Increasing Organisational Resilience in the NHS

The Department of Health's NHS Resilienceand data, this means little to, for example, a care
Project is promoting the adoption of the Britishhome manager whose primary focus is on
Standard for Business Continuity Managementfeeding, clothing and care of the patients. Whilst
(BCM) BS25999 to build collective resilience acrossthe care sector has become increasingly reliant on
the organisation. The recent launch of the NHSsystems, staff, their knowledge and day to day
Standard BS NHS25999 further strengthens thisessentials such as personal protective equipment
initiative.remain core.
But what are the realities of implementingA care services Business Impact Analysis should
business continuity management within the NHSalso consider multiple and community based
and more generally, a care services environment?working environments, specialist medical
How different is a care services setting to aequipment and priority items for salvage that
'traditional' office environment? What are the likelymay be difficult or expensive to replace. It should
challenges and how can the standard businessalso make use of relevant impact criteria e.g.
continuity management approach be applied?possibly a greater emphasis on threat to human
Over the past two years, Steelhenge haslife rather than lost revenue.
supported Primary Care Trusts and a number ofPragmatic Site Risk Assessment
other organisations involved with the care ofConducting a site risk assessment (or finding out
vulnerable people in the delivery of their continuitywhether one has ever been done) as part of the
objectives. This article explores our experience ofbusiness continuity programme can be particularly
adapting business continuity programmes for careuseful in a care services setting. It is not unusual
services.for services to run out of ageing or problematic
Intelligent BCM Programme Managementbuildings. A site risk assessment can sometimes
Whilst the benefits of BCM in ensuring continuedreveal a whole host of issues, such as
delivery of critical services are clear in principle,inappropriate storage of a hazardous substance or
gaining buy-in amongst staff and particularlya lapse in fire and evacuation rehearsals that could
front-line staff, where multiple initiatives, targetslead to a BC incident.
and drives for change frequently take an alreadyAction Orientated Plan Development
overstretched workforce away from the 'dayCare services often encompass a wide
job', can be an obstacle. An autocratic directivegeographical area and multiple sites - for example,
from the top and allocated resource may be alldistrict nurses. Therefore the approach to planning
that's required in a commercial environment,has to be applicable and useful for those people
however, the care sector may require morewhom the plans support. The plans need to be
compelling powers of persuasion.pragmatic and action orientated covering both
This buy-in will be greatly helped by not onlyservices and the physical locations.
senior management commitment to theA useful way of ensuring key areas are covered
implementation of a business continuityis to focus on key scenarios. Business continuity
management system (BCMS) but also gaining theplan development workshops that explore the
same commitment and understanding at the tiersresponse to these scenarios can be an economical
below this to ensure the resources and peopleand effective mechanism to achieve this alongside
with the right knowledge are involved in thegaining ownership of the plans.
project.Build on Existing Strengths
Steelhenge has found that having the ability toLastly, it is important to remember that the NHS
articulate the drivers and lasting benefits of thehas a good record of responding well to 'big-bang'
project (beyond the legal requirement) in aevents. The last couple of years have seen many
language that staff will understand is essential.care organisations focused on pandemic flu
Patient welfare is at the sharp end of the careplanning. This coupled with experience gained
services world and business continuity needs toduring periods of snow and flooding has forced
be explained in this context.many organisations to examine their continuity
Meaningful Business Impact Analysis (BIA)priorities. Many NHS organisations will also already
Conducting the Business Impact Analysis (BIA)have well developed Major Incident Plans and care
can be hugely resource intensive. However, theservice staff are often used to dealing with
Steelhenge team found a practical, phasedincidents.
approach to the BIA process worked well whilstWith a bit of thought and tailoring, all these
still gathering the quality of data needed. Thisstrengths can be built on and applied to a
avoids the process becoming an overly onerousstandard business continuity programme without
and time-intensive task for the staff involved.completely reinventing the wheel to achieve
Taking the time to tailor the BIA so that it useslasting results.
relevant language is also important. WhereSpecial thanks to Rebecca Norton, Project
traditional BIA's focus on incremental work areaManager with Steelhenge Consulting, for her
recovery requirements, such as desk spaces, ITextensive contribution to this article.