MAI-108 Response Accepted AI-assessed

Regular Major Incident training for ambulance commanders

Recommendation

The Department of Health and Social Care and the National Ambulance Resilience Unit should ensure that all ambulance commanders receive regular Major Incident training. The training should include training on HART capabilities, on all the command roles and where they will be located, on how to gain situational awareness through the deployment of sector commanders and other roles, on the importance of getting ambulance personnel to casualties without delay and on the circumstances in which they may use operational discretion.

Published Evidence Summary
The following publicly available evidence relates to this recommendation:
According to gov.uk progress, 2026-02-27, command training and competence for ambulance commanders are addressed by the NHS Emergency Preparedness, Response and Resilience (EPRR) Framework and NHS Core Standards, which apply to all NHS Trusts. Additionally, national command and control guidance for ambulance services has been produced. According to JESIP, 2024-04-01, the JESIP Joint Doctrine was updated in April 2024 to improve interoperability and extend emphasis to frontline responders. According to the Cabinet Office, 2025-11-14, the government published a formal dashboard tracking all MAI recommendations in November 2025.
How was this assessed?
Assessed by gemini-2.5-flash on 19 Mar 2026
Checked data held on this site (government responses, progress updates, independent evidence)
External sources searched: www.gov.uk, mainquiry.dac.grid.civilservice.gov.uk, www.legislation.gov.uk, hansard.parliament.uk
Jurisdiction
UK-wide
Response
Accepted
Accepted UK Government
03 Nov 2022

The Home Secretary made a written statement to Parliament on 3 November 2022 following publication of Volume 2, acknowledging the findings on emergency response failures and stating the government would work with emergency services to implement improvements. The response committed to reviewing interoperability arrangements between emergency services and strengthening joint training and exercising protocols for major incidents.

Read Full Response
Progress Timeline
Official Report
27 Feb 2026

Command training and competence is covered by the requirements of the NHS Emergency Preparedness, Response and Resilience (EPRR) Framework and the NHS Core Standards for EPRR. This applies to all NHS Trusts. Additional national command and control guidance for ambulance services has been produced by the National Ambulance Resilience Unit (NARU). Operational discretion is an area for further development within training programmes. NHS England are currently reviewing training to ensure it is evidence based and defensible. Major Incident Training forms part of continuous professional development, meaning work on this recommendation will always be ongoing.

Official Report
14 Nov 2025

Command training and competence is covered by the requirements of the NHS Emergency Preparedness, Response and Resilience (EPRR) Framework and the NHS Core Standards for EPRR. This applies to all NHS Trusts. Additional national command and control guidance for ambulance services has been produced by the National Ambulance Resilience Unit (NARU). Operational discretion is an area for further development within training programmes. NHS England are currently reviewing training to ensure it is evidence based and defensible. Major Incident Training forms part of continuous professional development, meaning work on this recommendation will always be ongoing.

Published Evidence

Published assessments of implementation progress from inspectorates, select committees, official progress reports, and other sources. Check the source type badge to see whether each assessment is independent or government self-reported.

Reasonable Progress
14 Nov 2025
Cabinet Office Other

Government published formal Manchester Arena Inquiry recommendations dashboard on GOV.UK (14 November 2025) tracking all 149 recommendations with implementation progress updates.

Manchester Arena Inquiry recommendations dashboar… View Source
Reasonable Progress
03 Apr 2025
UK Parliament legislation

Terrorism (Protection of Premises) Act 2025 received Royal Assent 3 April 2025. Creates two tiers: Standard Duty (200-799 capacity) and Enhanced Duty (800+). SIA will be regulator. Not yet in force -- at least 24 months before enforcement (expected April 2027).

Terrorism (Protection of Premises) Act 2025 View Source
Good Progress
01 Apr 2024
JESIP Other

JESIP Joint Doctrine updated to v3.1 (April 2024) following inquiry findings on interoperability failures. Operation Plato reformed to cover all terrorist attack types, not just firearms. Emphasis extended beyond command-level to frontline responders.

JESIP Joint Doctrine Version 3.1, April 2024 View Source
Reasonable Progress
05 Jun 2023
National Police Chiefs Council Other

NPCC, Counter Terrorism Policing and College of Policing provided comprehensive updates to Sir John Saunders demonstrating "continued drive to improve collective response to terrorist incidents."

View detailed findings

Representatives working with UK Intelligence Community to address closed Volume Three recommendations. Cross-government monitoring ongoing.

NPCC Monitored Recommendation Hearings Update View Source
Source
Report Manchester Arena Inquiry: Volume 2: Emergency Response 03 Nov 2022
Responsible Bodies
National Ambulance Resilience Unit Primary
Department of Health and Social Care
Recommendation age 3.4 yrs
Last formal update 27 Feb 2026