How a trip to casualty and brush with global terrorism got me to thinking

Sunday doesn't feel like a good time to be heading off to a casualty department in any event, but when I pulled up outside the A & E department of University College Hospital (UCH), in London's West End at lunchtime last Sunday (7th September 2003), my heart sank. The sight of a fleet of police vehicles and an array of ambulance crews and hospital staff, made it clear that something was up and that my problems might very well turn out to be the least of their worries. I was escorting my brother, Brian, whose swollen and bruised face and grunts of pain suggested that his attempts at DIY had landed him with a broken jaw and it now looked as though we might be in for a long, long day.

A polite but firm police woman made clear that we would not be able to park outside the building, and, no, she did not know where we could park in the vicinity. Fortunately we found a spot in an adjacent street, and, making sure I had a concerned and desperate look on my face, I escorted Brian back around the corner to the hospital entrance where an attentive security guard immediately escorted us; into the building, straight to casualty reception, seated us and informed the casualty nurse that we were waiting.

With the worry over getting into the building out of the way and seated in reasonably comfortable seats I started to wonder what was going on. There were certainly a lot of people standing around or purposefully striding about and there was a definite air of anxiety outside the orderly calm of the casualty waiting area. However, we had barely made ourselves comfortable when the casualty nurse called us into the examination room where she quickly assessed that Brian needed to be seen by two sets of doctors and would need to have two sets of x-rays, one each for the; suspected concussion and jawbone fracture. She was also able to tell us what was going on. It was an exercise to test emergency response to a chemical attack on the underground and, good news; she didn't think it would delay us.

Over the course of the next three hours, Brian: saw a doctor, twice (no concussion), had two sets of x-rays (in completely different parts of the hospital), saw a consultant, twice (needed to get a second opinion), was allocated a bed, admitted to the ward and examined by a surgeon, all before being discharged with severe bruising in time for tea!

Reflecting on our experience I felt renewed confidence and pride in the good old National Health Service. While the timing of the exercise was unrealistic (terrorists are hardly likely to choose the quietest day of the week to strike) I could not help but be impressed by the way in which critical functions were being maintained in the face of exceptional circumstances, and in our case providing an exemplary service. And that got me to wondering about other emergency situations and shattering events, 9/11, the London and US blackouts, BSE, and the like and the preparedness of other kinds of organisation. Businesses, in particular, are vulnerable because unlike publicly funded institutions, an interruption in business continuity or loss of vital resources, people, infrastructure or data can bring about rapid commercial failure from which recovery is impossible. But, more to the point, I wondered how many organisations in the midst of an unexpected crisis would be able to, not just muddle through, but find within it an opportunity to outperform all expectations.

by PHIL TURNER