HART Programme

HART: Ambulance Staff Inside The Inner Cordon
The national vision, support and training for all HART teams is provided by the National Ambulance Resilience Unit (NARU).

HART teams – what are they?
Hazardous Area Response Teams (HART) are comprised of specially recruited and trained personnel who provide the ambulance response to particularly hazardous or challenging incidents, and in some cases where there is a mass casualty incident.

Utilising HART: Effective mobilisation of HART resources & the benefits to patients
These incidents may involve Chemical, Biological, Radiological or Nuclear (CBRN) or other hazardous materials, or could involve incidents such as train crashes, large-scale motorway accidents, building collapses or significant fires, and could be the result of an accident or caused deliberately.

Where are the HART Teams based?
HART teams are based in each of England’s eleven NHS Ambulance Trusts, which means they are able to cover the whole of the country, in some cases working together on specific incidents. Scotland has its own equivalent Special Operations Response Teams (SORT), whilst Wales has a Welsh HART team. View details of each HART team here.

How do they operate?
HART teams work alongside the police and fire & rescue services within what is known as the ‘inner cordon’ (or ‘hot zone’) of a major incident. The job of the HART teams is to triage and treat casualties and to help save lives in very difficult circumstances. They are also there to look after other emergency personnel who may become injured whilst attending these difficult and challenging incidents.

Part of the Model Response
HART forms part of the health response in support of the National Capabilities Programme being led by the Home Office, which aims to ensure that fewer lives would be risked or lost in the event of a terrorist-related attack, or accidental CBRN incident. Within this, the key objective is to improve CBRN response capabilities towards ensuring that, “if a terrorist attack occurs, the response from all concerned will be quick and effective with the result that lives are saved and the impact on property and the environment is minimised.”  (Office for Security & Counter-Terrorism: “Prepare”)

The latest HART Service Specification can be found here.

The Strategic Mandate for HART
The national strategic mandate for HART can be located across a range of central government priorities.  Provided here is a brief summary of the principle national drivers for HART.

Overview of the National Strategic Mandate for HART

National Mandate for HART

Civil Contingencies Act 2004

The Act designates the ambulance service as a Category 1 responder and creates a series of statutory duties in relation to responding to emergencies. The HART capabilities support compliance with a number of these statutory duties.

UK Counter Terrorism Strategy (Contest)

p.90 – 106 – Prepare strand of Contest strategy – HART provides a key part of the DH / NHS contribution to Contest work streams. HART specifically referenced in strategy.

National Capabilities Programme

Cabinet Office coordinated programme. 22 capability work streams combine to support the resilience of the UK. HART is a fundamental aspect of the NHS contribution to a number of these priority work streams. The work streams are outlined at:  http://www.cabinetoffice.gov.uk/content/22-capability-workstreams

Pitt Review

p. 10 – section on being rescued and cared for in an emergency (flooding) – Government accepted the need to extend rescue and care capabilities in flooding – HART IWO programme now contributes to this strategy

NHS Operating Framework

p.21 of the 2012/13 framework – emergency preparedness section mandates PCT commissioners to maintain the current capability and capacity of HART units.

Strategic Ambulance Contract

annex F – p.108-123 of the 2010/11 national contract guidance document provides a commissioning service specification for HART. The 2011/12 Annex to the 2010/11 guidance keeps HART Annex F applicable for the  2011/12 commissioning period.

National HART Service Specification

National HART Standard Operating Procedures