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National Health Service in Scotland Manual of Guidance:
Responding to Emergencies


O.1 A major incident is news. Representatives of the media will arrive at the scene, at any casualty receiving hospital and at response control points very quickly, and in large numbers. News desks will also make repeated requests for information by telephone, especially in the early stages of an incident. Similar media pressure will accompany other types of major emergency. How the media is handled will affect how they report the emergency and the response to it. How the emergency response is reported can enhance the effectiveness of that response, both immediately and in the longer term. To this end, NHS managers responsible for emergency response must become familiar with media needs, methods and time schedules, and should prepare and train appropriate staff for media liaison duties.

O.2 Should the scale or circumstances of a major incident require it, initially the police will co-ordinate both the release of information to the media and the response to media enquiries. It is thus most important that police advice and assistance is sought by NHS managers when reviewing their arrangements for media liaison. Similarly, within the NHS, each Board must take the lead and establish a single focus for NHS liaison with the media, should more than one NHS organisation become involved in responding to an emergency in its area. The nature and scale of the emergency, and the nature of media interest, will determine the degree to which NHS Boards should act in concert with the police, local or other authorities. Plans for mutual support between Boards should be considered, and while assistance of the Scottish Government Communications Directorate may help a co-ordinating NHS Board in providing international, national and regional media with NHS information, Boards should not underestimate the demands on them which co-ordinating media liaison is likely to bring.


O.3 While this Annex uses a scenario in which casualties are the primary focus of media interest, the principles and arrangements outlined should be adapted as necessary to other major emergencies

These might include:

  • An outbreak of disease in the community, among hospital patients or NHS staff
  • Coping with the effects of bad weather or industrial action
  • A quality control, equipment malfunction or other problem with a particular clinical procedure, screening process or pharmaceutical product

O.4 At every level, managers should ensure that arrangements for liaison with the media are integral to their major emergency plans. When these plans are exercised the media arrangements should also be exercised in as practical a way as possible e.g. participation by trained journalists.

O.5 As part of a NHS Board's emergency plan, a large room should be identified as a Media Centre. It should be sufficiently close to the Hospital Control Centre to facilitate authoritative briefings by members of the Hospital Control Team. If journalists there are provided with access to adequate communications, are supplied with refreshments, are regularly briefed and have questions answered, they will be less likely to wander elsewhere in the hospital. Ease of access to parked outside broadcast vehicles should be borne in mind.

O.6 A member of staff should be selected as Press Officer who can be dedicated to that role throughout an emergency. He or she should be of sufficient standing and personality to command respect and support within the hospital, particularly among nursing and medical staff. Additional staff should be earmarked to provide on a continuous basis the necessary administrative support which the preparing, typing and copying of news releases and statements will require. The advantages of designating a Press Officer include:

  • Journalists and photographers will have a single point of contact for information and will tend to leave other staff free to work without interruption
  • The Press Officer will quickly build a working relationship with the Press to the mutual benefit of hospital and media.
  • Information communicated to the media can be more readily controlled.

O.7 Depending upon the circumstances surrounding the emergency NHS Boards may wish to consider joint arrangements with the police and/or local authorities.


O.8 Emergency plan implementation should invariably include alerting the NHS Board's Press Officer. However, a telephoned media enquiry may well be the first intimation of emergency, and others may be received before a press officer is available. It is thus important that duty managers and/or on-call staff are permanently available and prepared to handle such calls.

O.9 The Press Officer's immediate action should be to ensure the Media Centre is functioning and that its communication facilities are operational. Hospital staff should be briefed that when the media arrive they should be escorted to the Media Centre. Film crews and photographers, after taking pictures of ambulances arriving with the injured, will want to take further pictures of the injured in hospital. All hospital staff should thus be on the look-out for strangers with cameras (apparent or concealed) and know of arrangements made to escort them back to the Media Centre.

O.10 Should the major emergency be caused, or suspected to be caused by an act of terrorism or crime, the police may impose a degree of security around casualties and hospitals treating them. Depending on the circumstances, the police may prevent anyone other than essential health personnel from entering the hospital grounds, including the media. Where this is necessary, it is likely that the police will co-ordinate media briefings and the preparation and release of information. However, an increase in telephone calls from the media to the hospital seeking information is to be expected. Thus it will be essential for the hospital press officer to make himself/herself known to the senior police officer present at the hospital, so that arrangements can be made to secure the co-operation of the media and which satisfy their needs, together with those of the police and the hospital

O.11 If the emergency is such that more than one hospital receives casualties, has major public health implications or is otherwise likely to attract significant media scrutiny, its Central Co-ordinating Media Office should be set up by the NHS Board as soon as possible. All hospitals and other NHS organisations involved should keep that office fully up to date with information, including any proposed news releases etc., prior to issue. The staff of the Central Co-ordinating Media Office will require to liaise closely with police information staff, with those of other authorities or agencies involved in the emergency, and with the Scottish Government Communications Directorate. The earlier such co-ordination of media liaison is established, the less likely will it be that reporters and their enquiries will get in the way of those engaged in responding to the needs of the emergency itself.


O.12 Whatever the nature of a major emergency, a media briefing should be held as soon as possible. Press Officers must be aware of the need to maintain medical confidentiality and that any decision to release details of any individual patient must have prior medical and patient consent. At a hospital receiving casualties the Press Officer should, in preparation of briefing, seek to collate the following factual information:

  • The time the hospital was told to expect casualties.
  • The time the first casualties arrived.
  • The number of injured received.
  • General information about the casualties as to whether male or female, children under 16, the general nature of injuries, the general type of treatment being given, the numbers admitted or discharged after treatment
  • Information about any patients transferred to other hospitals, either for specialist treatment e.g., burns/neurosurgery or to spread the load.
  • A brief outline of the hospital's emergency plan, when it was activated and the effects on routine hospital work, normal visiting hours etc.
  • Details of numbers of staff on duty, of specific specialist teams on stand-by or deployed, of routine operations cancelled and any other background information.

O.13 Based on such information, the hospital press officer should prepare a statement. Prior to issue, and after any scrutiny required by the Chief Executive, it should be agreed with the NHS Board's Central Co-ordinating Media Office and with the police, who may require to consult the Procurator Fiscal before agreement to release can be given. The text of the agreed statement must be furnished to the Scottish Government Communications Directorate in advance with details of time and place it is to be issued. The Chief Executive, ideally supported by a clinical director/senior consultant (in white coat) and senior nurse will be expected to:

  • Read the statement to the media, answering questions arising from it
  • Be prepared to repeat the statement to radio interviewers/television reporters if required. .
  • Announce arrangements for further briefings on a regular and frequent basis.

O.14 The statement to the first media briefing should provide the basis for staff answering many subsequent telephoned media enquiries. Calls should be expected from local daily or evening newspapers or news agencies seeking information about the involvement in the emergency of people from within their circulation areas. The Press Officer should have sufficient support to allow such calls to be dealt with on a 24 hours a day basis, with all calls being logged. Where confirmation of information not previously released is sought, arrangements should be in place to check with senior staff that confirmation may be given or further, new, information released.


O.15 In preparing the second and subsequent media statements, the Press Officer will need to clear the release of information as before. The following might be given:

  • Details of patients, giving names, addresses and ages bearing in mind the rules surrounding medical confidentiality, data protection laws, and only where patient consent has been given. Patients should understand the possible impact release of their details might have on next of kin and that a media presence at their address might result.
  • Further details of the extent of injuries and of treatment.
  • Details on the numbers of deaths, emergency operations, patients in intensive care; patients discharged home. Note that the police will not allow names of the dead to be confirmed until positive identification has been made and next of kin informed

O.16 The number and frequency of media briefings will clearly depend on the development of the response to the emergency. Where there is nothing new to be said, then the Press Officer should make a statement to that effect, but promise further briefing when further information becomes available.


O.17 As soon as patients arrive at a hospital the media will seek to interview, photograph or film both patients and staff treating them. The Press Officer should check with the police (who may in turn wish to consult the Procurator Fiscal) whether or not any individual patient might thereby be put at risk by such publicity in the context of criminal investigations. Media access to any patient should only be arranged with the consent of the consultant looking after the patient who can confirm that he or she is well enough. No interview or photographs should be taken without the consent of the patient concerned.

O.18 Press Officers should seek to identify a small number of doctors, nurses, ambulance and other staff directly involved in caring for patients who could be made available to give interviews to the media. The media will normally welcome such an opportunity. First-hand accounts of the health response to an emergency reduce the risk of wrong information being circulated and provide an opportunity to publicise what the hospital and the NHS have to face. However, any member of staff being interviewed should be carefully briefed beforehand.


O.19 One method by which media access to patients and staff can be arranged is to organise a "short facility" with the media being admitted to a group of patients and/or staff under firm control.

O.20 Care must be taken to ensure that patients' wishes concerning interviews and photographs are made clear, that media activities do not take place without the patients' consent, nor in a manner which might cause them distress. The programme and time schedule for the facility should be agreed with the media beforehand. If necessary press, television and radio interviews should be done on a 'pool' basis to reduce disruption and stress for patients and staff.

O.21 Media deadlines (i.e., transmission/broadcast times or the times at which newspaper editions have to be finalised) may mean that the running order of groups above may need to be altered. Where there are space or time restrictions, pooling arrangements should be considered under which one reporter, one photographer, one radio reporter and one TV crew are admitted and subsequently share their reports/films with all.


O.22 Members of the Royal Family and Government Ministers or other dignitaries will often visit the site of a major emergency and hospitals involved in response to it. The Scottish Government Communications Directorate in consultation with other press offices as appropriate will be responsible for providing advice on media coverage of such visits.

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