Major hospitals around the UK are ill-prepared to cope with a major incident, a survey of doctors warns.
Hospitals should all have regular 'dry runs' of incident plans
A team from Wycombe Hospital, Bucks, asked 144 specialist doctors at 34 hospitals about their readiness in the wake of last July's London bombs.
Just over half had read their hospital major incident plan and only 54% were clear what their own role would be, the Emergency Medicine Journal reported.
The Department of Health said action had been taken to improve NHS planning.
The doctors questioned in the survey were anaesthetists, emergency care doctors, general surgeons, trauma doctors and orthopaedic specialists at large hospitals in major cities.
The researchers also contacted the major incident coordinator at each of the 34 hospitals.
They said it was difficult to get responses despite "persistent" efforts and only 17 replied.
There was wide variation in the frequency and timeliness of "dry runs" of plans to cope with major incidents.
Most - 82% - had carried out a dry run within the past five years but only 35% were planning to carry out a further test within the next 12 months - even though were supposed to check plans annually.
And one in four of the hospitals said incident planning teaching was not included in induction sessions for junior and middle grade doctors.
A lack of funds, no designated incident coordinator and poor technology were cited as reasons for the lack of preparedness for a major incident.
There was little difference between responses from doctors and planners in London and in other cities.
Dr Tom Cosker, who led the research, said things had appeared to improve to some degree since the survey was carried out last July.
But he warned a basic problem of new junior doctors not being given information was still an issue.
'More incidents likely'
Dr Cosker said: "The problem is that a major incident can happen at any time of the day or night.
"And at night, some of our most junior staff are on duty.
"We have to make sure that everyone knows where they are supposed to be, what their role would be and who they are responsible to."
The researchers warned it was highly likely that that British hospitals would face more major incidents in the future.
They said: "Effective major incident plans require forethought, organisation, briefing of relevant staff, and regular rehearsal."
Health Minister, Rosie Winterton said: "A huge amount of work has been done to make sure the NHS is ready to respond to major incidents."
She said each trust had to have a major incident plan which should be tested at least once a year.
Don MacKechnie, president-elect of the British Association of Emergency Medicine, said there was a need to ensure middle-grade doctors knew what a hospital's plan was and what their role would be.
"They move jobs fairly frequently and there does need to be an emphasis in their inductions on making it clear they need to read their incident plans."
But he said the time and resource pressures on the NHS meant it was more important staff knew where a plan was kept and who would be in charge, rather than having had a recent run-through.
Mr MacKechnie added: "The most important thing to note is that, where incidents have occurred, the NHS copes."