NARU Compliance and Assurance

HART Albermarle 2
The Compliance Function

The compliance function within NARU develops mandatory minimum standards for a series of national capabilities and, working closely with commissioners and regulators, ensures that these standard are maintained by provider organisations.

Key areas of responsibility include:

  • NHS service specifications for specialist capabilities
  • Interoperability standards
  • The national safe system of work
  • Supporting the commissioning and regulation of specialist capabilities
  • The national safety notification system
  • The national change management process

NARU is responsible for coordinating and maintaining the following national capabilities on behalf of NHS England:

  • Hazardous Area Response Teams (HART)
    • Incident Response Unit (IRU) [Hazardous Materials and CBRN]
    • Urban Search and Rescue (USAR) [Safe Working at Height and Confined Space]
    • Inland Water Operations (IWO)
    • Tactical Medicine Operations (TMO)
  • Marauding Terrorist Firearms Attack (MTFA)
  • Chemical Biological Radiological and Nuclear Response (CBRN)
    • Initial Operational Response (IOR)
    • Specialist Operational Response (SOR)

These capabilities are aligned to NHS service specifications and EPRR core standards.  They must remain both consistent and interoperable throughout England.  They are also subject to a nationally defined safe system of work.

NHS Mandate for Interoperable Capabilities

Presented as a hierarchy:

  • Legislative or Regulatory Standards
  • Direct Ministerial Mandate
  • National Multi-Agency Doctrine (backed by Government)
  • NHS Strategy

» NHS Standard Contract (Condition SC30)
» NHS England EPRR Core Standards

¤ NHS Service Specification
¤ Capability Matrix
¤ Safe System of Work (HSE Compliant)

Standard Operating Procedures
Generic Rescue Plans
Generic Risk Assessments
Training Information Sheets
Equipment Data Sheets

The National Safe System of Work

NARU, in conjunction with the Health and Safety Executive, has developed a national safe system of work for the capabilities set out above.  This creates a safety critical system which must be maintained locally by each NHS Ambulance Trust to ensure effective interoperability at the national and regional level.  This safe system of work is needed to protect both staff and patients during high risk operations.

Summary of the National Safe System of Work:

national-safe-system-of-work 2

Legal Duties

The NHS Ambulance Service owes an established legal duty of care to both its staff and its patients. Over the last 15 years that duty has been extended into new high-risk environments and has been distinguished in common law from the duty of other emergency services*.

As the NHS continues to commission complex pre-hospital capabilities under its Emergency Preparedness Resilience and Response (EPRR) agenda, safe systems of work are essential to protect our staff and patients safe whilst also allowing hazardous area clinicians to take calculated risks to improve clinical outcomes or safe life.

* E.g. Kent v Griffiths [2001] QB 36

Duty Of Care Interview

Christian_CooperChristian Cooper says: NARU supports NHS Ambulance Trusts to deliver a range of specialist responses to high-risk national emergencies.  It is essential that safety critical systems are maintained and effective risk management occurs during training and operational deployments.  

Our aim, through the compliance and assurance work programme, is to support Trusts in their legal duty of care to both staff and patients which is achieved through the maintenance of defined standards and service specifications.  We also work closely with Commissioners and NHS England on behalf of local Ambulance Trusts to maintain nationally interoperable services.”