Every hospital with an accident and emergency department has an emergency plan to help it cope with scores of casualties arriving from "major incidents" - anything from a massive motorway pile-up to a bomb blast in a crowded area.
Many hospitals will send doctors, nurses and surgeons to the scene to help people trapped in the wreckage.
But research conducted at Glasgow Royal Infirmary suggests that much needs to be done to make sure these teams are given the specialist training they need. The findings were published in the Journal of Accident and Emergency Medicine.
Researchers surveyed every A&E department in the UK, and found that a quarter of the medical incident officers and mobile medical team leaders - those at the sharp end - were expected to have no qualification at all for the job.
Of the remainder, approximately a third of both were taught locally, and had achieved no written qualifications.
No exercise experience
The report's authors said that it was highly unlikely that many of these officers would have had first hand experience of a major test exercise, as in a third of examples, these were held at most once every couple of years, and only those on rota would actually take part.
And they found that very little use was being made of GPs who are trained as "immediate care" doctors, driving to the scene of accidents to give life-saving medical treatment.
"Medical personnel called upon to work at the scene of a major incident are required to operate in an unfamiliar, hostile and inherently dangerous environment," they write.
"It is essential for their personal safety and effectiveness that they are adequately trained and practice regularly for this role."
The report conceded that some improvements had been made since another damning report released seven years ago, which led to the introduction of a comprehensive emergency training course.