UK hospitals poorly prepared for a 'major incident,' say researchers

UK hospitals are poorly prepared to cope with a "major incident," such as an act of terrorism, say doctors in Emergency Medicine Journal.

Prompted by the events of July 7 2005, in which 52 people lost their lives following acts of terrorism on public transport in London, the authors set out to discover if emergency care departments across the country were any better prepared than in 1996, when they were last surveyed and found severely wanting.

For the current survey the authors telephoned 179 senior doctors working in anaesthesia, emergency care, general surgery, trauma, and orthopaedics in 34 UK hospitals, to ascertain their readiness to respond to a major incident.

In all, they obtained 144 responses. Almost half of the respondents (47%) had not read any of their particular hospital's major incident plan.

And only just over half of the doctors (54%) were clear about the specific role they would have, should any major incident occur.

The authors then contacted the major incident coordinators in each of the hospitals represented in the survey. Only 17 responses were obtained, a feat which the authors described as "remarkably difficult to achieve."

Their questioning revealed that the frequency and timeliness of dry runs of responses to potential major incidents varied widely.

Most of the hospitals (82%) had carried out a dry run within the past five years, but only around a third (35%) were planning to do so within the next 12 months, despite the need for regular rehearsals.

And one on four of the hospitals said that they did not include any incident planning teaching in induction sessions for junior and middle grade doctors.

Lack of funds, absence of a designated incident coordinator, and inadequate technology were blamed for the inability to improve preparedness for a major incident.

Responses were similar, whether doctors were based in London or elsewhere, the survey showed.

The authors comment that, given the number of recent atrocities round the world, and the increasing regularity of false alarms and foiled plots, "it is highly likely that that British hospitals will face an increasing number of major incidents in the future."

"Preparedness for major incidents in the UK remains poor 10 years after [the original survey]. Effective major incident plans require forethought, organisation, briefing of relevant staff, and regular rehearsal," they conclude.