.4 Location and area for this plan

Nelson Marlborough Health is located in the top of the South Island and has facilities throughout the Nelson Tasman and Marlborough region. It is responsible for a population base of approximately 145,000 permanent residents.

The region encompasses a wide geographical area which ranges in terrain from alpine to coastal. The region is well known for its scenery and wine producing vineyards which make it a popular destination for visitors both domestic and international.

Seasonal tourism growth can increase the population significantly during holidays and major events which draw large numbers to the region. This can have implications for provision of services during an unplanned event such as a natural disaster or a pandemic.

The corporate offices of the DHB are located on the Braemar campus in Nelson city directly opposite the Nelson Hospital. While the majority of the administration and corporate functions are based in Nelson, there are some services located in Wairau.

Nelson Marlborough Health uses a high bandwidth dedicated fibre link to connect its secondary services as well as telephone and video conferencing to the majority of its primary and secondary providers.

The DHB is responsible for the provision of primary and secondary health services to the region.

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1.5 Purpose of the emergency plan

The purpose of this plan is to create the framework within which the Nelson Marlborough District Health Board (NMDHB) shall respond during any potential or significant incident requiring a health response.  In addition, the plan identifies steps to prevent, prepare for and recover from the effects of both natural and man made hazards. 

The plan has been prepared to reflect the current philosophy of emergency management, which is to build resilience to 'everyday' emergencies so they do not become major incidents. The plan is based closely on the New Zealand Coordinated Incident Management System (CIMS) that has been adopted by most emergency response services in New Zealand including most hospital services.

This plan is for individuals and organisations with a key role in the management of a health emergency in the Nelson Marlborough region. A list of key individuals and organisations is listed in section 1.21.

These organisations shall be able to use the plan to determine their roles and responsibilities in the event of a health emergency.

1.6 Objectives

The objectives of the NMDHB HEP are:
  • To identify and mitigate identified risks
  • To maintain or restore the health status of the population of the Nelson Marlborough Health area of responsibility, following a major incident or event
  • To define the communication network and procedures for alerting and working with functioning health service providers in the event of an emergency or potential emergency/incident
  • To  provide a consistent framework for how the Nelson Marlborough Health shall respond and deliver health services during a health emergency, locally, district and nationally 
  • Clarify roles and responsibilities of Nelson Marlborough Health, the Public Health Service and the Health and Disability Service providers.

1.7 Legislative Requirements

The plan meets the legislative requirements placed on the Nelson Marlborough District Health Board by:
  • The Health Act 1956
  • The Civil Defence Emergency Act 2002
  • The National Civil Defence Emergency Management Plan order 2005 ( paragraphs 28 – 32)
  • The law reform (Epidemic Preparedness) Act
  • The National Health Emergency Plan: Infectious diseases 2004
  • The New Zealand Influenza Pandemic Action Plan (latest version)
  • The National Health Emergency Plan: Hazardous substances Incident Hospital Guidelines, 2005.

1.8 Guiding Principles

This plan uses the following guiding principles:
  • Nelson Marlborough Health shall establish effective governance that ensures  emergency management services are planned, coordinated and appropriate to the needs of the population within the DHB district.
  • That Nelson Marlborough Health shall respond quickly and decisively to the changed health care needs of communities while ensuring the continuation of normal community health services.
  • To ensure that Nelson Marlborough Health is prepared to respond to an emergency management situation with normal resources 
  •  That Nelson Marlborough Health emergency preparedness allows for usual resources to be utilised more effectively and extra resources to employed

This plan has been developed using guidelines provided by the Ministry of Health (MOH) in the operating policy Framework 2.19 'Emergency Management.' The MOH National Health Emergency Plan is the overarching document governing the DHB Health Emergency Plan (HEP). The HEP also encompasses the 4R principles of  emergency management as per table 3 (below).

The document has been written using the verbs ‘shall’ and ‘may’. The use of the verb’ shall’ indicates that the action described is mandatory or a requirement. The use of the verb ‘may’ indicates that the action is permissive and not mandatory.

Principle Emergency Management
PrincipleDefinitionNMDHB Application
Reduction Identifying and analysing
long-term risks to human
life and property from natural
or man-made hazards; taking
steps to eliminate these risks
where practicable and where
not, reducing the likelihood
and the magnitude of their
impact.
  • Ongoing review of primary / secondary and other health providers (as applicable) and NMDHB relationships
  • Fostering of strong community health providers linkages to ensure prompt and accurate reporting of potential health emergencies
  • Fostering of strong Community Response Organisations, Public Health and NMDHB relationships to ensure optimal response to a health emergency
  • Ongoing monitoring of international, national and regional health trends through community laboratories, Governmental Monitoring Agencies (CCMAU / ESR) and Medical Officer of Health linkages, MOH initiatives and Planning
Readiness Developing operational systems
and capabilities before an
emergency happens. These
include self-help and response
programmes for the general public, as well as specific programmes for emergency services, utilities and other agencies.
  • Timely notification strategies of potential health emergencies (eg EACC notifications)
  • Development and regular and as indicated review of the Health Emergency Plans
  • Training and ongoing exercising of key operational responses using varied scenario to ensure diversity of application of the HEP
  • Awareness of staff, communities and organizations within and allied to the region
  • Participation in regionally based planning and exercising of HEP and associated responses
Response Actions taken immediately
before, during or directly after
an emergency, to save lives and property, ‘prevent the spread of disease as well as help
communities to recover.
  • Provide direction, supervision and implementation of strategies in accordance with the HEP
  • Support the provision of facilities, services and materials in accordance with emergency response planning
Recovery Activities beginning after initial impact has been stabilized in the Response phase and extending
until the community’s capacity
for self-help has been restored.
  • Activation of Recovery strategies as per the HEP

1.9 Plan Structure

The NMDHB HEP comprises the following:

Part 1: Introduction
  • Includes the purpose and structure of the plan
  • It also describes the relationship of the Plan to the National Health Emergency plan  strategy and links to other agencies such as CDEM groups
  • Key stakeholders.

Part Two: Hazards for Nelson Marlborough Health (Reduction)

  • Identifies the Hazards and risks for Nelson Marlborough Health. This includes a hazard and risk analysis
  • Risk management.
Part Three: Strategic Component  (Readiness)
  • Describes the objective of the plan and the goals for Nelson Marlborough Health and its emergency management  response. 
  • The general principles underpinning the operational component of this plan
  • planning requirements
  • key current issues for Nelson Marlborough Health
  • It describes the principles underpinning the operational component of this plan.
Part Four: Operational Component (Response)
  • Describes the way in which the DHB shall activate its HEP and respond to a health emergency
  • Outlines the operational requirements of the HEP and the relevant response plans objectives, targets and actions to address these issues
  • Training.

Part Five: Recovery

  • Sets out the requirements of the recovery from a health emergency within Nelson Marlborough Health.  The recovery plan is currently under development.
Part Six: Administrative Arrangements
  • Details relating to the provision of emergency management within Nelson Marlborough Health. This includes the emergency management structure within the DHB
  • Sets out the basic training and exercise programme relating to the HEP.
Part Seven: Plan Monitoring and Review process
  • Details the way in which the plan shall be monitored and reviewed over its 3 year term.