Planning for major incidents

A “major incident” can happen without warning at any time – day or night – and, despite being in a permanent state of readiness, such an event is feared by every Trust. The fact that the hospitals involved coped so well with the immediate aftermath of the London bombings of July 2005, was undoubtedly due to hours of preparation on the drawing up of “major incident plans” by personnel from all areas of the hospitals involved, in conjunction with representatives from NHS Blood and Transplant (NHSBT). This meticulous planning most likely saved the lives of many victims, following the event, who may otherwise have perished. All NHS Trusts have a duty to plan an effective response to a major incident occurring which either presents a serious threat to the health of its community or places abnormal demands on its services (especially if large numbers of casualties are involved) – the first and immediate priority being one of saving lives.

Emergency planning

According to Department of Health (DH) NHS emergency planning guidance, NHS organisations have a crucial role to play in the response to a major incident. As a result, they must be prepared to provide an organised and practised response to a major incident using appropriately trained and equipped staff. This response would include the ability to immediately assemble an incident response team, to work through the incident in a systematic way and to deal with ensuing enquiries from the public and media while also having the capacity to continue all their other essential routine  work. The latest DH guidance differs in that it deals with a much wider range of possible types of incident than the typical “blood and bandages” episodes, which have been the focus previously, and also outlines the roles of the likely key players involved. Inter-agency planning and co-operation “on the night” are constant themes, as is the training of personnel and the need to test and exercise the plans of each agency including health authorities, hospital, ambulance and community Trusts and other health service providers. The NHS has to face a variety of major incidents which may result in large numbers of casualties with the capacity to overwhelm normal services.