DHSC and NHS England support the issues that the recommendations for the North West Ambulance Service (NWAS) are directed towards. However, while NHS England considers local review of procedures and terminology to be important and necessary, the greater opportunity is to ensure consistent national arrangements across all ambulance trusts in line with the principles of JESIP. Therefore, there is opportunity to go further, in the spirit of recommendations 9 and 10, to deliver an improved national response. In line with our approach to consider emergency response nationally, the response to a major incident should not be determined by one ambulance trust in isolation and should not be treated as a matter for NWAS alone, in line with JESIP doctrine such as the 'Shared Situational Awareness' principle of JESIP. NHS England recognises the importance of clear procedures for declaring a Major Incident or Major Incident Standby, and for ensuring that declarations are communicated quickly and consistently within ambulance services and to emergency service partners. While NWAS should review its own systems and procedures, terminology used in major incident response must be consistent across all ambulance trusts and aligned with police, fire and wider emergency service partners, in line with the 'Communicate' principle of JESIP. The key risk is that local changes made by one trust could create further variation unless they are aligned to a national standard. The priority should be a nationally consistent approach across ambulance services and emergency service partners, so that terminology supports interoperability rather than creating local variation. Therefore, recommendations 9 and 10 should also sit with the Emergency Resilience Unit working with Association of Ambulance Chief Executives and ambulance trusts, and where relevant, the College of Policing, the national JESIP Team and other relevant partners to review and standardise across sectors. (Government Response to Phase 1 of the Southport Inquiry, CP 1623, 2 July 2026.)