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U N I T GENERAL. MANAGE?

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Use

Numbsr o f Pages

am t h e U n i t G e n e r a l M a n a ge r a t Jims N o r t h e r n G e n e r a l H o s p i t a l ,

S h e f f i e l d , an a my q u a l i f i c a t i o n s a r e AHSi i „ I ha vs been i n t h i s p o s t

s:=. nee 2 2 A u g u s t "1988 ( 2 2 0 8 8 8 ) , , I was f o r m e r l y t h e U n i t G e n e r a l

M a n a g e r a t t h e D o n c a s t e r R o y a l I n f i r m a r y , , I have been i n t h e H e a l t h

S e r v i ce s i n c e A u g u s t 1 9 7 Q

The N o r t h e r n G e n e r a l i s a l a r g e T e a c h i ng D i s t r i c t G e n e r a l H o s p i t a l

w i t h a number o f m a j o r r e g i o n a l s p e c i a l t i e s , i n c i u d i n g c a r d i o t h o r a c i c

m e d i c i n e and s u r g e r y , r e n a l s e r v i c e s , b u r n s a n a p l a s t i c s , , I t has

a p p r o x i m a t e l y 1 1 , 0 0 0 beds and 3 , 5 0 0 i n d i v i d u a l members o f s t a f f , , i t

has a budge t o f £. 14 m i I I i o n pe r annum i n t he new y e a r and c omrn i 11 s d

c a p i t a l e x p e n d i t u r e up t o £ 3 0 m i l l i o n - I t has one o f t h e two A c c i d e n t

and E m e r g e n c y D e p a r t m e n t s w i t h i n t n e S h e f f i e l d D i s t r i c t ? t h e o t h e r i s

PAGE S 139 "i

at tne Royal hallamshire Hospital,, As Unit General Manager I am

responsible for the overall efficient management of tne hospital and

a 11 o f i t s r e s o u r c e s .

Tne Mortnern General ana Royal Ha.;, lams hi r a Hospitals each have their

awn Major Disaster Procedure, althougn Ins re is a section in the

procedures common to both. Inis provides that the District hospital

Control point will i>e established at the Royal Ha 1 1 a ms h i r e Hospital

but that tne choice as to which hospital is to be the m i l iai

receiving hospital for casualties will be dependent upon a range of

factors, including the location of the accident, the number of

casualties involved and the nature of the incident. In view of the

proximity of the northern General to tne Sheffield Wednesday footaai

ground 1 had always assumed that any major accident at the ground

w o Id re s ii 11 i n t h e N o r t h e r n G e n era 1 o~: i n 9 t h e 1 n 11 i a 1 re c e i v 1 n g

centre? and indeed this is what happened on To April ( 1 :.:>u,;toV)

I vi a iVi a j 0 r d i s aste r m y f u n c t i 0 n i s to set u p t h e h 0 s p 11 a 1 C o n t r o 1 ̂ ■ — ' 1 — — — — — — — — — — ———— — •

which, together wi 1 h tne Nursing Base and Administrative base, form

the nerve centre for the hospital's response to the disaster,, if tn

N o r t h e r n G e n e r a 1 i s the 1! b a c k u p1' h o s p i t a 1 a n d n a t t h e its a i n r e c e 1 v i n

centre, our function is to stand by, having notified only a few key

people, arm await flirt her instructions from the District Hospital, s

Control based at the Royal Hal lams hi re Hospital,, If we are

the main receiving hospital, then we are in the thick of it, co­

ordinating the hospital'' s response to the disaster.

To do a job of control, 1 should have tne support of a Senior Surged

and Matron,, There is a designated room for the control team, which

is in the Orthopaedic and Fracture Clinic adjacent to the

PAGES139

A ci rn x n i s trative a n d N u r s i n g c o n t r o 1 s ,, 7 h e A d m i n :i. s t r ative c o n t r o 1 i s

rssponsi oig for uroanisina specific departments such as distribution

services ( w n c h e n s u r s t n e a v a i i a b i I it y o f ii t a f f , e q u i p m e n t a n d

v a h i d e s ) , porte r n g (w n i c h a s s i s t wit, h s e 11 i n g u p c a u s a 1 t y r e c: e p t i o

a n d o t n e r e m erge n c y p a t i e n t a r e a s , a r g a n i s s s i n t e r n a 1 m o v s rn e n t o f

patients and ensures a va i. 1 ab i I i ty of equipment from major disaster

storera o m s ) , car parking, transport, medical re cor as ana patient

Documentation, catering, linen, messengers, patients’ property,

supplies, blood bank, oharmacy, social work, etc,,

fiy duts.es as part of the Hospital Control team are set out on page 1:

of the Northern General Major Disaster P 1 an. Broadly, my prime

r a s pio ns x b i I i ty ? a n c e t he Co nt r o I R a an< has a s e n e s tab 1 i s ne d , i s t o

ensure the availability of up--to™ date casualty information s

compiled, and to liaise with the media and pr e s s » This really is an

iindsr s tatsme nt as t nere are s o many s taf f who r a q u i. r e a i r e c t i o n ant

marshalling; on 15 April (150489) 1 believe 1 spent a large part of

the first couple of hours marshalling staff in this way* This

involved arranging for staff to run errands between departments,

particularly between the medical staff and ourselves as it .is very

aifficuit to speak with trie medical staff over tne telephone when th

are in the middle of treating patients,,

X have never been involved in a major disaster before 15 April

<1SQ489), nor had I been involved in a "mock u p " = The hospital

considered the possibility of a practice some time ago and indeed 1

had gi s cussea this wx th thie Consu11ant i n cnargs of A & El, iir

W ARDR0PE, and Matron, Miss DANDC), and we had agrees to practice the

call out procedure (is the telephone alerting of staff),, This had

not actually occurred before "to April (150 489 5 ouc, in preparation,

PAGESI 391

one of the Assistant Matrons, Mrs € LIl\»DLE Y , met with alI the other

Assistant Mat rons arid went through the Ma j or Di saster ? 1 a n witn t h e m .

The Assistant Natrons are Key personnel in any major disaster as they

are the most senior nurse on duty and thus play a key role in

o r g a n i s i n g t h e n u r s i n o r e s p a n s e t o t h e P 1 a n - 0 1 h e r k e y p e o o 1 e i n c 1 u d. e

the A & £ staf f the tele phoni sts ana, to a i esser

extent , administrative arid clerical staff,,

There is a formal on-"call rota for administrative staff but 1 am not

on the rota,, Only one member of staff is on call at any one time and

the Plan provides for that person to contact me and all the other

a d m i n i s trat o r s i n t h e event of a m a j o r a i s a s t e r „ 0 rs 13 A p r 11 < 1304a 9 >■ S — «r -----------------------------------------

was the member of the administrative staff on duty

1 had returned home from shopping and switched on the television at

aI..-....t 3,, 1:o G „ >:'Q pm C ’13":3/ i Id-eiU) r. .... saw a report of problems

at the Hillsborough footDali ground. At that point it was not clear

whether there were any casualties or whether it was just footDal 1

hooliganism. I watched for a couple of minutes and I decided to ring

the Hospital. I rang switchboard and was told they knew nothing about

any incident at H i 11 s do r o u g h ,, 2 told the switchboard to let me

know should they be alerted to a major disaster,, 1 went back to watch

the television and within a few minutes I aecame more concerned, 1

suppose this would have been about 3..S3 pm ("1323),, 1 tried to ring

the hospital agai n and a 11hougn the pnone was ring i ng there was no

response. 1 thought that one of two things may be happening, either

a) a major disaster had been called ana tne telephonists were

i g n o r i n g c a 11 s , w h i c h i s t h e p r o p e r p r o c: e a ii r e * o r b ) 1 o t s o f o t h e r

hospital staff were watching the television, ringing into the hospital

and the telephonist just could not manage to answer ail the calls,, 1

PAGESI 391

dec idea to go into the nos pitaI ana 1 ran upstairs and quickly got

changed, I had a copy of the Major Disaster Plan in my car wm.cn my

wife fetched for me, so that 1 could have a quick look at it as I was

p r e pa r i n g t o s s t o f f f o r t n e n o s p i t a 1 I live i ii D o n c a s t e r a n d i s f t

home at 3.30 pm (1530), arriving at the hospital at about 4.00 pm

(1600)„ I was delayed ay a couple of minutes as 1 forgot to collect

my set of emergency keys for the major disaster cupooard and. I had to

return horn a for them, On entering Sheffield 1 noticed a trickle of

cto 11 i ng ham "orest fans leaving town and i could near the ambulance

sirens, I was also listening to Radio Hal I am on the car' radio and I

r e ca 1 1 hear i r)g a radi a p 1 ea f o r ra di og raphe r s t o a 11 end tne hos 1 1a 1 s

0 n a r r i v i ng at t he no s p 11 a 1 I pa r k e d t ne c a r and v / fn t s t r a i q nt t o t ne

A & E Deparment, I went through the Casualty Department to see what

was happening. The first person .1 saw >i>as h/ John GETTV, Consultant

Orthopaedic Burgeon. he appeared to be marshalling the area and

preventing improper access into the Department,, 1 spoke with him and

I gainea the impression that a lot of casualties nad been received byy

that time and that the situation /as chaotic. He confirmed the

E m a r g e n c y S e r v i c e s h a d n o t c a i / s a a rn a j o r d i s a s t e r , out t h a t t h s ?'< a j o

Disaster Plan had been i m pi ament ed within the hospital,, At about tne- - - / ~ •— -■ .........

time I arrived the po lice/to ntrol was being established* 1 made

myself known to the officer in charge and I tried to ascertain what

woula happen with regard to ail the enquiries from family and friends

of the injured and aead,, 1 recall the police control indicating that

the emergency numbers had not yet been set up although I seem to

recall as I had driven in, hearing on the car' radio that the emergency

numbers were being set up at that stage, This surprised me, 1 recall

at about 4„3D om (1630/ the emergency numbers nad still not been set

u p „

AuhS 139 - i

I continued to wai k through the Depsrtfhsnt arm headed for the Contr n

Room.. I m e t ______________ , o n e o f my a d i i i i r u s t r a t i v s s t a f f . He h a d U u

major disaster boxes in his hand, which contained the Control Room

telephones and stationery an a. he was setting up the Control R o o m . A

about that t 1 me it i s s DANDO ? Hat r o n of t he ho s p i ta 1 , ar rived, to ok

s t o k Q f t h e n u r s i n g p o s i t i o n a n d p r o csecs d to e s tab 1 i s n t n s hi u r s e

I . - ~ i . , I went into the Hospital Control 'Room and opened the boxes an

e ns u r e d t hera we r e no f u r t ine r i ns t r u c t i o n 3 f o r me t o uno.e r ta k e wh 1 c r:

was not aware of., 1 had drought my hajor Disaster Plan with me from

the car,, After establishing the Hospital Control Room, I left Hatro

with |_____________ | ar;d I r e s u m e a to the A & I Department to assess the

s i ! uat i c n

1 spoke with Jim WARDROPE, Consultant in charge of A & E, ana asked

him whether he needed anything further by way of staff, equipment,

etc. He indicated everything was fine. I told him the Hospital

Control Room was set up if he needed anything,, 1 then went to the

casualty reception desk to obtain information on the number and type

of casualties „ 7 hey had al ready compi 1 ed sorne s cant detai 3.s o f

patients. It was impossible to get an exact :i.aea of the numbers

involved? people were still arriving but it was clear that many

casualties were involved,, There were ambulances outsiae off loading

patients and there were patients in the resuscitation ro o m . Tnere w e ­

an abundance of rnedioa.;. and nursing staff ana the cubicles were full

of other patients in varying degress of distress,, I spoke to the

rsee pt ion staf f ana to tne nursing staf f and a 11hough they were ver y

busy eve rythi ng appeared t o be unde r cont r o 1„ Tne r e seemed to oa a

lot of doctors anci nurses, and also clerical staff, ana the reception

area was very ousy,,

p a g e s -* 39

I a p o x e w i t n t n e C a n s u i t ant R a d i o I o g i s t , M r 3 a rn H i£ WIT T A N „ H s h a a

obviously arrived fairly early and I gathered from him the X Ray

Department was functioning well. In fact, because of the nature of

t h e i n j u ris5, ( I I h i n k o n 1 y a n e p a t i e n t r e q u :i. r e a s u rgsry ) , I h e X R a y

Department was not desperately needed, In terms of tne scope and t y

of the injuries involved, this was quite a unique situation.

T h e M a j o r D i s aste r i::; 1 a n a s s u m e s t n at c a s u a i iiss w i I 1 r e q u i r e s u r g e r y

I returned to the Hosptiqii Control. The time would d s about 4.30 pm

( "1630 ;■ . At t h i s p r S r T MAPPi...E8 ECK , D i s t r i c t Ge ns r a 1 Manger,

telephoned me to get confirmation that the Northern General Hospital

C o nIr o 1 and t n e D i s t rict Ho s p it a 1s C o n t ro1 were e s t a h 1i she d „ M r

M AP P L E B E C K ? s role is as District Co ordinato r arid part of his functi

is to liaise betweeen the two major hospitals ana ensure tne

f a c i1 1ties are appro prlately used and shar ed be tween t h e m „ Tne

District Control is also responsible for ascertaining wliether other

hospitals need to be involved in tne exercise, for example the

C hi 1 dr en ’ s Ho s pi ta 1 , and wi I 1 a 3. iio 1 iai se w 11h t he 3 e d Bur eau. and

n a i g h b o u r i n g D i s t r i c t H e a 11 h A u t S'i o r i t ies. T h u s t n a D i s t r i c t C o n t r o 1

co o rdi nat es t he r es po nse to t he major disaster ac r oss t he who 1 e c 11

In coifiparision the hospital role is to ;Q^ok after the immediate

casualty situation within the hospital, and aeal with relatives ana

the media. Prom the numbers of casualties arriving .in the A & E

Department I had already formea tne conclusion that the Northern

General Hospital was the receiving hospital, rather than the Roy \ ^)

Hal lamshi re Hospital, I learned subsequently that before I arrived

t h s M o r t h e r n G s n eral , a r r a n g e m e n t s n ad been rn a a e to divert c a s u a 11 1 a

to the Royal Hal lamshire Hospital. hy conversation with Mr

MAPPI...E3ECK was t he f i r s t o p po r t un 11y I had had t o f i nd a ut what was

P AGE S 139 i

happening at the Royal Hal lams hi re Hosptial,, riy first priority hat;

been to get tne Northern General plan into operation ana in a sense it

had not mattered what was happening at the Royal Hal lamshi re Hospita', ,

At about thi s txme the A s s i s t a n t t o t h e D i s t r i c t

General M a n a g e r , arrived at the hospital to help. I gave hi n> the tas;<

of information gathering and he worked closely with * t h e

!i e a i c a 1 R e c o r d s 0 f f icsr, a n d h e r e a 1 1 e a g u e s i n c o ]. 1 a t s. n g c a s u a 11 y

i nf o r mat i o n .

I r e ma 1 n e a :l. n c 1 o s e c o n t act wit n t h e D :i. s t r i c t Pi o s p i t a 1 s C o n t r o 1 f o r

t n e r s m a i n a e r o t t n e after' n o o ? i and eve n i n g and t h r o u g h o u t S u n day,, i, - a

e c n a n g a a i n f o r rn a t i on c o n c e r n 1 n g t h e n u rn b e r o f c: a s u a 3. t i e s , e q u i p m e n t ,

etc,, I recall at one stage someone had indicated that we might have

insufficient ventilators if the number of casualties did not fall off.,

a n d I s p o k e t o t h e D i s t r i c t Pi o s p 11 a 3. s C o n t r o 1 a b o u t t h 1 s „ 1 n t h e

event; we did n o t r e q u i r e a ny f ii r t h a r v e n t i 3. a t o r s , or indeed a ny

other equipment, but it was useful to be able to make contingency

a r rang a me nt s through the District Control,, From the information

gathe r i ng e x e r c i se I 1 ear nt of t he nurnbe r of dead i n t he hos p 11a 1 ana

I went to make a check on this. There were eleven in tne temporary

mortuary, which was sited in the Orthopaedic Plaster Room, and there

was one further body in a cubicle next to the Hospital Control Room,,

I was concerned about the number of relatives and I was anx iouts to pa l ­

together as much information as possible about the casualties and the

a n d h sr a s s i s ta n t ,

____________ spent a long time collating all the i nfo nr-a t i on „ It proved

a very difficult exercise as a lot of the casualties had arrived at

the hospital with little or no identification,, iviany of the

casualties wore only jeans, I shirt and trainers and., as many of them

p a g e :S I 39":

were teenagers, carried no mean-:; of identification. It was not u n i ... ■

the ear i y h o u r s o f E< u n day rno r n i rig t ha t we ha a actually identified

everyone admitted to the ho s p i t a l .

As the day wore on, it da came clear to me that the call out procedur

ana cascaae system had asen imp1 ernented« I did not know fully, at

that stage, whs n the cascade ha a been i mpl erne nt e d , or the extent of

the Royal Ha 11 arm; hi r s Hospital's involvement,. What was being said

generally o y staff on the cay, was that the Major Disaster Plan haa

not been implemented by the Emergency Services, but by the hospital

i I s s 1 f 7 h i s s e sme d s a r p r i s i ng at t he 1 1 rne ,, 7 ne P 1 an , inow e v e r , do s -

allow for the hospital to implement tne Major Disaster Plan arid

c 1 e a r 1 y s t a f f nad used t n e i. r o w n i n 11, i alive a n d p u t t h e P lan x n t o

0 p e r a t i o n „

From about 6, OD pm (1S0D) onwards I had a reasonable amount of

information about trie casualty situation, i r. terms of broad numbers,

and 1 was able to give a press c p f erencs at about 6 „ 30 pm (1830),,

was accompanied at the press/conf srsnce by Jim W Art DR OPE, A & E

Consultant,, It was /not xiyd i 1 a few days later, when wa had sifted

through all the case ru/tes, that we were able to give exact n u m b e r s

casualties and dead, as there had been a harmful of routine casualty

cases admitted to the department which were totally unrelated to the

H i 11 s b o r o u g h D i s a s t e r , but w n i c h was n o t a p p are n t a t t h e t i m e .

My main role from then onwards was to ensure the information to

r s 1 a 1 1 vs s ana t he ms d :. a was as c orn pr ehe ns i ve as po s s i ij 1 e » We were

:i. n undated w i t h tale p h o n e c a 3. 1 s f r o m relative s and f r i e n d s w h o

1 n d i c a t e d t h e y c o u 1 d not get t h r o u g h t o t h e p o 1 i c e e m srge n c y n urn b s r „

PAGE 1SI 3 9 -:

charge of the relatives waiting area, which is situated on the floor

aelow A & E. In fact the Major Disaster Plan does not specificaliy

allocate anyone to this function, but it soon became apparent that it

was necessary to put a member of staff into that area to c:o ordinate

information and support services,, Brian J.BELL, the police co.

ordinalor and one of the Assistant Matrons undercook to supervise tr.is

o p e r a t i. o n . I u n deratand a r r a n g e m e n t s w e f,s m ads f o r 'Iran s p o r 1 1 n g

relatives between tne two hospitals, temporary mortuary at the

football ground gymnasium, etc, and arrangements were also made for

o v e s- n i ght a c c omrnoaatio n o n t ne ho s p i1a 3. site, a 11 ho ug h i n tne eve nt I

gather Social Services made provision for the majority of those wno

e q a i red a c c omm o da t i o n «

T h e D i s t r i c t C o n t r o 1 h ad as k e a w n e t n e r 1 needed a r; y p u a I :i. c r e 1 a t i on ::>

support,, I gather the Regional Public Relations Officer, Derek HULL •

was at the Royal H a 1 iamshire Hospital, arm he despatched one of his

t a t n e N o r t n e r n G e n e r a 1 „ £ h e was e t r e m e 1 ya s s i s t a n t s ,

h e 1 p f u I a n d o r g a n ised t h e p r e s s a n d m e o i a , k e e p i n g t h e m f u 3.3. y

informed. 1 made a decision not to no Id any further press conferences

until the following morning,, I went home at approximately 11 ,, 30 11.

45 pm (2330) (2345).

I returned to the Northern General Hospital at 7.30 am (0730) on

S u n d a y , 16 April (160489) and remained throughout the day until 7.SC

pm (1930). My prime interest at that stage was to clean up the

i n f o r it; a 1 1 o n , c o n s a ]. i date the p o a 11 1 o n a n d p r e^Sir e t h e h o s p i t a 1 f a r in : e

various 9 IP visits. 1 gave a press conference late Sunday morning arm

was accompanied b y :i. m w A R D 9 0 F1E , 0 o n s u 3. t a n t , G e a r g e 0 L A R K £3,

Consultant Anaesthetist, and Don PAGE of SYMAS. I gave a very brief

statement as the majority of questions were directed to George CLAPP-:

PAGE I31391

o n c e r n :i. ng t he c o nd :i. t i o ri a f t he pa t i e nt a 7 he Monday and 7 us s day we r e

largely taken up with VIP visits and my own review of the wards and

ITU to see how staff were coping. It was obvious tne staff would

require counselling ana I believe I spoke with tne Psychiatric

Department on Sunday evening to ensure staff counsa11ing was

established quickly and effectively,, Arrangements were made i nvo I v i r: g

tne hospital phys c: ho I og i s t s , tne Occupational Health Department ana

social workers,, Arrangements nave been made through a single contact

t o e n s u r s t h e r e i s n o a u p 1 c a t i o n and 1 gat h e r t n e c o u n s e 13. i n g h a s

been vary e f f e 1 1 v e

In the days following the disaster 1 conducted a series of da briefing

meetings witn staff to establish how well the Major Disaster Plan hau

see n p u t 3. n t o o p e r a 1 1 o n and w h e t h er it had w a r k s a e f f s c t i v e 3. y » T' in e r e

are o n e o r t w o m i n o r area s w in e r e I t > 11 n k t in e P 3. a n c o u id be i m p r o v e a

upon hut the overwhelming impression is that staff responded quickly?

e f f i c: i e n 1 3. y a n d p r o f e s s i o na 1 3. y to a n 3. mm e n s e t a s k ,, T In a u s e of t h e

word ’’standby'1 appears to have caused some confusion and I feel Lns

actual alert ana implementation of the Major Disaster Plan is an area

we mignt usefully discuss with the police and SYKAS.

STATEMENT TAKEN PLACE:

TI ME s

WITNESS TO SIGNATURE

OFFICERS SIGNATURE;

END OF REPORT