Cross Border Major Medical Emergency Exercise in the North West

Saturday 21 April 2007

How would the ambulance services and hospitals respond if there was a major medical emergency which stretched the normal response capability of such services in the border region, for example in the event of a multiple vehicle transport accident or a large-scale industrial incident resulting in multiple injuries? Would the existence of the border between Northern Ireland and the Republic of Ireland reduce the effectiveness of an emergency services response? These were some of the uncertainties put to the test on Saturday 21 April 2007 in a major cross border emergency exercise held in the coastal area of Magilligan in Co. Derry. This is the first such cross border scenario to be organised on the island of Ireland and further enhances cross border co-operation and collaboration between the ambulance and hospital services in both the Republic and Northern Ireland.

The exercise was sponsored by Co-operation and Working Together (CAWT), the cross border partnership for the Health Authorities located along the border between Northern Ireland and the Republic of Ireland.  This event is the culmination in a series of practical training events, which has brought together the Northern Ireland Ambulance Service and the Republic’s National Ambulance Service, in order to help foster a common approach when dealing jointly with a major medical incident. Speaking on behalf of the sponsors, Colm Donaghy, Chief Executive of the Southern Health and Social Care Trust and Director General of Co-operation and Working Together (CAWT) emphasised the importance of this ground breaking cross border event. He said: “The Health Authorities, North and South have been collaborating in the border region for many years now through the Co-operation and Working Together initiative. Major emergency management is a key challenge for both jurisdictions and today’s exercise has facilitated the testing of the cross border response by the ambulance services, with the support of the military and the police in the unfortunate event of such a serious incident happening in the border region. I want to commend the Ambulance Services from both jurisdictions for their active participation in the exercise and I also want to acknowledge the medical and aviation co-ordination and support provided by the Royal Air Force, the Territorial Army and the Irish Army Air Corps. It has been a fantastic team effort by all those involved.”

Today’s event is the result of months of preparation by the ambulance services and military in both jurisdictions. To prepare for the exercise a number of ambulance services personnel underwent specialised training with the support of the Royal Air Force, the Territorial Army Medical Services and the Irish Army Air Corps.

With the assistance of both the Territorial Army Medical and Signals regiments, two simulated scenarios involving significant casualties were staged at the same time. Ambulance services from North and South responded to both incidents in order to test their co-ordination of the cross border response required. The first incident involved a domestic gas explosion and the second a major road traffic accident, both resulting in multiple casualties. Such was the scale of the simulated incident in both scenarios that arrangements were made to airlift some of the casualties by military helicopter to the nearest hospitals. The Royal Air Force transported casualties to Letterkenny General Hospital and the Irish Army Air Corps conveyed casualties to Altnagelvin Area Hospital. This enabled both sets of military personnel to undertake valuable air evacuation training with the ambulance services in the event of having to transport casualties to hospitals in one or both jurisdictions. Both Altnagelvin Area and Letterkenny General Hospitals found the exercise valuable in enabling them to partially test vital aspects of their own major emergency plans, which would be set in motion should a major incident of this scale happen.

Frank McClintock, Assistant National Director, at the National Hospitals Office of the Health Service Executive outlined the value of the event. He stated: “This simulated major emergency exercise has provided an invaluable platform for a multiplicity of agencies to work together and this was not always possible to achieve.  The input from all of these agencies has enabled a fantastic skills development and learning experience and one that the Republic of Ireland National Ambulance Service will continue to strive to improve and build upon. This view was also echoed by Liam McIvor, Chief Executive of the Northern Ireland Ambulance Service who said: “We welcome the opportunity to engage in joint training with our colleagues from the National Ambulance Service in the Republic. This major incident exercise provided ambulance services, North and South, with another opportunity to test our plans and our capacity to deal with major incidents.”

Speaking on behalf of Altnagelvin Area Hospital, senior A&E consultant Alan McKinney said: “Altnagelvin has had many tests of its major emergency plan, both simulated and real.  From every test, there are lessons learned and improvements made so we were pleased to be involved in this exercise, which enabled us to test important aspects of our plan again.  As we always do after any test, we will be reviewing the outcomes and refining our plan as necessary. Our colleagues in Letterkenny General Hospital will also be doing the same. I congratulate the organisers on their foresight in setting up this important and useful exercise,” he added.

Spokesperson for the military, Major Tim Rogan said: “The military are delighted to have been invited by CAWT to help facilitate and take part in this exercise. It provides an ideal opportunity to develop relations and cooperation with other agencies. It also gives us a valuable opportunity to practise our own procedures and test personnel and equipment from a number of military units.”
Congratulating CAWT on the success of the exercise, Minister for Health at the DHSSPS, Paul Goggins said: “We must be prepared for major incidents that can happen anywhere, at any time.  These can be overwhelming and have devastating consequences if the response is not properly planned.

Our emergency services must be prepared for all eventualities, and have in place contingency plans, that support co-operation.  The exercise itself has provided us with an excellent opportunity to identify any obstacles that would continue to hinder such a response.”

The Minister for Health and Children, Ms Mary Harney T.D., praised the efforts of all those involved in organising this Major Emergency Exercise. The Minister acknowledged the enormous effort and months of preparation by personnel, at all levels, in various Government Departments, Health Authorities, the Ambulance Service and Defence Forces, both North and South, whose hard work came to fruition today. The Minister said:  “I am sure that the knowledge and experience gained from this cross border exercise will ensure a high level of consistency of response across the border region in the event of a major emergency.”  The Minister added: “the success of this exercise was a result of an effective collaborative effort and the experience will benefit future cross border initiatives.”

Valuable support was also provided by An Gardaí Síochána and the Police Service of Northern Ireland at the relevant hospital in both jurisdictions. The event was observed by a number of independent assessors who will evaluate the complete exercise and make recommendations in order to improve the effectiveness of a cross border response should such an incident happen for real in the border region.

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