LONDON BOMBING: THE RESPONSE NHS managers' accounts from the front line

Published: 14/07/2005, Volume II5, No. 115 Page 8

Thursday's four bombs left around 700 casualties, many of whom needed NHS treatment.

Four hospitals were at the heart of the rescue operation: the Royal London had over 200 patients, over 60 patients were taken by both the Royal Free and University College, and around 40 were taken by St Mary's. But trusts across the capital were involved in the operation: Great Ormond Street Hospital for Children, Whittington Hospital, Guy's and St Thomas', Chelsea and Westminster Healthcare, King's College Hospital, North West London Hospitals, North Middlesex University Hospital, Barnet and Chase Farm Hospitals, and Moorfields Eye Hospital all treated casualties.

Meanwhile, managers played their part in makeshift rescue operations to give support and treatment to the injured and traumatised.

Westminster PCT

A remarkable sequence of events led to victims of the bomb at Edgware Road underground station being treated by staff from Westminster primary care trust in a Marks & Spencer store and a hotel.

An osteopath from the PCT, travelling on a tube train behind the one that was hit, raised the alarm. Firstaiders from the PCT, based in nearby Marylebone Road, were rushed to the store next to the station where casualties were gathering.

Moments later PCT head of occupational health services Christine Hunter was walking past the store when she was called in to help by its manager, who she knew from the trust's slimming programme.

Ms Hunter, who is also a nurse, co-ordinated the triage efforts at M&S before the emergency services arrived.

Staff from various PCT clinics, including physiotherapists, a diabetes nurse, midwives and even clerical staff dashed to help.

'The people coming in were disorientated, some were hysterical, some were crying quietly, some were full of cuts and bruises. When they shook their hair glass fell out like dandruff, ' said Ms Hunter.

'We comforted people, we checked them for injuries, we gave them first-aid dressings, we cleaned them as best we could. The atmosphere was terrific; it was complete calmness in the middle of all this chaos.' After around an hour, a security alert at the store meant the walking wounded were transferred to the Hilton London Metropole hotel across the road.

Meanwhile the PCT played a vital role in identifying patients who could be discharged from St Mary's Hospital in Paddington so it could treat the acutely ill.

'It was good to be involved, otherwise had you been sitting and looking, not knowing what was happening first hand, you would probably have felt a great deal of uncertainty, anxiety and anger, ' said Ms Hunter.

'If you are in the middle of it you give your all to get on and do something. I never thought about myself or another bomb going off or even my family until late in the morning.'

Royal Free Hospital

Planning for the millennium bug helped staff deal with emergency admissions at the Royal Free Hospital in Hampstead, north London, when mobile phone systems went down.

Trust divisional director for medicine Lorna Donegan said preparing for the bug meant the trust's major incident plan could revert back to 'human to human' contact.

Medical students and hospital staff from departments that had closed down as part of the major incident plan acted as runners to keep people in contact throughout the morning.

'Even when things got very busy we were able to revert to the more traditional model of sending people with notes and they were all on standby and ready. There was never a time when we couldn't get messages to people, ' said Ms Donegan, one of the managers responsible for accident and emergency on the day.

And she was full of praise for staff: 'Obviously A&E staff are prepared. This is the kind of day they hope never happens but they are all trained to expect.'

St Mary's Hospital

The efforts of more than 200 members of staff who worked non-stop for more than six hours at St Mary's Hospital, Paddington, were praised by A&E consultant Dr Trish Ward.

'Including nursing staff, catering staff and domestic staff, 203 people were all involved, ' she explained.

'The trouble was that it was a very prolonged incident - that is the most difficult thing. We got our first call at 9.20am and we didn't stand down until around 4pm or 4.30pm, so it is quite a long time.

'Everybody had a role to play.'

Whittington Hospital Hospital staff had the extra burden of fearing their own loved ones could have been caught up in the blasts when they were dealing with victims.

Whittington Hospital trust major incident controller Fiona Elliott said psychologists, social workers and a mental health liaison team were on hand to help staff as well as patients.

'This was different to other major incidents because such a huge chunk of London was involved and what we were also trying to cope with was the anxiety of staff at not knowing where their families were, ' said Ms Elliott.

'Not only were our staff trying to key themselves up to receive casualties, but they were also trying to cope with the fact that there was no network for mobile phones and they had to wait to find out whether their relatives were alright or not.'

University College Hospital

Support for the A&E department at University College Hospital, Euston, was so overwhelming that at one point it had twice as many doctors as casualties.

The hospital received offers of assistance from around the world.

'We had a fantastic response from our own staff and academic staff from the university, ' said University College London Hospitals foundation trust chief executive Robert Naylor. It dealt with 50 casualties following the attacks.

'A whole lot of academics came across the road to help and at one stage we had twice as many doctors as casualties, ' added Mr Naylor.

'We had offers from clinicians from all over the country. In fact we had offers of assistance from some colleagues from a hospital in Israel.' At the time of going to press the trust had a member of staff missing.

A senior clinical academic at the trust is stable in intensive care.

'It has obviously had a devastating and traumatic impact on staff that we have had these people involved, ' said Mr Naylor.

'It has also had quite a traumatic effect on some of the frontline staff, in particular the younger members who have never experienced anything like this before.'