Trusts should seek extra funding to be ready for major incidents, says inquiry

Only seven of the 319 North West Ambulance Service Trust vehicles available on the night of the attack, in 2017, were able to deploy immediately, the report said. It said experts believed that “such a situation would almost inevitably be replicated if a similar incident were to occur again anywhere in the country”, given current resources and demand.

Ambulance trusts are now hugely more stretched than in 2017, with response times having significantly lengthened due to lack of resources.

The second volume of the report from the inquiry, chaired by Sir John Saunders, published today, is critical of the emergency services’ response to the bombing which killed 22 people. NWAS “failed to send sufficient paramedics into the City Room [an area adjoining the Arena]” and did not use available stretchers to remove casualties in a safe way, it says. A key role for managing the incident – that of ambulance intervention team commander – was not allocated for half an hour.

But it also raised issues of ambulance capacity and availability for major incidents involving mass casualties. “Around the UK, ambulance services are always ’playing catch up,’” it said, with no spare frontline capacity.

With demand doubling over the last 10 years, the inability to respond to such incidents is only going to get worse – and lives will be lost if they do not attend the scene quickly and in sufficient numbers, the report said.

Sir John concluded that all ambulance services should review their capacity to respond to a mass casualty incidents and make recommendations to their commissioners about any additional or different resources they need.

The Department of Health and Social Care should give “urgent consideration” to recommendations made by the trusts and the commissioners, it added.

The inquiry also made recommendations for how ambulance trusts could fine tune their response to major incidents, organise the efficient triage and transfer of patients to hospital and better equip those on the scene to save lives.

Daren Mochrie, chief executive of NWAS since 2019, told a press conference that he accepted that more staff should have been deployed into the City Room and that there was “deep regret” that the ability of blue light partners to work together fell short of expected standards.

“The principles of multi-agency working are incredibly important to the way we deal with major incidents. It should never have broken down so quickly and so drastically,” he said.

“We take our share of the responsibility for that. We failed to communicate situational awareness reports, we failed to share our major incident declarations, and we failed to establish adequate communication between our control rooms and each other. 

“I am confident that if something like this happens again the response will have more effective preparation, management and coordination between the blue light partners here today. I also believe that everyone at NWAS would strive to respond with professionalism, compassion, and the desire to help.”

A DHSC spokesperson said: “This report is a devastating reminder of the Manchester Arena attack when 22 lives were lost. Our emergency services show incredible courage when responding to appalling incidents like this, and we are grateful to the Inquiry for the work to examine this attack.

 “We are carefully considering all recommendations aimed at the department and its delivery partners from the report, and are working with partners to understand what steps can be taken.”

Updated 19.45 with DHSC comment