Published: 14/07/2005, Volume II5, No. 115 Page 14
Ministers are reviewing ambulance communications systems after the collapse of the mobile phone network hampered the initial response to last week's London bomb attacks, HSJ can reveal.
On-scene crews had difficulty communicating with central command, who in turn faced problems contacting the rest of the NHS.
The installation of digital radio equipment would have enabled ambulances to bypass the mobile network. But a series of delays has meant that the system, originally due for national roll-out by the end of 2004, is now at least two years behind schedule.
No ambulance service trusts have installed the system through the national procurement programme although two - Mersey Regional and Hereford and Worcester - have installed it independently. A national contract is due to be signed in the next few weeks.
A digital system would have enabled radio communications in the Piccadilly line tunnels, where at least 21 people died in a train between King's Cross and Russell Square underground stations.
Now senior figures in the ambulance service are calling on the government to speed up the installation of the digital radio network to improve the NHS response to a future terrorist attack.
Health secretary Patricia Hewitt admitted last week that communications problems did arise on the day of the terrorist attacks and that a review of the emergency plan would take any lessons into account.
She told HSJ: 'We and Cobra [the government's emergency planning committee] will obviously look at the totality of the emergency planning. There are certainly communication issues we'll want to look at.' She added: 'Most of the mobile phone networks went down and there were concerns about the emergency service networks getting overburdened. She added: 'The Department of Health is due to sign a contract for digital radio imminently.' Julie Dent, chief executive of South West London strategic health authority and NHS emergency planning lead for London, agreed that 'huge communications issues' had arisen.
'The networks clogged up far quicker than we thought, ' she said. She was forced to order the overriding of mobile networks at 9.39 - blocking them to the public, except for emergency services - after ambulance crews experienced problems.
'Whatever had been planned we need to plan for better use of a variety of media including e-mail and dedicated phone lines, ' she said.
London Ambulance Service chief executive Peter Bradley told HSJ there was no evidence that the ambulance service's response was affected by a lack of digital technology. He said: 'It is too soon to fully evaluate what lessons there are to learn, but we feel confident that the current radio system did not diminish the effectiveness of the response.' But he stressed that 'the unique nature of this event, on four separate sites, inevitably brought communications challenges.' Assistant chief officer Russell Smith agreed that he was 'reasonably satisfied that we coped', but said the full picture would emerge after a debrief in the near future.
London Ambulance Service chair Sigurd Reinton said the digital system would have been a benefit because ambulance staff had to rely on mobile phones to contact hospitals. He was disappointed that digital radio was not yet being used.
'It should have been here earlier and the whole thing is being reviewed, ' he said. 'The original plan was a leisurely pilot process, and we were quite far back in the queue because we are a large organisation which is not great for testing teething problems on.' Mr Bradley said he would be pushing for London to be moved up the queue to receive digital radio.
The project - which will be centrally funded - would cost at least£500m to install nationally and require dozens of new base stations and radio masts. There are also problems over rural coverage.
The Department of Health said an announcement about the contract would be made 'very shortly' and that the procurement process to meet service needs had been 'complex'.
A spokesperson added: 'It is crucial that the next generation of ambulance radios is fit for purpose for many years to come.'
Five years of talk, but still no roll-out The Department of Health produced a strategy document in 2000 that stressed the then 32 English ambulance trusts' 15-year old analogue radio systems needed to be upgraded to a single digital system.
In summer 2002, then junior health minister Hazel Blears announced to the annual Ambulance Service Association conference that the government would procure a 'modern national digital infrastructure' for the ambulance service.
The NHS Information Authority, which was tasked with leading the project, stressed that the service needed 'modern radio services capable of handling heavy data traffic needed for vehicle location and mobilisation'.
NHSIA project lead Mike Sprague said that a 'reliable data service' was needed to 'reduce errors and the need to retransmit information over noisy radio channels.
'Since 11 September 2001, the government has taken great interest in ensuring that the principal emergency services enhance their ability to communicate with each other at major disasters or incidents, ' an NHSIA briefing informed trusts, adding that it would lead on this.
The NHSIA said it would select a preferred bidder by January 2003, pilot the system by the end of 2003-04 and roll it out during 2004.
But the NHSIA has now been wound up as part of the government's programme to cut arm'slength bodies, and the project has slipped twice.
After a decision was taken to extend the digital radio project to Scotland and Wales and divide different parts of the projects to separate providers, health minister Rosie Winterton told parliament last May that full roll-out would be completed by the end of 2006-07, on a revised timetable that promised a provider would be signed 'imminently'.
Now, according to sources close to the project, 'complex and difficult technical issues' mean the project has lagged and a provider has yet to be contracted for the ambulance service, although the police have now rolled out an O2 digital radio system.
The Radio Authority is due to close down analogue frequencies in 2006.