1. 1
Mass Casualties Table Top
Exercise
Scenario based at West Ham United
Football Club
Exercise date: 5 March 2009
13.00 – 17.00 hrs

2. 2
Aim of the exercise
To exercise London’s
collaborative response to a
mass casualty incident in
London and to scope the
effectiveness of existing
plans.

3. 3
Objectives
1. To scope the need for further
Mass Casualty Plans;
2. To ensure that all organisations develop an
understanding of:
the role of their own organisation in a
coordinated response to mass casualty
incidents;
the resilience required to maintain / refresh
a response over a unspecified protracted
period.

4. 4
West Ham football stadium
is situated on Green Street,
a high street that runs
north-south between the
A118 Romford Road and
the A124 Barking Road.
It is on the boundary of the former County
Boroughs of East Ham and
West Ham, in the Borough
of Newham.
Nearest underground
station is Upton Park.

5. 5

6. 6
The stadium is based at the
Boleyn Ground, commonly known
as Upton Park, in Newham, East
London.
The capacity of
the Boleyn
Ground is 35,303.

7. 7
The match begins at 19.45 hrs
on a Wednesday in March 2009

8. Incident reporting
20.20 hrs – first news of the
incident reported on SKY news. A
serious incident has occurred at
West Ham Football stadium. The
match has had to be abandoned
and the crowded football stadium
is being evacuated due to the
number of casualties.

9. 9
Shortly after kick off
The steel gantry above the fans in one of
the stands had suddenly collapsed due to
an apparent structural failure.
Panic sets in as the
fans in the upper
stand attempt to
escape from the
falling masonry
and steel girders.

10. 10
Injured fans surged forward and
attempted to climb over the
seating and jump into the lower
stand and to escape onto the
pitch. Many have been crushed
before they reach assistance.
Many more have
been injured in
the panic to try
and get to safety.

11. 11
At 20.30 hrs the London Ambulance
Service presence at the match
notifies Ambulance control of the
incident.
Vehicle access is
difficult via Green
Street due to the
volume of people
exiting the stadium.
Initial alert to blue light services

12. 12
Casualty estimates
An unknown number of
supporters have been crushed to
death by the collapsed masonry and
steel.
Approximately 2,000 more are
thought to have been injured.

13. 13
MAP SHOWING ACUTE TRUSTS
IN LONDON
HARD COPY WILL BE PROVIDED FOR EACH TABLE

14. 14
Group session 1
In your syndicate groups, please discuss for
each organisation represented:
1. How will your organisation be alerted?
2. What initial actions will you take?
3. Who will be coordinating the incident
management?
4. What are the challenges you will face?

15. 15
At 21.30 hrs casualties are estimated as:
Category Patient condition Nos
P1 Casualties needing immediate life-
saving resuscitation and/or surgery
500
P2 Stabilised casualties needing early
treatment but delay is acceptable.
500
P3 Casualties requiring treatment but a
longer delay is acceptable
1,000
Note: The critical trauma patients only have 60 minutes from the time of
injury to reach definitive surgical care, or the odds of successful recovery
will diminish dramatically.

16. 16
Local hospital capacity for
injured
Nominated Trust Category 1 Category 2 Category 3
Newham University NHS Trust 4 30 56
Whipps Cross University NHS Trust 6 10 60
Homerton University NHS Foundation Trust 10 30 200
King George’s University NHS Trust 3 10 30
TOTAL LOCAL BED CAPACITY 23 80 346
London Ambulance Service alert receiving hospitals of
the potential casualties and local trusts confirm the
following bed capacity.

17. 17
Group session 2
In view of the bed capacity gap locally,
please discuss:
1. What will your organisation do?
2. How will the response be coordinated
locally?
3. How will the response be coordinated
regionally?
4. How will organisations be
communicating with each other?

18. 18
Resources are stretched as
more casualties arrive

19. 19
By 22.30 hrs local hospital
capacity is exceeded
There are at least:
Category 1 Category 2 Category 3
500 500 1,000
who need to be accommodated at alternative Trusts.
Category Category 1 Category 2 Category 3
Capacity available
elsewhere in London
87 700 1194

20. 20
Group session 3
In light of this information, please discuss
for each organisation represented:
1. What actions will be taken?
2. What are the problems?
3. What are the problems associated with
the distance of other available hospitals?
4. What solutions can be delivered locally?

21. 21
Group session 4
It is now 09.00 hrs the following day and all
casualties requiring hospitalisation are in definitive
care. All those that could be treated and discharged
have been processed.
In light of this information, please discuss for each
organisation represented:
1. What are the organisational issues now?
2. What are the problems?
3. How will we offer immediate psychological
support to 2,000 people who may have psycho-
social problems in the aftermath of the incident?

22. 22
Group session 5
It is now one week after the incident.
1. What ongoing recovery issues will
your organisation be facing, if
any?
2. How will we offer medium and
long-term psychological support
to 2,000 people who may have
psycho-social problems in the
aftermath of the incident?

23. 23
Next steps
Please identify the next 5 steps for
mass casualties planning for your own
organisation.