Scottish Government

Checklists

General issues/prompts for planners

• Plan local simulations
• Draw up frequently asked questions and answers and display them wherever the public are likely to go. Include in all local authority communications
• Allocate and publicise clear lines of responsibility and authority - devolved as locally as possible - to enable quick and robust decision making
• Institute a process of contemporaneous recording regarding decisions taken and why
• Identify deputies for key decision-making personnel, including Directors of Social Work and senior management team
• Establish good neighbour networks, building on existing links in communities/localities
• Establish a staff hotline
• Educate staff and carers in identifying and reporting/referring people in confused states arising from infection
• Advertise low-level tasks volunteers could help with (eg pet feeding, shopping), as well as requirements for more intensive support
• Encourage participants in youth organisations such as Scouts and Guides to volunteer
• Plan for likely impact on out-of-hours teams
• Get local media involved
• Consider how to keep payment systems going. Plurality of providers makes this a real issue in community care

Workforce issues

• Communicate messages about how to keep yourself well and how to self-care when ill
• Consider how to handle the cancellation of planned leave
• Plan across sectors with the full involvement of trade unions
• Map skills and profile existing health and community care workforce, including commitments and locations
• Collaborate with employers outside health and community care
• Consider regional agreements, particularly as pandemic is likely to occur in waves in different areas and how feasible this is
• Train staff in infection control and basic physical care. They will need regular refresher training
• Identify in advance the work patterns that staff will need to follow to combine home and work responsibilities
• Work with your health colleagues, as accident and emergency staff will need awareness and guidelines about dealing with people with mental health problems or learning disabilities, migrant workers, asylum seekers, homeless people and tourists
• Establish pairing/buddying arrangements between services and establishments
• Consider terms and conditions issues (eg overtime/Working Time Directive, special leave and certification)
• Identify staff to work from home
• Consider verifying the identity of casual/voluntary staff
• Match level of risk to level of vulnerability in the use of checked/unchecked staff
• Learn lessons from seasonal influenza. Talk to providers about this
• Recruit volunteer drivers. This may be especially important in rural areas

Planning for people with mental health problems

• Convene a multi-agency planning group including service users and stakeholders from the health, housing and voluntary sectors
• Create a comprehensive map of services
• Consider any specific issues for people from black and minority ethnic communities
• Establish clear arrangements for stocking, prescribing and collecting medication.
• Ensure priority drugs are identified
• Work with the local police force to ensure clear arrangements (eg for provision of a place of safety)
• Create and keep updated lists of approved community workers
• Establish a contact point for carers
• Create a list of prompt questions for staff
• Consider arrangements for older people with mental health problems
• Consider specific arrangements for people with additional issues such as learning disabilities
• Create a pool of peripatetic staff, drawing across agencies and sectors and including retired staff
• Compile charts showing where staff are usually employed and agree reallocations during a pandemic
• Establish operating instructions for services - which to close, which to remain open
• Allocate individuals to make judgements on:
  • safety issues for staff and service users
  • staffing levels
  • the relevant qualifications of staff on each shift
• Draw up clear guidance and support for staff
• Ensure that records are up-to-date and address both priorities and risks for individuals
• Consider an open access centre to deal with emotional and psychological issues such as fear, anxiety etc
• Produce self-help leaflets
• Work with GPs to establish what each practice will be able to deal with
• Draw up care plans to include contingency arrangements either to increase or to reduce support as required
• Draw up care plans to identify any heightened risks of self-harm or harm to others in the event of a pandemic
• Consider arrangements to reduce or close non-essential services and increase capacity of crisis teams
• Collaborate with leisure and education departments and the private leisure industry to reduce social isolation
• Establish arrangements whereby service users can be contacted over the telephone rather than in person
• Where possible, reduce the number of personnel visiting an individual
• Expand the remit of all staff if necessary
• Set up a specific mental health helpline (consider engaging the voluntary sector to do this)
• Develop user support and good neighbour schemes
• Identify and clearly communicate the priorities for inpatient treatment and what supporting resources will be available
• Ensure that short-term assessment places are available
• Increase locally held records on patients that indicate how services should be safely delivered
• Ensure that rationing criteria are open, clear and consistent with national guidelines
• • Consider where facilities and resources can be pooled across agencies and sectors
• • Consider how to access secure services
• Acknowledge longer-term consequences such as the likely need for an increase in talking therapies, bereavement counselling etc
• Agree any role for the voluntary sector in the administration or monitoring of medication

Community services

• Establish a database/map of priorities (drawn from care plans)
• Consider how you can plan to introduce more flexibility
• Draw up a priority list of core activities
• Step up verbal messages
• Use local and community radio to communicate daily messages
• Undertake modelling work based on planning assumptions from Pandemic influenza: A national framework for responding to an influenza pandemic
• Ensure contracts include business continuity plans
• Plan which services are to be kept open/which are to be closed and at what stage
• Start planning now to expand the use of telecare etc
• Highlight the expectations in guidelines for maintaining care records
• Plan the use of short-term care

Issues to note

Issues for working with black and minority ethnic groups

• Some small specific services may be vulnerable
• Communication issues
• Understanding of where to go for help if members of these groups have influenza
• New people arriving in the country need to get information, so a one-off communication exercise is not sufficient
• Different approaches/rituals concerning illness and death
• If a pandemic starts in South East Asia it is likely to have a significant impact on communities of South East Asian origin here
• Minority ethnic communities may be scapegoated and seen as 'carriers'
• Need to work through existing networks, leaders and meeting places
• Need to build on established ways of reaching some isolated groups (eg tuberculosis and hepatitis outreach services)

Issues for working with homeless people and highly mobile populations

• Definitions (eg rough sleepers), including those with and without some contact with services
• Communication links with housing authorities for those who are temporarily homeless and in short-term accommodation
• Difficulties of penetrating the culture of some mobile populations such as travellers and migrant workers from Eastern Europe
• 'Invisible' population of illegal immigrants
• Risk of certain parts of society, eg those people who are visibly homeless or migrant workers, being scapegoated as responsible for the spread of influenza
• Low access to healthcare; poor self-care
• A proportion of homeless people will have mental health problems and/or substance misuse issues - culture of self-neglect
• People newly released from prison but with no fixed abode
• Communication strategy - make it clear that a pandemic is different to seasonal influenza
• Difficulties in identifying deceased
• Vulnerability of young people who are care leavers and on the street
• Surge of demand on hostel places
• Scoping and mapping - these groups will need different responses from the 'mainstream' population
• Supply of prescription medicines such as methadone

Issues for care homes

• Need to plan residential care as part of its community - by looking at the wider resources
• Point/person to contact for advice
• Hygiene training and awareness
• Involve residents (where possible) and families in planning
• Map of provision, what it offers and what it could offer in an emergency
• Daily monitoring of capacity and sickness levels by a dedicated council official
• Staff-sharing schemes, including managers
• Admission criteria during a pandemic - decision-making powers
• Minimum staffing levels
• Daily living - need to balance restrictions to reduce spread against risk of social isolation
• Potential for relatives to stay in the home or locally
• Deployment of staff amongst ill/well residents
• Best use of those who have recovered and are now immune
• Support to small independent operators
• Status and deployment of staff, including Disclosure checks etc
• Expectations regarding care records - prioritise those who are ill, detail the specific issues to record
• Strategy for use of short-term care