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View Article  LAS Official Response To 7th July Review

News Statement

5 June 2006

Response to London Assembly 7 July Review Committee report

To be attributed to Chief Executive Peter Bradley:

"The events of 7 July were unprecedented and the courageous actions of our staff and their colleagues from other agencies undoubtedly saved lives.

"We have acknowledged we faced difficulties with communications that day, but this did not prevent us treating and transporting more than 400 patients to hospital from all the sites within three hours; this is a testament to the way everyone involved handled what was a tremendously challenging situation.

"We have been honest about the fact that there were a number of lessons to learn, and indeed the Committee has previously praised us for the amount of information we have made available.

"While the committee’s findings broadly reflect those of our own debriefs, we will study the recommendations closely to ensure they are fully addressed in our ongoing work to further improve our ability to manage future incidents."

Ends

Notes to editors:

Our full response provided to the Assembly in March can be found on our website – www.londonambulance.nhs.uk

Improvements to our major incident planning since 7 July

Since the events of 7 July, we have made a number of improvements to the way we will respond to major incidents. These include:

  1. • Issuing radio pagers to managers for use in major incidents
  2. • Developing a pre-determined response for any future major incidents, including sending 20 ambulances and six managers to the scene as soon as a major incident is declared
  3. • Reconfiguring our new incident control room, with an improved ability to manage multiple simultaneous major incidents
  4. • Successfully lobbying to be brought forward in the rollout of the new national digital radio system for ambulance services. This will be introduced next summer and will be fully operational in early 2008. Ahead of this we will also be receiving an interim allocation of 200 digital radio handsets. The first of these will be arriving next month and will be issued to operational managers.

  1. • Reviewing levels of equipment carried on our emergency support vehicles, as well as now carrying additional supplies on 25 training officer vehicles.

Our response to specific issues within the London Assembly’s report:

Communications/mobile phone issues

We have been open about the fact that we were over-reliant on mobile phones. We have now issued all our managers with radio pagers, which are more resilient in a major incident.

Technically our radios worked, though we have admitted that the volume of traffic on our radio system made it difficult for managers to get through and speak to the control room. We have made changes to our internal procedures to address these problems, and have reconfigured our major incident control room so we can deal more effectively with a number of simultaneous incidents. The Service has also been brought forward in the roll-out programme for a new national digital radio system for ambulance services, and this should be fully operational early in 2008.

To clarify, it was our managers who had difficulty in communicating with our central control room that day; once at scene our ambulance crews come under the direct control of local management teams and do not need to contact our control room for instructions, either by mobile phone or radio.

Use of hospitals

On 7 July, we initially put all the hospitals in London on standby, letting them know that a major incident had occurred and that we might need their assistance. We then confirmed with seven hospitals that we would be bringing patients into them.

Distribution of patients to these hospitals was generally good, with the exception of the Royal London Hospital which received three busloads of patients with minor injuries from two of the scenes. Faced with communication problems, our operational managers on the ground quite rightly took the decision to use the buses based on information they were receiving from ambulance crews and their local knowledge of hospitals in the area.

There is no doubt, however, that if communications had been better, we would have achieved a better distribution of patients with minor injuries by spreading the load across three or more hospitals.

Delay in additional ambulances being sent to Russell Square

We got to all the scenes very quickly and gave priority to those people who were most seriously injured, treating and taking them to hospital as quickly as possible.

We experienced delays in getting a second wave of ambulances to Russell Square; our communication problems made it difficult for our managers to request further resources, and it is also evident that ambulance crews who were on their way to Russell Square instead became involved with the rescue operation at the bus bombing in nearby Tavistock Square. Once it became apparent that this was happening, staff were redeployed to Russell Square.

The delays in sending the second wave of ambulances meant that it took us longer to get the less seriously injured patients to hospital, but we still managed to treat over 400 patients and take them from the sites within three hours.

Availability of medical equipment

Given the nature of the incidents and the large number of casualties involved, it was inevitable that medical supplies were going to be used up quickly. We accept that there were delays in getting further equipment to some of the scenes, but we worked hard do address this and were able to move all patients to hospital within three hours.

We have since reviewed levels of equipment carried on our emergency support vehicles, and we also now carry additional supplies on 25 of our training officer vehicles.


Thanks to the folks in the communication department for getting back to me and letting me post this up on here.  As I got it off our internal network, I thought it best to ask permission first.

View Article  My Thoughts On The 7/7 Report

As always, the thoughts on this blog are my own, and have nothing to do with my employer, the London Ambulance Service.  I do not represent them in any official capacity and the views here are how I see things and I may have incorrect information.  Also while I’ve read the report, my sinuses are blocked and my head feels like it’s going to explode.

The report on the 7/7 bombings makes interesting reading and despite what some of the media may have you believe it is not ‘slamming’ the response of the emergency services.  (I could mention all the ways in which ‘The Sun’ report is inaccurate, but I can’t be bothered wasting my breath).

Personally I agree with a lot of what it suggests.  In the whole I think that it is a reasonably balanced report and that a lot of the changes it suggests are reasonable ones.

However there are a few points that I believe are misinformed.

The people making up the review take on the role of ‘informed layperson’ – looking at the backgrounds of the people involved in the review, one is a barrister specialising in employment law, one has a degree in economics, one is a solicitor, one a business trainer and one has a BA in politics and economics (and incidentally studied where I trained to be a teacher).

My concerns about the report is that I believe none of them have any experience in emergency situations.  It is very easy to look back and criticise the actions on the day – but the ‘fog of war’ is a very serious obstacle.  Much like you, dear reader, perhaps had little idea of what ambulance work was like until you read this blog – I think that some of the reports recommendations show a lack of understanding of what a major incident is really like.

The main finding and recommendation of the report is that the communication network was inadequate, and that more should be done to improve communication between staff on the ground and Gold Control, who’s job it is to coordinate our response.  Eighteen years after the Kings Cross fire and the emergency services still needed to rely on ‘runners’ for communication as the radios we have don’t work underground.  With this I recommendation I agree completely, our communication needs to be upgraded – unfortunately, from what I hear the TETRA airwave system that we will be getting in the start of 2008 is not going to solve many problems.  It simply isn’t as good a system as people would have you believe.  (But this is a topic for another post).

There are some recommendations which are a little strange, such as allowing medical staff who are untrained in pre-hospital care to start setting up field hospitals and the like.  While medical knowledge is incredibly useful, it’s also very useful to not have people who may be unaware of all the dangers on scene wandering around explosion sites in nothing more than theatre scrubs.

I understand the urge to help, I would have done the same when I was working in A&E and I don’t want you to think that I’m degrading the work that these volunteers did on the day – but the risk of creating more casualties is just too high.

One thing that the report does is to record the accounts of members of the public caught up in the explosions – unfortunately the report does not mention that in such times of trauma the brain can easily become mistaken with what is happening.    Perception of time can become altered – two minutes can easily feel like ten.  Also there can be a misperception of what the first ambulance on scene does – on arrival the driver should stay in the ambulance and provide communication with Control, while the attendant makes a survey of the scene in order to report on what additional resources are needed.  The first ambulance on scene does not treat any patients until the scene management is taken over by an officer.  Add in that the first person needs to be sure that the track current is off, and then needs to walk fifteen minutes to get to the train – spend a couple of minutes assessing what has happened and then walk another fifteen minutes to get back to the ambulance, and it is unsurprising that a lot of the injured felt that the ambulances took a long time to arrive.

While the evidence from the public should be gathered, I think that by publishing emotive eyewitness reports on what they believed happened is a poor idea.  In some places the report reads more like a disaster movie rather than a report on how to better improve our response.

Some mention is made of the lack of equipment, unfortunately in the first response to a major incident you are going to get ambulances, and not the ‘bigfoot’ support vehicles – we can only carry a limited amount of equipment in an ambulance, and to be honest it’s not unusual to only need to use an oxygen mask or two in the course of a normal twelve hour shift – so while we are equipped to deal with a patient or two, we simply do not have enough room in our ambulances to stock for major incidents.

As I said at the start – the report makes a number of excellent points, and at no time does it criticise the actions of those ‘on the ground’ who did an excellent job under difficult circumstances.

I know that the LAS has already made improvements, such as reinstating the ‘obsolete’ paging technology for it’s managers – something that came in extremely useful two weeks later with the failed second attacks.  I do have the LAS’ news release concerning this report sitting on my computer, I just need to OK to post it here…

Welcome to Random Acts Of Reality, a Blog based in London, England, written by an E.M.T working for the London Ambulance Service. Also, number one search result for "Womble porn". All names have be changed to protect the guilty. This Blog was previously known as "Why I Hate Humanity" but the antipsychotic medication seems to have kicked in.

All opinions on this website are mine alone, and may not reflect those of the L.A.S or other ambulance crews

Find out more about me here.

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