An inquiry into the 2017 Manchester Arena terror attack has made a series of recommendations for events after identifying numerous failings by the emergency services.

The Manchester Arena Inquiry, led by chairman Sir John Saunders, yesterday (3 November) published the second of three reports about the bombing, which killed 22 people at an Ariana Grande concert on 22 May 2017.

The inquiry heard that firefighters did not arrive at the venue until two hours after the explosion, only one paramedic entered the scene in the first 40 minutes. Greater Manchester Police did not declare a major incident for more than two hours.

It concluded that injuries suffered by one of the victims – 28-year-old John Atkinson – were survivable but for “inadequacies” in the emergency response, and found that the venue’s then event healthcare provider Emergency Training UK (ETUK) “had not adequately prepared to deal with a major incident response”.

“THERE WERE NOT ENOUGH STAFF WITH NECESSARY CLINICAL QUALIFICATIONS, SKILLS AND EXPERIENCE ON DUTY”

“There were not enough staff with necessary clinical qualifications, skills and experience on duty,” it states. “Some staff were not sufficiently qualified to provide healthcare at events… Overall, ETUK’s provision of a healthcare service on the night of the attack was inadequate.”

ETUK’s director, Ian Parry, had failed to refresh his expired qualifications on major incident management and advanced life support, while ETUK staff members provided their own first aid equipment because equipment provided by ETUK was insufficient.

Manchester Arena operator SMG was criticised for taking an “unacceptable approach to ensuring that there were adequate healthcare services at the arena”. “SMG failed to carry out basic checks that would have revealed major deficiencies in ETUK’s approach,” it says.

In his 716-page report, Sir John recommends that SMG should review its processes to ensure that it shares its most current emergency response plans and policies for dealing with an incident at the arena with the emergency services, and to review its approach to the provision of healthcare services and equipment at the venue.

MEMBERS OF SHOWSEC STAFF, INCLUDING THOSE WHO HAD BEEN INJURED, “DID THEIR BEST TO HELP THOSE AFFECTED BY THE EXPLOSION”

In a statement, SMG, which is now part of ASM Global, says the company has been “committed to helping the inquiry throughout”, adding that it welcomes “any recommendations from the chair which will give clearer guidance to events medical services providers and organisers, as well as improve industry standards even further”.

Members of Showsec staff, including those who had been injured, “did their best to help those affected by the explosion”, notes the report. SMG event technicians and other employees also did the same.

Among Sir John’s 149 recommendations within the report are that “a standard should be set for the level of event healthcare services that are required for any particular event”.

“I recommend that DHSC [Department of Health and Social Care] consider what that standard should be,” he adds. “I do not consider that it is a standard that should be contained only within guidance. Serious consideration should be given to putting it on a statutory footing. The consequences of failing to meet the standard could be fatal.”

“IT IS VITAL THAT ESTABLISHMENTS OF A SIMILAR SIZE TO THE ARENA HAVE A REASONABLE NUMBER OF ADEQUATELY TRAINED AND EQUIPPED MEDICAL STAFF ON HAND TO GIVE EMERGENCY CARE”

He continues: “There will always be a time lag between the emergency having happened and the arrival of the emergency services that are able to assist the casualties. That is a critical time when lives can be lost if no action is taken to save casualties. This makes it essential that as much help as possible can be provided on site by people who are in the vicinity and prepared to help. This means that it is vital that establishments of a similar size to the arena have a reasonable number of adequately trained and equipped medical staff on hand to give emergency care, to bridge the gap before the ambulance service and the fire and rescue service can arrive.

“Standards need to be laid down and enforced to ensure that this happens. There needs to be liaison between site operators and event healthcare staff and the ambulance service to co-ordinate their responses to an emergency.”

Other recommendations made in the report include all event healthcare staff being trained in, and having immediate access to, tourniquets; as well as compulsory training in major incident response. DHSC was urged to review the provision of Public Access Trauma kits “in all locations where they are most likely to be needed”, while the Department for Education was asked to consider a national scheme to teach pupils how to deal with catastrophic injuries.

The findings follow the first report, published in June 2021, which found there were multiple “missed opportunities” to prevent or minimise the impact of the bombing.

The report, which looked into security arrangements at the arena on the night of the bombing, concludes that bomber Salman Abedi should have been identified as a threat on the night of the attack.

Sir John found a number of security failures that he says would have reduced the impact of the bombing, if not prevented it completely. The “most striking missed opportunity”, the report details, came from a member of the public, who raised concerns to stewards about Abedi’s suspicious behaviour in the run-up to the attack.

Chief Constable of Greater Manchester Police Stephen Watson yesterday apologised for the “substantially inadequate” response to the bombing.

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