As Royal Bolton Hospital’s Emergency Planning Manager, James Tunn would have hoped that his plans wouldn’t have to be put into action when he took the role in 2008. But with the Manchester Arena bombing in 2017 and the global COVID-19 pandemic on our doorstep in 2020, James’ plans and preparedness have been put to the ultimate test.
“Some people can go through their career in the NHS for thirty or forty years and look back and think we have never had to deal with a major incident. Unfortunately I can’t say that,” James said from his base in the COVID Incident Response Team office at the Trust.
“On the night of the Manchester bombing I remember just a general and overall sense of calm that was in the A&E department. People understood what they had to do, and they just got on and did it and they looked after patients really well.
“From an Emergency Planning Manager’s point of view it was very satisfying to know that I played a small part in that, and I do say ‘small part’ in that, in helping people to get ready for those types of incidents.”
From the bombing three years ago to the pandemic of today, both major incidents have brought a range of unique challenges and questions for all the staff at the Trust to think about, some of which could have been predicted, and many of which were unforeseen.
“We describe major incidents in different ways,” James says. “There is a “big bang” or high impact type of incident where we have to quickly respond and then recover. Pandemics are referred to as a “rising tide” event, where you can see the problem coming towards you, so you have time to plan, and that is the difference.
“When we first started planning for the pandemic we thought that the first indications of the tide approaching would be large numbers of patients attending through A&E but that wasn’t necessarily the case. The early triggers were the cohorting and testing of patients and staff absence due to having symptoms or illness. Of course our staff are our most valuable resource, we can’t do what we need to do without those key staff.”
To be expected, in the ever changing landscape of the virus, James dealt with a variety of different issues and responses to the pandemic. He was at the front-line helping plan the Coronavirus Priority Access Pods (CPAP) in A&E, has negotiated with the British Consulate in China to secure additional supplies of PPE and has even dealt with an influx of holiday scuba-diving masks after national news revealed that some Trusts were using a specially adapted full-face snorkelling mask to assist with ventilation in patients.
As James surveys the many different styles of surgical masks above his desk, a testament to the ever changing face of the coronavirus pandemic, his focus now switches to help preparing for the hospital restart and, in what he calls the ‘interwave’ period, the possibility of a second wave to come.
“We have got a museum of masks, all the different types of masks that nationally are no longer available,” he smiles.
“What the focus on the minute is reset and recovery, looking at restarting some of our clinics and sessions that were shut down as part of the business continuity arrangement, they are slowly ramping back up.
“But we have to be really careful that if we do notice any significant spikes or activity that will then stop and we will go back into response mode.
“It [the pandemic] has been so unique, such a different level of response. It has been hard work, and it still is hard work, including those staff who have been shielding or working from home, it has never stopped. The frequency of phone calls and urgent requests into the COVID office may have reduced, but there is still loads going on.
“It threw up a lot of novel problems that we hadn’t imagined we would have to deal with, but in true Bolton style we dealt with them. It’s about having the right teams in the right place. I think Bolton is very lucky because it has got some really great operational staff and managers who have risen to the challenges they faced. I think we have done really well here at Bolton and across Greater Manchester as a whole and I am very proud of all our staff.”