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Major Incident with Mass Casualties Group - Bulletin 4, August 2018

The Major Incidents with Mass Casualties (MI-MC) Group met on two occasions during August, with the second of these meetings focussing on shaping the new national plan.

Planning basis 

The new plan focuses on the following:  

  • Sudden impact incidents resulting in large numbers of casualties with trauma injuries;
  • NHS Scotland’s response to a MI-MC as a single, integrated entity, in conjunction with Health and Social Care Partnerships (HSCP);
  • Delivery of an appropriate and timeous response to the needs of children and adults in order to secure the best possible outcomes for them;
  • An assumption of health and social care services responding simultaneously to 175 Priority (P)1 and P2 (i.e. seriously injured) casualties, and hundreds of P3 ( ‘walking wounded’) casualties;
  • A 21-day period post incident, and the process towards the recovery phase.


Progress towards preparedness

Plans for treating paediatric P1 and P2 casualties have been outlined to prevent Paediatric Centres being overwhelmed and to make the best use of skills and facilities in such situations. The Group has also set out where facilities for P3 casualties should be sited so that NHS Boards can make plans accordingly.

The roles of HSCPs, reflecting the broad span of their responsibilities, and of General Practitioners, including GP Out-of-Hours Services, during a MI-MC situation are in the process of being agreed. A model for involving Rehabilitation specialists in the treatment of casualties at an early stage has also been identified as a feature of the plan acknowledging the importance of this specialism in securing the best possible outcomes for patients.

NHS 24 will be at the forefront of the health and social care response to a MI-MC, assisting with public messaging, signposting P3 casualties and families to appropriate services, or supporting them directly by using its special helpline capability. Relevant (pre-prepared/ready-to-push-out) materials and protocols for a range of scenarios are currently being developed for the plan. Work is also being progressed to ensure that there will be synergy and consistency in messages that will be issued at various stages between NHS 24, Scottish Ambulance Service, NHS Boards and Police Casualty Bureau.

Work is underway to ensure that there is appropriate capacity and access to Psychological Trauma and Bereavement Support Services within health and social care services across Scotland for victims and families in the aftermath of MI-MC incidents.

Digital / technological solutions to assist response efforts are being explored, including a patient-tracking system (to monitor the movement of patients from scene of incident through their hospital stay) and a Bed Dashboard (to real-time monitor hospital specialist bed capacity).

For further information contact Ray de Souza sghru@gov.scot  or  nss.scottrauma@nhs.net