Concerns about ambulance staff being held back from casualty scenes have been raised by the coroner who held inquests into the deaths of Derrick Bird and the 12 people he shot dead in Cumbria last year.

West Cumbria coroner David Roberts said there were clear concerns of national importance that came out of the four-week hearing involving communications between the police and the ambulance service.

The police airwave system struggled as armed officers were deployed to stop Bird and there was a lack of communication at strategic level between Cumbria Constabulary and the North West Ambulance Service.

The 52-year old taxi driver drove more than 40 miles around West Cumbria on 2 June last year, shooting 12 people dead and injuring 11 more before killing himself.

Ambulance crews and paramedics refused to attend shooting scenes until areas were declared safe as they followed health and safety protocol, which the police in Cumbria were not aware of and had not been consulted upon.

After the jury recorded verdicts of suicide for Bird and unlawful killings on each of his 12 victims, Mr Roberts said: “Clearly there are issues regarding the question of safe rendezvous points [with police] and whether these are going to be practicable in similar circumstances involving mass fatalities.

“It does not take a leap of imagination to see a situation where, if this incident was replicated, it may be the ambulance service or paramedic assistance would be needed for be someone to survive who otherwise would have died.”

He told the hearing that he would write letters of concern on the above issues to the home secretary and the health secretary.

Giving evidence on his independent review into the response on the day by Cumbria Constabulary, assistant chief constable of West Mercia police Simon Chesterman said such confusion about the response of ambulance staff “cannot go on”. He said the public should expect the emergency services to put themselves in the way of harm to protect them.

Following the inquests, North West Ambulance Service director of emergency service Derek Cartwright said: “The role of the ambulance service is to save life and I stand here proud of every one of the ambulance staff who were involved in this tragedy.

“It is my belief that the ambulance staff fulfilled their duties to the best of their ability, but we accept that, as often happens in cases such as this, there are lessons to be learned, albeit on a national level, and we need to reflect on the helpful comments made during this inquest.”

An independent review of how Cumbria Constabulary responded on the day ruled that police could not have stopped Bird any sooner.