A blueprint for learning: How NHS England (London) learned during its response to the Covid-19 pandemic.

Identification and sharing of lessons is a key aspect of emergency preparedness, resilience and response (EPRR) activity in the national health service (NHS) in England (NHS England, 2022). The overall intent of the lessons identification and implementation process is to improve readiness and response to future major incidents and emergencies, such that, wherever possible, patient harm is minimised and staff well-being is maximised. In this commentary, we draw on international literature to outline some of the major challenges in healthcare organisations to learning from major incidents and emergencies. We describe our experience of identifying lessons and set out the approach used by NHS England (London) to identifying lessons from the NHS response to the Covid-19 pandemic in the capital. We describe the knowledge garnered in our organisation about learning methods during the Covid-19 pandemic. The commentary considers the different approaches to identifying lessons, and the subsequent challenges of learning and implementation. This paper places its focus on the learning processes followed rather than what was learned as a result. It also explores whether the learning process undertaken by NHS England (London) demonstrates the hallmarks of a learning organisation.

European Pandemic Influenza Preparedness Planning: A Review of National Plans, July 2016.

Pandemic influenza A (H1N1) commenced in April 2009. Robust planning and preparedness are needed to minimize the impact of a pandemic. This study aims to review if key elements of pandemic preparedness are included in national plans of European countries. Key elements were identified before and during the evaluations of the 2009 pandemic and are defined in this study by 42 items. These items are used to score a total of 28 publicly available national pandemic influenza plans. We found that plans published before the 2009 influenza pandemic score lower than plans published after the pandemic. Plans from countries with a small population size score significantly lower compared to national plans from countries with a big population (P <.05). We stress that the review of written plans does not reflect the actual preparedness level, as the level of preparedness entails much more than the existence of a plan. However, we do identify areas of improvement for the written plans, such as including aspects on the recovery and transition phase and several opportunities to improve coordination and communication, including a description of the handover of leadership from health to wider sector management and communication activities during the pre-pandemic phase. (Disaster Med Public Health Preparedness. 2019;13:582-592).

Intervention strategies for emerging respiratory virus infections: policy and public health considerations.

Respiratory viruses have emerged and re-emerged in humans for hundreds of years. In the recent past avian and animal influenza viruses have caused human disease ranging from conjunctivitis to respiratory illnesses, including the 2009-10 A(H1N1)pdm09 pandemic. Coronaviruses, human metapneumovirus (hMPV) and enteroviruses have also impacted humans globally. Since the likely public health impacts are common, plans and policies for intervention strategies can be developed, encompassing early detection through surveillance and diagnostics, as well as treatment and prevention through clinical and non-clinical interventions. The global comprehensiveness of these varies according to differing resources, competing health priorities and the causative agent, yet, irrespective of this, activities must be proportional to the threat. Pandemics and severe epidemics enable policies to be tested and gaps identified.

Рамочное руководство по оценке ответных мер, реализованных в стране в связи с пандемией гриппа А(H1N1) – 2009

ЕРБ ВОЗ разработало модель и инструмент с целью оказания помощи странам в разработке их собственной национальной оценки ответных действий против пандемии. Дополняет инструмент, разработанный ECDC. Обновлено в апреле 2011 г.

Guidance framework for assessment of country response to pandemic influenza (H1N1) 2009

WHO/Europe has developed a framework and a tool for countries to perform their own national evaluation of the pandemic response. It complements a tool developed by the ECDC. Updated April 2011.

Bird flu: if or when? Planning for the next pandemic.

Avian influenza or "bird flu" is causing increasing concern across the world as experts prepare for the possible occurrence of the next human influenza pandemic. Only influenza A has ever been shown to have the capacity to cause pandemics. Currently A/H5N1, a highly pathogenic avian influenza virus, is of particular concern. Outbreaks of this disease in birds, especially domestic poultry, have been detected across Southeast Asia at regular intervals since 2003, and have now affected parts of Africa and Europe. Many unaffected countries across the world are preparing for the possible arrival of HPAI A/H5N1 in wild birds and poultry within their territories. All such countries need to prepare for the rare possibility of a small number of human cases of HPAI A/H5N1, imported through foreign travel. Although it is by no means certain that HPAI A/H5N1 will be the source of the next pandemic, many countries are also preparing for the inevitable occurrence of human pandemic influenza.