The government sends out guidelines on how police, fire, ambulance and doctors coordinate their efforts to make sure that the most severely injured get the right medical help as soon as possible.
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After the Paddington rail crash, there were several major hospitals within a radius of 10 miles who were able to take the extensive number of casualties.
These included St Mary's Hospital in Paddington itself, which can cope with both major trauma and burns cases.
The more rural location of the latest crash means that hospitals are more spread out.
The nearest major hospital is the Queen Elizabeth II in Welwyn Garden City.
Also equipped to handle trauma cases are hospital in Northampton and Addenbrooke's Hospital near Cambridge. There is also a similarly equipped hospital in Milton Keynes.
The emergency services response is mapped out from the moment that the call comes that a major incident has taken place.
Put on standby
When the first emergency services reach the scene - and confirm the scale of the disaster, phone calls are made to nearby hospitals and the ambulance service to put them on standby.
All non-urgent operations are cancelled and the hospital calls staff who are not on duty and asks them to come in.
Accident and emergency departments will be cleared of all but the most seriously ill patients in preparation for accident victims.
The disaster victims can be divided into three types, says Dr Matthew Cooke, a consultant in A&E medicine from Walsgrave Hospital in Coventry.
He is an expert on the delivery of immediate care following a major incident.
There are the most seriously injured, who require medical attention straight away - these are tagged with red labels so that they are prioritised.
They are sent to the nearest hospital.
Prioritising the injured
There are those with moderate injuries, which require swift treatment but are not immediately life threatening - these are tagged with a different colour, and sent further away for treatment so that the first-line hospital is not overloaded.
And there are far greater numbers of people with lesser injuries, the so-called "walking wounded".
"In a train crash, there are a lot of people thrown around, who perhaps have a cut face or broken arm - still very distressing, but not immediately life-threatening."
Dr Cooke said: "With these people - if you can get them into a coach and send them further away, it helps a great deal."
Doctors, although not those from the hospital closest to the crash, come out to set up "field hospitals" in controlled areas next to the scene.
"These are like a mini A&E," said Dr Cooke, "and they can handle anything which doesn't involve the patient going into the operating theatre."
Where there are large numbers of casualties, the chief skill is juggling, constantly monitoring the numbers of patients the closest hospitals can take, and diverting them elsewhere when necessary.
There have been complaints in the past that doctors rarely get to experience a full disaster simulation - research showed that because of changing shift patterns, it was highly unlikely a doctor would be working when the simulation took place.
However, the situation has improved in recent years, with many hospitals holding simulated major incidents far more frequently than the two-yearly minimum demanded by the Department of Health.