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Head of the National Audit Office Sir John Bourn today reported to Parliament on how well prepared the NHS is to respond to disasters. The NAO started this study before September 11 2001 and since then updated its work to take into account progress made by the NHS in this area during the subsequent period of heightened awareness of terrorist threats.

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According to the report, the NHS is prepared to cope with the sort of major incidents of the kind experienced up to now such as rail and plane crashes. There is also a scale of incident to which no NHS or other organisation could be expected to respond fully; and it is not sensible to expect everyone in the NHS to be prepared for everything. However, the report found that, while there had already been improvement in the planning for major incidents, there was still more to do especially for the newer post September 11 threats.

The purpose of today’s NAO report was to assess the adequacy of major incident planning by the NHS, identify areas of good practice and assess the potential for this to be spread more widely. The report was not intended to address wider issues of emergency planning outside the NHS or the likelihood of any particular disaster occurring. The NAO found that, in the best cases, there had been a thorough review of hazards and a proper assessment of the required response. There had also been substantial improvements since September 11. However, momentum needed to be maintained to deal with remaining weaknesses in the following areas: planning for incidents, testing the plans, training relevant personnel, the provision of protective equipment and decontamination facilities and dealing with hazardous substances. There were also geographical variations in the adequacy of planning arrangements.

Among the NAO’s recommendations are that the Department of Health provide guidance on how to develop major incident plans and commission a training strategy for dealing particularly with major incidents associated with deliberate release of hazardous substances. Chief Executives of acute and ambulance trusts should also take immediate steps to identify and address any deficiencies in NHS trust major incident plans and planning arrangements, including the feedback of lessons learned into the planning process, and ensure that they cover mass casualty and chemical, biological, radiological and nuclear incidents.

"Since the events of September 11, the NHS has made a concerted effort to improve its planning and preparedness for dealing with major incidents and in many respects has succeeded. But there is still room for improvement in the systems in place to ensure that the NHS response is as good as possible.

"I recognise that there are limits to what can be done in improving readiness. Some incidents are of a scale for which no organisation could expect to be fully prepared. And it does not necessarily make sense for everyone in the NHS to be prepared for every eventuality.

"However, the nature of the threats now potentially facing us means that the Department of Health and the Chief Executives of hospital, ambulance and primary care trusts need to continue to act with determination to improve their planning and readiness."

Sir John Bourn


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