The National Health Service (NHS) remains inadequately prepared to respond to large-scale terrorist attacks, according to a senior ambulance official. Anthony Marsh, chief executive of West Midlands Ambulance Service, expressed concern that emergency services lack the necessary training, equipment, and resources to effectively handle incidents on the scale of the 2017 Manchester Arena bombing.

In a letter dated October 2 addressed to NHS England’s director of urgent and emergency care delivery, Marsh highlighted ongoing deficiencies in the NHS’s readiness nearly a decade after the attack at the Manchester Arena, where 22 people lost their lives. The letter, also shared with the West Midlands Ambulance Trust board, emphasized that little progress has been made in implementing key recommendations from the official inquiry into the bombing.

The 2022 inquiry into the Manchester Arena attack exposed significant shortcomings in the emergency response, including inadequate coordination and insufficient training among ambulance services. It called for urgent improvements in preparedness to better manage future terror incidents. Marsh, who has spent more than two decades leading ambulance services, warned that the sector is still not equipped to respond immediately to similar events, including attacks comparable to the 7/7 London bombings.

The current terrorism threat level in the United Kingdom is classified as severe, indicating that an attack is considered highly likely. Marsh’s warnings raise important questions about the NHS’s capability to manage mass casualty situations in light of these ongoing risks.

In response, an NHS England spokesperson stated that efforts continue to focus on working with ambulance services to implement the inquiry’s recommendations. The spokesperson also noted that local NHS organizations regularly review their plans for handling major incidents to ensure appropriate preparedness.

Marsh’s call for urgent action reflects concerns within the emergency services community that without substantial investment and training, the NHS may struggle to respond effectively to future terrorist events. With the anniversary of the Manchester bombing approaching, the letter underscores the need for a comprehensive review of the NHS’s emergency response infrastructure and capability.