Emergency services ‘hampered by communication problems in London Bridge attack’
LAS medics were aware of patients requiring treatment in the courtyard, but were unable to reach them.
Confusion and communications problems at the London Bridge terror attack hindered emergency services efforts to support injured victims, an inquest heard.
Paul Woodrow, direction of operations at the London Ambulance Service (LAS), said it took “too long” to make a decision to commit specialist teams to treat patients at the scene.
Giving evidence at the Old Bailey on Monday, Mr Woodrow said initially LAS struggled to get “overall situational awareness” at the “chaotic” scene of the attack.
The inquest heard that shortly after the attack armed police officers stopped medics entering the courtyard area around the Boro Bistro restaurant, where five of the attack victims died, due to reports of shots being fired nearby.
LAS medics were aware of patients requiring treatment in the courtyard, but were unable to reach them as a high security “hot zone” was placed over the Borough Market area.
Jonathan Hough QC, counsel to the inquests into the attack victims’ deaths, said: “Two groups of people were aware of casualties potentially requiring urgent treatment in the general area of the Boro Bistro court yard.
He added: “Neither of those groups got the message to the people in the court yard that ambulance staff couldn’t get to them.”
Mr Woodrow said that the “chaotic” aftermath of the attack had contributed to “confusion” and “issues around communication”.
He said: “It hindered our ability, jointly, to get full situational awareness on that situation.”
Mr Woodrow said emergency service workers were receiving information covering multiple locations within a wide area, which some staff “would not have an intimate knowledge of”.
“In the very early stages of these incidents, they really are chaotic, and it’s just a fact that we do not have an army of people there to filter the information,” he said.
He admitted it “took too long to make a decision to commit” specially trained ambulance intervention teams, made up of ambulance, fire brigade and armed officers, to search for victims.
Gareth Patterson QC, representing the families of some of the victims, told the inquest that paramedics had not entered the courtyard area until after 1am, despite the attack shooters being killed at 10.16pm.
Mr Woodrow said the area had been deemed unsafe, that the “hot zone” had been established by police and was changing as the attack’s aftermath unfolded.
He said the LAS could not make an independent decision to deploy specialist teams, requiring input from police and fire services.
Mr Patterson said there was no evidence whether the courtyard area specifically had been designated as a “hot zone” or not.
Khuram Butt, 27, Rachid Redouane, 30, and Youssef Zaghba, 22, killed eight people and injured 48 others in a van and knife attack on June 3 2017.
They mowed down pedestrians on London Bridge before stabbing innocent bystanders at random in nearby Borough Market.
Xavier Thomas, 45, Christine Archibald, 30, Sara Zelenak, 21, Sebastien Belanger, 36, James McMullan, 32, Kirsty Boden, 28, Alexandre Pigeard, 26, and Ignacio Echeverria, 39, all died.
Mr Woodrow said that despite issues, medics working in “really difficult circumstances” had done “really good work” treating victims – and praised those who volunteered to enter the potentially dangerous “hot zone.”
“I’m proud of my staff who put themselves in harm’s way,” he said.
The inquest heard that under normal procedures, ambulance crews would never enter a high risk hot zone, but the rules were broken to send in volunteers on the night of the attack.
Mr Patterson said there was a “period of three hours where nobody went into the courtyard” to further assist victims.
He said the delays were not consistent with the need to provide urgent medical care in the “golden hour” immediately after an incident.
Despite calls for help, police officers aiding the injured in the courtyard were not told about the presence of ambulance resources on Borough High Street, Mr Patterson told the inquest.
“There was clearly a breakdown in communications at that stage,” Mr Woodrow conceded.
Mr Patterson highlighted that one of the medics leading the response at the scene lacked training relating to Operation Plato, a plan for dealing with a suspected marauding terrorist attack.
He claimed there was an “absence of a system or procedure to give notification” of information once Operation Plato was declared at London Bridge.
Mr Woodrow said: “It does take time for command structures to be put into place, what we need to recognise is ways we can reduce those delays.”
He said the LAS was “overflowing with information” and had received 134 related 999 calls, on top of 4,400 already received from other incidents on a “busy Saturday”.
Mr Woodrow admitted the ambulance service struggled to co-ordinate the flow of conflicting information from London Bridge.
“It’s a difficult problem and this has brought it into stark view, but its not a problem that is easily resolved,” he said.
“It’s just not realistic to expect that we can get 100 to 150 people into an area in the first 10 minutes of an incident.”
Mr Woodrow said the LAS was committed to improving the deployment of Operation Plato-trained officers in major incidents and how it handles responses to dangerous situations.
He argued there might be a need for specially trained LAS staff to be permanently based with police and fire service colleagues and a better use of technology to locate victims.
Later on Monday, Fenella Wrigley, medical director at LAS, was asked by Victoria Ailes, representing the family of Mr Belanger, whether his injuries would have been survivable if he had received different treatment.
After viewing body-cam footage from the incident Dr Wrigley concluded his level of blood loss prevented his survival.
She said if he had been an “isolated” patient in an incident there might have been a “window of opportunity” where additional treatment would have helped him.
But she said by the time help arrived he was already going into cardiac arrest and there had been no realistic chance of survival.