This document discusses strategic leadership during crises. It outlines the stress and pressure of responding to emergencies with limited information. Successful response teams have the right members in place, clear decision making, timely communication, and the authority to act. Leaders must be aware of risks like pandemics, flooding, and terrorism by understanding national, regional, and local risk registers. Command and control is handled at the local level but can escalate to higher strategic levels depending on the incident's scope and impacts. The document also provides definitions for different response levels and indicators for when an incident requires escalated coordination and management.

1. 1
Strategic Leadership in a Crisis
Dominic Mellon
Regional Resilience Manager
29 June 2010

2. 2
Responding to the emergency
Response conditions:
 Stress & anxiety
 Pressure from rapid response
requirements
 Working with limited information
 Rapidly evolving situations

3. 3
Successful incident response
teams:
 Having the right team in place
 Clear, accountable, decision making
 Timely communication to appropriate
stakeholders
 Crisis response team with the authority to
act
 Team members accepting their
responsibility & authority

4. 4
Risk awareness
 Pandemic Flu
 Flooding
 Terrorism
 Awareness of national, regional & local
risk registers
 Local leaders understanding of risk in their
community

5. 5
Subsidiarity in Command & Control
 Emergency Response lead at local level
 Strategic Health Authority empowering
Primary Care Trusts
 SHA Command & Control
– Major Incident impacting several PCTs
– Pandemic Flu- National command and
Control

6. 6
Incident
Response Levels
Level Definition
1 Major incident contained within one Local Resilience Forum
area
2 Major incident covering more than one Local Resilience Forum
area
or
exceeds the command capability of local Primary Care Trust
3 Major incident exceeds command capabilities of multiple
Primary Care Trusts cooperating through the Strategic
Coordinating Group
or
Strategic Health Authority Strategic Command requested by
the Department of Health
4 Incident external to NHS South West area with regional
impacts requiring national and regional coordination

7. 7
Indicators
 Where mutual aid is required;
 Requiring the attendance of the NHS at the
Strategic Coordinating Centre or Regional Civil
Contingencies Committee;
 Requiring communication links with national
coordination;
 Serious untoward incidents;
 Declared or suspected terrorist incidents;
 Chemical, biological, radiological or nuclear incident;
 Significant incident that requires media coordination;
 Incidents self declared by an NHS organisation,
including by the South West Strategic Health
Authority.

8. 8
Strategic Incident Management
 National capabilities survey identified need
to improve strategic level training
 National Occupational Standards outline
competencies for executive directors
- Response principles
- Applicable legislation
- Communications & media