Recommendation MAI-108: Regular Major Incident training for ambulance commanders
From Manchester Arena Inquiry: Volume 2: Emergency Response, published 3 November 2022.
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.
In brief (written by this site)
The Inquiry recommended that ambulance commanders receive regular Major Incident training. In February 2026, the Cabinet Office reported that command training is covered under the National Health Service (NHS) Emergency Preparedness, Response and Resilience (EPRR) Framework and that the National Ambulance Resilience Unit (NARU) has produced additional command guidance (Cabinet Office, Feb 2026). It stated that operational discretion requires further development and NHS England is reviewing training, though topics including Hazardous Area Response Team (HART) capabilities, command roles, and rapid casualty access were not mentioned (Cabinet Office, Feb 2026). The report noted that work will remain ongoing because this training forms part of continuous professional development (Cabinet Office, Feb 2026). Earlier, in November 2025, the UK Government accepted the recommendation in full (Cabinet Office response, Nov 2025).
AI-generated summary of the record on this page, checked by a second model and automatic checks, 5 Oct 2026. The record below is the sources' own words.
Government response
Accepted in full
Delivery
Cabinet Office says in progress (27 February 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.
Earlier statement on delivery (1)
Cabinet Office (14 November 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.
From: Manchester Arena Inquiry Recommendations Dashboard, original version (data file)
Published evidence
Published findings referenced by inspectorates, select committees, official progress reports, and other sources. Source type badge indicates whether the finding is independent or government self-reported. Each finding is this site's summary of what the source found, with a link to the source; this site does not add its own progress rating.
Summary by this site of the published finding
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.
Source
Responsible bodies
Themes and tags
Who has spoken
- UK Government
Response - Cabinet Office
Delivery statement