Ambulance services underprepared for ‘mass casualty incidents’

Ambulance services would still struggle to respond effectively to a mass-casualty event like the Manchester Arena bombing, HSJ has learned, as nearly all have been denied the funding needed to bolster preparedness.

The public inquiry report on the May 2017 attack, which killed 22, was sharply critical of the emergency services’ response, including North West Ambulance Service Trust. The inquiry’s November 2022 report made nearly 150 recommendations to prepare for future attacks.

Crucially, ambulance trusts were told to review their capacity to respond to a mass-casualty incident – including whether they had enough trained specialist staff – then tell commissioners what extra funding they need to ”respond effectively”.

Gaps identified included the availability of 24/7 “critical care cars”, specialist practitioners in hazardous area response teams, and tactical commanders in operations centres.

But eight out of England’s 10 ambulance trusts have confirmed to HSJ – through Freedom of Information requests and follow-up enquiries – that they have not received funding from commissioners to cover what they found was needed.

HSJ understands that, while some trusts have strengthened specialist teams using other income, they have not received funding for the majority of what the reviews said was needed, and there are therefore still significant gaps in readiness.

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Source: 14 February 2025