• Message to trauma centres to prepare for possible further terrorist attack
  • Simon Stevens told NHS England board trusts are being urged to check staffing levels and mutual assistance plans
  • Terrorist threat level was raised to critical – the highest level – following attack in Manchester on Monday night

Emergency departments across the NHS have been told to prepare for a possible terrorist attack, following the raising of the threat level.

An alert has been sent to major trauma centres in England urging departments to be ready and to ensure staff know what to do if an attack takes place.

It follows a decision to increase the terrorist threat level from severe to critical – the highest level – after Monday night’s bombing at Manchester Arena, which killed 22 people. Police investigating the attack have said a potential terror network could have been behind the bombing.

HSJ understands the message to England’s 27 major trauma centres is the first time since the 2008 attack in Mumbai that NHS trusts have been told to prepare for a similar type of incident.

The message from Chris Moran, the national clinical director for trauma, said: “The trauma community in Manchester has provided a tremendous response to the atrocity on Monday night and this is a credit to their dedication and clinical skills and also the preparation that has taken place.

“You will be aware that we have a bank holiday weekend approaching. There are a number of things that all trauma units and major trauma centres can do to prepare for a further incident and I should be grateful if you could disseminate these within your network so that frontline clinicians are aware.”

The message urged trusts to ensure all staff have easy access to their major incident plan.

It also said trauma clinicians should:

  • review their meeting point;
  • review their role in a major incident;
  • remember to carry identification;
  • know where their entry point will be if the hospital is in “lock down”; and
  • consider they may need to walk to reach the hospital.

The message advised surgical teams to prepare for the consequences of attacks by reviewing the early management of patients with blast and ballistic injuries, as well as advice on dealing with infections and use of antibiotics.

NHS England chief executive Simon Stevens told its board meeting this morning that trusts are being urged to check staffing levels and mutual assistance plans.

In a separate letter sent to trusts yesterday, Anne Rainsberry, national incident director at NHS England, said trusts needed to take specific steps following the increased threat level. These include reviewing staffing levels, equipment stocks and blood supplies as well as identifying patients who could be discharged safely to create capacity.

An NHS England spokesman added: “Since the [Joint Terrorism Analysis Centre] has announced the threat level has changed from severe to critical, this triggers longstanding, tried and tested NHS protocols reflected in this letter, which reminds NHS organisations of the precautionary measures they need to take ensure care is in place should it be needed. “

Following attack on Monday, 116 people received inpatient care with 75 people admitted across eight hospitals, including 23 patients in critical care units.

There are 27 major trauma centres in England, of which 11 treat both adults and children.