The Interoperable Capabilities

Extending the NHS reach into high-risk environments

NARU’s role is to provide the national coordination required to ensure these capabilities remain interoperable

The United Kingdom’s Risk Register of Civil Emergencies details a range of threats to society.  These include accidental, environmental and malicious hazards.

The NHS is obligated to provide care to those caught inside the inner cordon of high-risk emergencies. Ambulance personnel cannot rely on other responding agencies to provide clinical care and extrication from these environments. Hence, a series of special capabilities allow the NHS to extend its reach into high-risk environments which is essential to save life and improve clinical outcomes.

In extending its reach, the NHS has also extended its legal duty of care, both to employees and to those critically in need of its services. It has simultaneously increased its exposure to risk. The capabilities that facilitate this care must, therefore, be subject to clear standards and a consistent safe system of work.

These capabilities have been commissioned nationally (and specified under the NHS Emergency Preparedness Resilience and Response Framework) to be ‘interoperable’.  This means they must remain consistent across all Ambulance Trusts so they can be combined to create a unified response to a national incident.

A fundamental part of NARU’s role is to provide the national coordination required to ensure these capabilities remain interoperable.  Our coordination activities include:

  • Specifying the capabilities through national contract standards.
  • Developing and maintaining the national safe system of work for each capability.
  • Providing national training and education to ensure consistency in the competence of specialist responders and commanders.
  • Specifying safety critical equipment and maintaining national buying frameworks.
  • Supporting a range of inspection and assurance activities.

A summary of the Interoperable Capabilities

The interoperable capabilities include:

These capabilities form part of the Government’s mitigation to events articulated in the National Risk Assessment and National Risk Register of Civil Emergencies. They also form part of the Department of Health and Social Care (DHSC) and NHS England contribution to Central Government Counter-terrorism strategies.

Each interoperable capability has a corresponding set of National Standards with include a number of funding obligations which fall upon each ambulance commissioning body.

The national capabilities that NARU coordinates centrally have been deployed to a number of high-profile emergencies including the Somerset floods, the terrorist attacks at Westminster Bridge and London Bridge, the Manchester Arena attack and the nerve agent attack in Salisbury and its aftermath.

In addition to these national emergencies, the specialist capabilities coordinated by NARU are used on a daily basis to provide care in hazardous situations by regional HART teams. These include:

Urban Search and Rescue (USAR)

Incidents involving working at height, in confined spaces or where there is difficult access or unstable terrain.

Incident Response Unit (IRU)

Incidents involving Chemical, Biological, Radiological or Nuclear (CBRN) materials or other Hazardous materials.           

Water Operations

Incidents including flooding and swift water rescue.

Support to Security Operations

Incidents including Marauding Terrorist Attack and police operations.