Ashford and St Peters Hospitals NHS Trust

Every NHS major incident receiving hospital is required to undertake a full unannounced test of its major incident plan every three years.   In addition at Ashford and St. Peter’s a ‘table top’ exercise is undertaken every year and every six months communications and call out systems are tested.

For this triennial full exercise St. Peter’s Hospital along with three local hospitals were theoretically ‘activated’ but for the purpose of the exercise only St. Peter’s received the activation call and live casualties.   A total of 25 walking wounded, 5 seriously injured, 6 critical cases and 2 dead were received at St. Peter’s Hospital.   The role of the live casualties was taken by trainee police constables and volunteer staff from Surrey Police.   They were transported to St. Peter’s in a fleet of ambulances organised by St. John’s Ambulance who in a real major incident would provide support to South East Coast Ambulance Service.

At the scene of any major incident, casualties are triaged and sent by ambulance to hospitals with the capacity to cope and depending on the assessment, the specialist services required.   For example whilst  St. Peter’s has a major A&E for trauma, serious burns and brain injury cases would be taken for specialist treatment, after the patient is stabilised, to hospitals such as the Atkinson Morley (for brain injury) or Queen Victoria at East Grinstead (for burns).

As soon as St. Peter’s Hospital was activated an automatic call out system sent messages to pagers and mobile phones to alert key staff.   Phone calls were also placed to some key staff to enable them to be briefed quickly.   These staff then started a well rehearsed routine to implement the Trust’s Major Incident plan and either delay staff going home from their shift or bring additional staff in to cope with the casualties.

As in a real incident some of the first people to arrive at St. Peter’s were representatives from the media – including Woking News and Mail, Surrey Comet, Surrey Herald and BBC Southern Counties Radio along with around 15 trainee journalists fromNewscene.    Standing outside A&E in the cold light of early morning they were able to witness ambulances and patients arriving and were first briefed by Police and hospital spokesmen at 07:30hrs.   Two briefings in the hospitals temporary media centre with hospital Chief Executive, Paul Bentley, were held at 08:30 and 10:00.   Outside A&E interviews were also conducted with hospital nurses, a ‘patient’ and a senior ambulance man from South East Coast Ambulance Service.

In A&E staff coped with both the influx of patients from the exercise and real patients and the additional staff who stayed behind and were brought in made a real difference.   Most of the hospital was able to continue operating normally although in a real incident some major surgery would have to be postponed and patients who were assessed as ready would be discharged to Ashford and neighbouring community hospitals.

Co-ordination of the hospital’s response to the incident was managed from an Incident Control Room set up in the centre of the hospital.   Staff that were activated as part of the major incident were required to report to the control centre and collect equipment and instructions or be allocated to tasks.   Volunteers play an important role in major incidents by providing support to both staff and relatives.   A special centre for relatives was established in the Education Centre at St. Peter’s staffed by volunteers and the Trust’s chaplaincy service.

Speaking after the exercise, which ended at around 10:30hrs, Trust Chief Executive Paul Bentley said: “This was a real test of how the organisation would cope and I am proud of the way hospital staff and volunteers reacted.   As a major Accident and Emergency Centre, with nearby Heathrow and the busiest stretch of motorway in the country running past our front door, it is important that we are prepared for all eventualities.   I am pleased to say that everything went really well and we will be ensuring that the lessons we have learnt from this morning are implemented and shared with our colleagues elsewhere in the NHS and emergency services.”