Half of key UK hospital doctors 'ill-prepared' for major incident
Half of key hospital doctors likely to be involved in responding to a major incident in the UK are not properly prepared, a survey has suggested.
Researchers said incidents including the Manchester Arena attack and the Grenfell Tower fire in London demonstrated the need for an incident plan.
But doctors are less prepared than their peers were in 2006, when the last survey looking at this issue was carried out, findings published in the Emergency Medicine Journal suggest.
Researchers at Oxford University conducted a phone survey to find out if the relatively low level of preparedness more than a decade ago had changed.
They contacted 296 specialist trainees (on-call registrars) in emergency medicine, trauma and orthopaedics, anaesthetics and general surgery from 74 hospital trusts that had dealt with more than 30,000 patients in emergency care in the first three months of 2017.
They had responses from 186 (63%), while the rest did not respond or did not consent to being included in the survey.
All hospitals in England are required to have a major incident plan (MIP) to respond to an incident involving a large number of casualties. Half of specialist on-call registrar respondents had not read the plan at all, while about one in four had read part of it.
Less than half of respondents (47%) knew where to find a copy of the plan, one in six (just under 18%) did not know where to locate it, and the rest were unsure.
When asked what role they would have in a major incident response, just over a third (36%) knew what they would be required to do. A similar proportion (37%) were not sure, and about one in four (27%) did not know.
Among those responding, emergency medicine doctors were the most prepared, but researchers said it was worrying that the overall situation had not changed in 12 years.
“Of concern, we found no improvement since 2006: indeed, fewer individuals were confident in the role they would play if an MIP came into effect while they were on call,” the report, Preparation for the Next Major Incident: Are We Ready? A 12-year update, says.
The primary author, Dr Jamie Mawhinney, now at St Thomas’ hospital, said: “The take-home message from my study is that the majority of middle-grade doctors in England are not confident in the role that they should play in a major incident.
“We were surprised that this was the case, especially given recent high-profile emergencies in the UK such as the Grenfell Tower disaster and the London Bridge and Westminster terror attacks.
“Our results in fact show that registrar doctors are less confident in responding to the major incident plan than previously. In order to improve confidence amongst staff I believe it will be necessary to increase training. Specifically we believe that all doctors should receive education on their hospital’s major incident plan at all trust inductions, as well as an abbreviated version of their own particular role.”
The researchers said the findings of the observational study needed to be considered in light of the response rate of just under 63%.
They said the study included only specialist registrars who would be expected to lead the emergency response, but major trauma centres in the UK are moving towards 24/7 consultant cover.