Business Continuity Stress-Test Playbook

A written business continuity plan only proves its worth when the team rehearses it. A structured stress test shows whether people, processes, and partners can respond together during disruption.

Test regularly and plan ahead

• Run a comprehensive test at least once a year, scheduling it six to eight weeks in advance.
• Include shorter focused drills for critical systems quarterly, such as clinical system outages or major incident protocols.
• Rotate scenarios so different risks and response teams are tested over time.
• Book testing dates at the start of the financial year to secure protected time and avoid clashes with audit season or flu campaigns.

Pick scenarios that stretch the plan

• Loss of access to clinical systems for half a day during peak clinic times.
• Building closure due to a fire alarm fault, flood, or power outage.
• Sudden staff shortage following severe weather, transport disruption, or illness outbreak.
• Cyber attack compromising patient data, email systems, or appointment booking platforms.
• Supply chain disruption affecting prescriptions, vaccines, or essential medical equipment.
• Simultaneous incidents such as IT failure during a major incident declared by the local health system.

Choose the right testing method

1. Tabletop exercises: Discussion based sessions that walk through plans without real time execution, ideal for validating decision making and contact trees.
2. Functional drills: Focus on specific departments or functions such as reception managing a booking system failure or nurses switching to manual cold chain monitoring.
3. Full scale simulations: Comprehensive exercises that test the entire organisation response, including real actions like activating backup systems or evacuating part of the building.

Start with tabletop exercises to build confidence before moving to functional drills and full scale tests.

Plan the exercise carefully

1. Define the objectives. Decide what you want to validate, such as contact trees, manual prescribing processes, or patient communication routes.
2. Invite a cross section of staff: partners, admin leads, nursing teams, pharmacy, and PCN representatives.
3. Prepare a timed script with decision points, resource constraints, and any external inputs such as helpdesk availability or partner practice capacity.
4. Assign a facilitator to keep the session moving and a scribe to capture decisions, action points, and any surprises.
5. Brief participants in advance so they understand the purpose and can review relevant procedures before the test.

Run and debrief effectively

• Log every assumption, escalation, and dependency as the scenario unfolds.
• Note when staff had to improvise, when information was missing, or when contact details were out of date.
• Capture what worked well, what failed, and which actions need ownership and deadlines.
• Share a summary with all staff within 48 hours so lessons spread beyond the people in the room.
• Test follow up actions within an agreed timeframe and record the outcomes in your next governance meeting.

Avoid common pitfalls

• Testing without clear objectives leads to inconclusive outcomes and wasted time.
• Lack of senior management support undermines resource allocation and follow through on actions.
• Infrequent testing means plans become outdated and fail to reflect new systems, staff, or premises arrangements.
• Skipping the debrief or failing to assign action owners allows identified gaps to persist.

Evidence the exercise

• Store the agenda, attendance list, scenario script, and action log together in a clearly labelled folder.
• Keep sensitive vulnerabilities or supplier details in a restricted folder and reference that location in your summary.
• Align findings with the wider emergency preparedness, resilience, and response standards so gaps are easy to explain during inspections.
• Record testing dates and outcomes in your business continuity plan version control log.

Disclaimer

This guidance is for general information. It is not a substitute for legal, clinical, or specialist advice. Always seek professional support tailored to your practice.