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PROVIDING PUBLIC HEALTH, ENVIRONMENTAL, SCIENTIFIC AND TECHNICAL ADVICE TO STRATEGIC COORDINATING GROUPS IN SCOTLAND

December 2012

Part 1

Part 1

1. Introduction

Strategic Coordinating Groups (SCGs) often require expert advice on a range of scientific and technical issues in order to deal effectively with the immediate and longer term consequences of an emergency. This expert advice must be coordinated and can come from a range of agencies and cover a variety of areas such as public health, environment, animal health, water, technical failures, etc.

This guidance is part of the Scottish Government’s Preparing Scotland resilience guidance (Ready Scotland: Preparing Scotland), drawing also on the UK Cabinet Office’s guidance1 to allow provision of expert advice through establishment of a Scientific and Technical Advice Cell (STAC).

The purpose of this STAC guidance is to provide a core basis for providing expert and timely advice to an SCG. This guidance is flexible and adaptable in recognition of the differing structures, capacities and practices that exist in responding to emergencies across Scotland. The guidance should therefore be tailored to fit the local circumstances. Part 2 should be adapted to allow the development of localised practical guidance.

This guidance updates the previous 2008 guidance with lessons identified in previous exercises and an evaluation of the Interim Multi/Primary STAC Guidance (issued February 2010).

As with all Preparing Scotland guidance, the STAC guidance will be reviewed periodically to ensure it remains reflective of the needs of the Strategic Coordinating Groups for the provision of scientific and technical advice during emergencies.

2. Background

Previously there was a variety of existing but separate arrangements for organising expert advice to the strategic coordination level in the response to a number of specific types of emergency, e.g. pandemic flu (PICT/PIMT); civil nuclear (HAG/JHAC); CBRNE (JHAC); oil and chemical spill (Environment Group); animal diseases (NDCC/DSG). Some of these separate arrangements are still in place and continue to be used (such as the Environment Group, NDCC and DSG), whilst others have been discontinued.

This guidance consolidates the above arrangements, where the generic term STAC is used for any discrete expert advisory group formed under local area arrangements. This ensures that generic expert advice made available to SCGs is so, through the mechanisms provided by a STAC.

Establishing a STAC will be particularly important in a potential or actual emergency situation where there are obvious and current threats to public health or the wider environment, but also where potential threats to public health may arise, including those which might result from action taken to manage an emergency, e.g. in evacuating people. Additionally, a STAC may be activated to provide scientific and technical advice in other circumstances where an SCG has been activated, e.g. in the event of a critical national infrastructure failure, such as a major power failure.

NHS Boards in Scotland have the statutory duties of “the securing of improved health for people in Scotland and the prevention, diagnosis and treatment of illness”.2 Where there are issues of public health to consider, these statutory responsibilities place an onus on the NHS Board to provide a chair, normally the Director of Public Health (DPH) or a Consultant in Public Health Medicine (CPHM) on behalf of the DPH, and administration for the STAC during an emergency. The NHS Board should continue to chair the STAC as long as there are significant issues of public health to consider.

When there are considered to be no significant issues of public health, but a STAC is established to consider environmental or other concerns, the chair and responsibility for administration will be borne by the lead agency for the type of consequence advice required, e.g. local authority, SEPA etc.

Where several SCGs are established at the same time or in sequence, to deal with a related series of events or an incident affecting several areas, e.g. terrorist activity, pandemic influenza, there is a need to coordinate provision of STAC input via a Primary STAC (See Section 12).

3. Aim of STAC

The aim of the STAC is as far as is practicable to provide SCGs with authoritative information and agreed advice on the risk assessment of health and environmental hazards and technical failure, by:

  • bringing together or arranging contact with all the relevant specialist advisers through a single group;
  • providing agreed recommendations on risk management action;
  • providing agreed risk communication messages; and
  • confining the main discussion on such issues to within the STAC itself (rather than at the coordinating group meetings).

4. Integration of STAC in Scotland’s response structures

Figure 1. provides a simplified view of the emergency response structures in Scotland. This shows relationships between SGoRR, SCGs and STAC and the other local functional arrangements.

The STAC operates as an advisory group and is not an operational group. Its focus is to provide practical advice on public health, environmental, scientific and technical issues to those responsible for mounting and coordinating the response to an emergency. It will therefore provide advice to any strategic level coordinating group and assist tactical level decision making whilst adhering to their set strategy. SGoRR when activated, will receive key points from the STAC advice within the SCG Common Recognised Information Picture (CRIP).

 

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Simplified emergency response structures in Scotland
Figure 1. Simplified emergency response structures in Scotland

 

The STAC may link with other structures at Scottish and UK national levels as well as advising local area strategic and tactical coordinating groups. Communication with national and local strategic levels will usually be through the STAC chair, facilitated via the SCG.

A STAC can remain in place to advise the SCGs in the later or recovery phase of an emergency or might be first activated at this point. The composition of the STAC may change as the response progresses and the agenda and requirements of the coordinating group/s change.

For details of Scotland’s resilience management and governance structures, please see (Ready Scotland: Preparing Scotland Core Guidance).

5. Composition and structure of STAC

The STAC should have a standard core membership to ensure consistency, to support a rapid response and for planning purposes. The core membership should normally consist of the following – preferably in person or by tele/videocommunications if necessary:

  • NHS Board – Director of Public Health or Consultant in Public Health Medicine, as initial chair in the majority of cases unless early circumstances indicate that risks to human health are not considered to be a significant concern
  • Local Authority – Senior Environmental Health Representative
  • Fire and Rescue Service – if accident involves hazardous material HAZMAT Officer, or Scientific Adviser if available locally
  • Health Protection Scotland – Consultant
  • SEPA Representative
  • Animal Health and Veterinary Laboratory Agency Vet – if the incident impacts on animal health and welfare
  • Lead Responder – Liaison Officer to liaise between the STAC and the wider multi-agency (SCG) response (usually from the Police)
  • Communications Officer (a representative from the SCG Public Communications Group)

As the incident progresses the composition of the STAC can be tailored to reflect the nature, scope and scale of the specific emergency, e.g. representation from other agencies such as Scottish Water and Scottish Ambulance Service. Technical advisers from installations and assets that are involved in the situation may also be invited.

Unless early circumstances indicate that risks to human health are not considered to be a significant concern, the STAC should initially be chaired by a senior representative of a local NHS Board, normally the Director of Public Health or a Consultant in Public Health Medicine. The chair of the STAC may pass to another agency as the emergency progresses based on an assessment of the consequences by the current STAC and SCG chairs.

Irrespective of which agency chairs the STAC, the individual chairperson should have the relevant skills and experience to chair complex technical meetings in a crisis setting, in order to fulfil the remit of the cell in providing coordinated advice. The lead individual should be someone at an appropriate level of seniority within their own agency. The chair should be able to arrive at a consensus that conveys the combined expert view of the STAC and not of their own organisation.

In order that coordinated work in the STAC continues during periods when the chair is reporting to the main strategic or other coordinating groups, a member of the STAC should be briefed to act as deputy chair.

All STAC members and support staff should be competent to undertake the roles assigned to them as part of STAC. Opportunities for specific training should be maximised to familiarise themselves with the requirements of these roles.

An example list of key agencies that could provide expert advice is provided in Table 1 on Page 15.

6. Prolonged emergencies

Organisations represented on or providing information or admin/managerial support to the STAC

should make sure that they have appropriate plans in advance to ensure continued support to the STAC at a suitable staff level over a prolonged period if required. Mutual aid or surge arrangements should be made where insufficient staff are available locally to provide a two or three shift system.

7. Flexibility in approach

Whilst this document provides broad guidance, the detail must be left to the discretion of those involved in managing the response in SCGs and Scottish Government. Flexibility will be critical in making these arrangements work as there is a wide range of possible scenarios which could arise and the approach taken will depend on assessment of the situation at the time. Rapid and close liaison between key personnel in local and national agencies and in the Scottish

Government will be essential in identifying and activating the most appropriate mechanism.

There are some existing specific coordination arrangements relating to particular hazards, e.g. the Scottish Waterborne Hazard Plan (SWHP) for response to contamination of drinking water supplies and Airborne Hazard Advisory Cell (AHAC) Guidance for significant airborne hazards (detailed here, including relationship to STAC https://www.sepa.org.uk/environment/air/airborne-hazards-emergency-response-service/). Unless a further level of coordination such as a STAC is deemed to be required by the lead responders, the existing specific arrangements should be used.

Additionally, there are circumstances that may initially be managed by an NHS Board as a ‘Public Health incident’, following Scottish Government guidance. This will involve activation of a NHS-chaired Incident Management Team (IMT). However, such an incident may escalate or be deemed sufficiently serious to require activation of a coordinated SCG response. The guidance entitled Management of Public Health Incidents – Guidance on the Roles and Responsibilities of NHS led Incident Management Teams provides options in the response to these situations (available at http://www.scotland.gov.uk/Publications/2011/11/09091844/0)

Where a STAC is convened, it should be aware that there may be such other groups dealing with specific aspects of the response and should negotiate how to best link with these groups in order to provide a single source of advice and avoid duplication of effort. Dependent on the scenario and requirements at the time, it may be that these groups could best operate as sub- groups of the STAC.

8. Activation

The STAC should be activated by the lead responder through the SCG’s generic procedures for obtaining scientific and technical advice. The provision of scientific and technical advice should be part of the first considerations of a tactical or strategic group. Where other arrangements exist for specific types of emergency, as described at 7.2-7.4 above, they should be recognised when consideration is being given by the SCG for the activation of STAC arrangements. However, a senior public health professional (i.e. Director of Public Health or deputy) may recommend to the SCG chair that a STAC needs to be established due to the potential impact on the health of the local population from an actual or evolving incident.

A meeting of the STAC should be held as quickly as possible to carry out the initial risk assessment and to identify the ongoing requirements for specialist advice to the coordinating group.

Immediately following the occurrence of an emergency the lead responder(s) may be without a coordinated source of expert advice. In this situation the primary source will be local area expertise, e.g. local Directors of Public Health, Environmental Health Officers and FRS HAZMAT Officers. They may be able to provide an early assessment of the likely or actual impact of the emergency, which may include advice on first responder safety.3

Initial STAC discussions and provision of advice to the lead responder/s can be conducted by telephone/teleconference/IT links. Adequate 24/7 contact and communications arrangements for STAC members should therefore be in place.

9. Administration and support of STAC

There will be a need for adequate administrative support staff to enable the STAC to operate effectively. The organisation chairing the STAC will be responsible for ensuring that there are adequate administrative arrangements in place to support the operation of the STAC.

It is essential that telecommunications and IT equipment, internet access and access to teleconference or video-conferencing should be provided. This equipment should be tested and compatible with partners’ and STAC facilities in other areas.

10. Communications

As with any major incident there is likely to be media interest and it is important that the public are accurately and regularly warned and informed of potential risks and actions to take.

The STAC should be linked in to the communications team for the emergency (i.e. the SCG Public Communications Group [PCG]4) so that public advice or information from STAC will be coordinated with other information outputs through the main coordinating group. STAC communications are issued via the PCG. The SCG should ensure that a structured communications strategy is put in place as soon as possible, including input from all local agencies.

11. Specialist advisers to strategic level

In some specific types of emergency, individual or groups of specialist advisers, e.g. the Government Technical Adviser in civil nuclear emergencies, Defence Science and Technology Laboratory in counter terrorism/CBRNE emergencies, or other government agency advisers can support the work of the SCG. The advice from these specialist advisers must be fed to the SCG through the STAC to ensure coordination of the advice.

12. Scientific and technical advice when multiple strategic coordinating groups have been established

This section sets out guidance for the provision of health, environmental, scientific and technical advice to SCGs where a major or widespread emergency has led to the establishment of multiple SCGs and their associated STACs. In such a multiple location incident, similar issues requiring expert assessment and advice are likely in all the affected areas but it will not be practical for national agencies (SEPA, HPS, FSA, HSE, etc) to support multiple STACs. Hence there is a need to coordinate provision of STAC input via a primary STAC as detailed below.

An emergency may start in one SCG area resulting in a STAC being established in accordance with local arrangements and national agencies would normally be asked to support it. The emergency may then spread to involve other SCG areas. Each SCG would normally establish its own STAC and the potential would then exist for national agencies to be faced with requests to support multiple STACs. In such a scenario a Primary STAC will be designated by agreement between SCG chairs to coordinate and disseminate the advice from the national agencies to the other established STACs to allow them to interpret and interrogate the advice in the context of their local emergency response. This has the advantage of enabling the Primary STAC to provide coordinated expert advice from national agencies to all the STACs and ensures consistency and quality of the advice provided.

The designation of a Primary STAC will still require each of the other affected SCGs to set up what will then be called a Secondary STAC. The membership of the Secondary STAC should comprise members drawn from local agencies. It is recognised that practice and capabilities may differ between SCG areas and therefore arrangements should be flexible and scalable as circumstances require (i.e. could range from a DPH or nominated CPHM working alone up to a STAC with the full complement of local agencies as deemed necessary). Therefore, instead of requesting direct input from national agencies, these Secondary STACs should set up links to the Primary STAC. This Primary STAC should then take on the role of coordinating the advice from those national agencies and sharing it with the Secondary STACs established in other SCGs. Whilst communication lines should be between STACs, the SCG hosting the Primary

STAC should be advised of significant matters that affect the wider response regardless of which STAC they originate from.

It is vitally important that advice and guidance from agencies forming the Primary STAC is coordinated and directed so as to avoid confusing responders or issuing conflicting advice.

The Primary STAC should take on responsibility (supported by its sponsoring SCG) for maintaining coordination via regular telephone and/or video-conferencing with all the other STACs. The chair of the Primary STAC would also be responsible for chairing joint STAC meetings. The details of the Primary STAC would be communicated to SGoRR.

Even though each SCG would still be recommended to maintain its own Secondary STAC of relevant local personnel, there would have to be a clear understanding and acceptance between all relevant SCG chairs and STAC chairs that the Primary STAC was responsible for the coordination and provision of specialist advice from the national agencies. Figure 2. details the various groups involved in managing emergencies when a Primary STAC is advising STACs in other SCG areas (different areas represented as Q,R,S,T).

 

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Primary and secondary STAC structures
Figure 2. Primary and secondary STAC structures

 

13. Multiple STAC coordination

The Primary STAC will coordinate the provision of specialist advice to STACs in other SCG areas and communication between all those involved will normally be via video or teleconference link as deemed appropriate. Therefore, all STACs will require access to adequate dedicated meeting room facilities, equipped as necessary to enable routine video and/or teleconferencing.

The importance of the availability of compatible, robust and reliable telecommunication links cannot be over-emphasised. In some circumstances communications will be of a sensitive nature and should be treated accordingly.

The arrangements described above should be viewed above all else as a vehicle for ensuring coordinated and consistent advice from national agencies. Unless there are exceptional circumstances which require the direct intervention of the Scottish Government, the response to an emergency will be coordinated by the local SCG which may apply any advice it is given to its own particular circumstances. SGoRR when activated will receive key points from STAC advice within the SCG Common Recognised Information Picture.

14. National Emergencies and Scientific Advisory Group for Emergencies (SAGE)

In some circumstances, the response to an emergency may require coordination by the Scottish Government (e.g. volcanic ash cloud, severe weather across many regions). In such a scenario, the Scottish Government will consult with its own professional advisors such as the offices of the Chief Scientific Advisers (CSAs), Chief Medical Officer (CMO) or Chief Veterinary Officer (CVO) and wider networks as required, to establish a body of scientific or technical advice. These bodies provide advice via SGoR Officials (SGoR(O)) meetings convened as necessary during the emergency. SGoRR coordinates this process, coordinating and sharing this advice as appropriate with the SCGs. The SCGs are responsible for disseminating this advice to their STAC.

The management of emergencies in Scotland is a devolved matter. In the event, however, of an emergency in Scotland which impacts elsewhere in the UK or affects matters reserved to Westminster, the UK Government may establish a Scientific Advisory Group for Emergencies (SAGE). SAGE provides advice to support decisions made during the UK Government’s response to an emergency. The membership of SAGE may change during the lifetime of the response depending on the topics being covered, and the chairing of SAGE may also change as an emergency moves from the response to recovery phase. The Scottish Government may be represented at SAGE through the Scottish Government professional advisers (CSAs, CMO, CVO). Where SAGE is active and where its considerations touch on devolved matters, it will link directly to the SGoRR arrangements with professional advisers. Any direct communication between SAGE and STAC if required would be facilitated and coordinated by SGoRR (as shown in Figure 1 on page 7).

Table 1. Key agencies that could provide expert advice within a STAC

Animal health and welfare

Scottish Government – Directorate for Agriculture, Food and Rural Communities – Animal Health and Welfare – Animal Health and Veterinary Labs Agency (AHVLA) – a Defra agency with a GB remit

Scottish Society for the Prevention of Cruelty to Animals (SSPCA)

Local authority – Animal Health and Welfare Officer Scottish Agricultural Colleges / Veterinary Services

CBRN

Defence Science and Technology Laboratory (Dstl)

Atomic Weapons Establishment (AWE)

Environmental decontamination

Government Decontamination Service (GDS)

Local authorities specialist contractors

Environmental protection

Scottish Environment Protection Agency (SEPA)

Local authorities – Environmental Health

Scottish Government – Environmental Quality Directorate

Food safety

Food Standards Agency (FSA) – Scotland

Local authorities – Environmental Health

Fisheries

Scottish Government – Marine Directorate – Fisheries

Scottish Government – Fisheries Research Services

Health and safety of workers

Employer

Health and Safety Executive (HSE)

Maritime safety and marine environment

Maritime and Coastguard Agency (MCA)

Meteorological and P lume dispersion information

Met Office

NHS response

Scottish Ambulance Service

Scottish Government – Health Directorates

Public health

NHS Board – Director of Public Health

Health Protection Scotland (HPS)

Public water supply

Scottish Water

Scottish Government – Environmental Quality Directorate – Drinking Water Quality

Private water supplies

Local authority

Radiological

NHS – Radiation Protection Advisers

Health Protection Agency – Centre for Radiation, Chemical and Environmental

Hazards

HAZMAT

Fire and Rescue Service – HAZMAT Officers or Scientific Advisers

Site specific information

Site operator

Wildlife and natural environment

Scottish Natural Heritage (SNH – NDPB responsible to Scottish Government) Royal Society for the Protection of Birds (RSPB) Scottish Wildlife Trust (SWT)


1 See Cabinet Office. Provision of scientific and technical advice in the strategic co-ordination centre – Guidance to Local Responders – http://www.cabinetoffice.gov.uk/resource-library/provision-scientific-and-technical-advice-strategic-co-ordination-centre-guidance-l

2 Part I of the National Health Service (Scotland) Act 1978 confers a duty on the Cabinet Secretary for Health and Wellbeing, discharged through the NHS Boards in Scotland.

3 The Emergency Co-ordination of Scientific Advice (ECOSA) is a Home Office led arrangement for the coordination of scientific advice in the first few hours of a suspect CT, CBRN incident that would then handover to STAC on activation. These arrangements are to become active during 2012.

4 See p13 of Preparing Scotland – Warning and Informing Scotland, Communicating with the Public Guidance http://www.scotland.gov.uk/Publications/2012/02/4073

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