Current UK NHS emergency and continuity of operations plans are ‘vastly inadequate’
In the paper – ‘Thinking the Unthinkable: the NHS and Terrorist Action’ - Charles Hancock and his co-author, Professor Chris Johnson from the University of Glasgow, use a fictional scenario to stimulate debate about possible terrorist attacks on NHS premises. Charles and Chris believe that current NHS emergency and continuity of operations plans are ‘vastly inadequate’, containing little planning to manage the risk of direct terrorist attack. The fictional scenario used in the book involves a major fire and resulting gas explosion at a hospital, and simultaneous car bomb explosions at two local fire stations. To develop the scenario the authors examined the plans of several NHS trusts and the ways in which staff responded to previous non-terrorist incidents, and drew on their direct involvement in evacuation drills. They also used a specially devised simulation of evacuation procedures, using a computer-generated model of NHS facilities and current evacuation practice. Through this simulation they were able to estimate how long it would take to evacuate a ward with different types of patient. For instance, they estimate that it could take almost six times longer to evacuate a ward with non-ambulant than with ambulant patients. Charles Hancock believes that current NHS emergency procedures need to be reviewed urgently to address the very real risk of terrorist attack. "At the moment, most of the NHS's current risk management work focuses on the role of healthcare workers in the response to a major terrorist incident, but their planning and training scenarios rarely consider what might happen if an NHS facility were itself the target of an attack," explains Charles. "Its emergency plans concentrate on dealing with low-intensity, isolated incidents which are caused accidentally. Major assumptions are also made, for instance that the hospital's communications systems will remain open and that the fire protection system will be adequate. He continues: "Only key individuals – i.e. those who it's assumed will play critical roles in any evacuation - undergo training, and therefore few staff ever participate in practice evacuations. "And the training itself focuses heavily on the use of 'horizontal evacuation' procedures - moving patients to safety in another part of the building. The assumption is that the emergency services will arrive in time to handle larger, more serious incidents, and evacuate patients from the building if necessary. But experience of terrorist attacks and natural disasters have shown that prompt intervention from external agencies can be delayed." In their article, the authors put forward several points for NHS managers' consideration in revising their emergency procedures. They suggest that: "Hospitals are very ‘un-secure’ places. Through our studies of previous hospital evacuations, we found that gaining access to a hospital was easy - terrorists could pose as visitors, agency nurses or care assistants, and hospital security, while much improved in recent years, was still far from perfect," says Charles. "The threat of terrorist attack is very real, and it is vital that hospitals have adequate plans to help them deal with such situations."
•Date: 13th June 2006• Region: UK • Type: Article •Topic: Public sector |
