Claire Briggs

OFFICIAL 

2 February 2024 

By e-mail only 

Adrian Farrow  
HM Assistant Coroner 
Manchester South 

Our ref: Regulation 28 Report into the death of Claire Nicole Briggs 

Dear Adrian 

Thank you for your email and attachments regarding the Regulation 28 Report in the case of 
Claire Nicole Briggs. It was sad to read of the events that unfolded on the evening of the 28th 
of November 2022, that lead to the death of Claire, and our condolences are with the family 
at this time for their loss. 

Whilst the British Transport Police (BTP) were not involved in this case, and were not 
present at the hearing, I understand that reassurance is required regarding how BTP will 
ensure that the method of patient escalation is consistent with local responders and that the 
role of each responder is understood and communicated. 

Through the learning of the Manchester Arena Incident (MAI) review, BTP has improved 
communication between emergency services as well introducing a consistent approach to 
triage and identification of casualties across the UK. Whilst these reviews were as the result 
of the MAI, it was acknowledged that more focus was required on the triage of all incidents 
and not solely major incidents.  

Triage and Escalation  

As a result of the MAI enquiry, a review was carried out to look at different approaches to the 
triage of patients across the UK.  A working group of police, ambulance and fire & rescue 
responders was brought together to test various triage tools available and review the 
outcomes. This review concluded that the methods in existence for triage were poor at 
identifying patients’ immediate needs that includes lifesaving intervention. As a result, the 
“Ten Second Triage” (TST) tool has been developed, by the National Ambulance Resilience 
Unit, to provide a consistent and timely method of triage; this is expected to be in place 
across the NHS by April 2024. 

BTP are also adopting this model that improves the identification of incidents/ patients 
requiring escalation. Actions currently underway to ensure BTP officers and staff are 
adequately aware of this approach include: 

Page 1 of 2 

A29 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 OFFICIAL 

• 

• 

• 

Training in TST - This is now included in the BTP annual First Aid refresher 
sessions for 2024 - this has already started and will be completed by mid-2024. 
Officer Briefings – These have now commenced with circulation to all officers via 
the BTP “Lessons Exploitation Centre” as part of a Lesson of the week Bulletin. 
Control Room Briefings – Specific communication for staff in the BTP Control 
Rooms have been provided to support the exchange of initial triage information 
with our partner responder agencies. 

Communication 

Following the major incidents of MAI and Grenfell Tower, a recommendation was made to 
improve communications directly between the three Emergency Service Control Rooms 
(3ES -Police, Fire, Ambulance). This resulted in the creation of ESICTRL (Emergency 
Service Inter-Control) radio talk groups that provide 24/7, uninterrupted, radio 
communications directly between the 3ES control rooms. 

There are 12 ESICTRL talk groups established nationwide that provide each region with 
dedicated and reliable communication channels between Police, Ambulance and the Fire 
Service. BTP, as a national force, monitors all 12 talk groups that include the Northwest Area 
Talk group, that captures NW Ambulance Service, Northwest Fire and Rescue, and GMP; 
this is now a live and tested communication channel. 

These channels have allowed BTP to support the multi-agency response to incidents that 
occur within/ impact on its national railway jurisdiction and ensure responder roles and 
responsibilities are clearly communicated and understood.  

The actions to introduce TST supported by the capability for BTP to communication directly 
with other emergency responders, via ESCTRL, provides and enhanced level of response to 
those victims and patients in need of time critical support.  

Kind Regards, 

T/Assistant Chief Constable, Public Contact and Specialist Crime 

British Transport Police 
Address: Force Headquarters, 25 Camden Road, London NW1 9LN 
Email: 
Contact Telephone: 

Page 2 of 2 

A30

From: 
To: 
Sent: Fri Dec 22 2023 14:53:04 GMT 
Subject: External: CHESHIRE RESPONSE TO R28 Claire Nicole Briggs (deceased) (ref: 28264272) 

(Attachments:) Regulation 28 Report Cover Letter - Cheshire Con..pdf, Regulation 28 Report - Briggs 
(JOP).pdf 

Dear Sir 

I can confirm as follows in response to the Regulation 28 response for Cheshire Constabulary in 
connection with the Briggs inquest.  

1.  Cheshire Constabulary has been in liaison with NWAS and throughout the development of the 

JOP has been supportive and keen to move this forward.  

2.  In October 2023, we signed the original JOP, there were no barriers from us,  although other 

parties have “rejected” the proposed  JOP.  

3.  I have authorised for the revised JOP to now be signed and this has been completed by our Head 

of Public Contact on the final draft version dated 22/12/2023. 

4.  The document also includes several fire services, and British Transport Police. I am told they have 
not yet endorsed the policy but there is a meeting on 16th January 2024 for the coordination and 
the further signatories to meet and sign the document  

Cheshire Constabulary are supportive of the report and have fully agreed to endorse the final draft.  

From: Manchester South Coroner 
Sent: Friday, December 8, 2023 5:27 PM 
To: 
Cc: 
Subject: [EXTERNAL] RE: Claire Nicole Briggs (deceased) (ref: 28264272) 

CAUTION: This email originated from outside of the organisation. Do not click links or open attachments 
unless you recognise the sender and know the content is safe. 
Time in diary on 4/1 – deadline for response is 2/2/24 

Dear ACC Dutton, 

Our case reference: 

Please find attached a Regulation 28 Report for your attention. 

Kind regards, 

Coroner's Officer 

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 Contact us about this case 

NOTE: Please do not edit the subject line when replying to this email. 

Confidentiality:- This email, its contents and any attachments are intended only for the above named. As the email 
may contain confidential or legally privileged information, if you are not, or suspect that you are not, the above 
named or the person responsible for delivery of the message to the above named, please delete or destroy the 
email and any attachments immediately and inform the sender of the error.  

A2

31 January 2024 

Dear Mr Farrow 

Mr A Farrow 
HM Assistant Coroner 
HM Coroner Manchester South 
Email: 

Re: Regulation 28 Prevention of Future Deaths Notice 2023-0513 – Claire Nicole Briggs  

Thank you for your letter dated 8th December 2023 sent following the conclusion of your inquest 
into the death of Claire Nicole Briggs. 

I  understand  that  you  will  share  our  response  with  Claire’s  family,  and  I  wish  to  pass  on  our 
sincere condolences for their loss.   

Through the Regulation 28 letter you have raised a concern which involves North West Ambu-
lance Service (NWAS): 

‘A Joint Operating Protocol between the  North West Ambulance Service (NWAS) and the five 
regional police forces designed to address the issues of which emergency service should take 
responsibility for incidents involving drug overdoses and the method by which the police officers 
attending such incidents prior to the arrival of the ambulance service can escalate their concerns 
over a person suspected to have taken a drug overdose, was in an advanced stage of completion, 
but was stalled in July 2022. 

Whilst I heard that discussions have recently recommenced, they now encompass the Right Care, 
Right Person model, the findings of the Manchester Arena Bombing Enquiry and that additionally, 
the Fire and Rescue Service and the British Transport Police have now become involved. 

Pending agreement of a Joint Operating Protocol, there does not appear to be any consistent 
and reliable understanding in place across the police forces and the North West Ambulance Ser-
vice to provide clarity as to the roles of the respective services and the method by which concerns 
about individual patients can be escalated to the ambulance service by police officers dealing 
with those who are suspected to have taken drug overdoses.’ 

As  mentioned  in your  concern  during  the  time  of  the inquest  NWAS  had  engaged  with  all  the 
North West Police Forces and were advanced in the development of a Joint Operating Protocol 
(JOP) for the opening, updates, and closures of logs between NWAS and Police Forces. I can 
now confirm that four of the North West forces including Cheshire Constabulary and Merseyside 
Police and have now agreed and gone live with their JOPs.   

The main aims of the JOPs are to: 

•  Ensure clear process for sharing of information between agencies, understanding of pri-

macy and a clear escalation process for any operational issues. 

•  Set out the process to follow for requesting open lines. 
•  Detail the key principles for establishing a lead agency. 
•  Detail the process to follow for contacting NWAS’ clinical hub. 

The JOP should mitigate the gap in process that you highlighted and the learning from Claire’s 
tragic death and progress updates on the implementation of the Joint Operating Protocol will be 
overseen by the NWAS Regional Clinical Quality Assurance Committee which has representation 
from the Lancashire and South Cumbria Integrated Care Board (LSC ICB) as a commissioner of 
ambulance services.  

NHS Cheshire and Merseyside 
No 1 Lakeside, 920 Centre Park Square 
Warrington, WA1 1QY 

Communications@cheshireandmerseyside.nhs.uk 

Cheshireandmerseyside.nhs.uk 

A23 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 I am grateful to you for raising these issues with the NHS Cheshire and Merseyside ICB and I 
hope that this response has addressed the concerns raised. Should you require any further clar-
ification or information, please do not hesitate to contact me. 

Yours sincerely 

Executive Director of Nursing & Care 

NHS Cheshire and Merseyside 
No 1 Lakeside, 920 Centre Park Square 
Warrington, WA1 1QY 

Communications@cheshireandmerseyside.nhs.uk 

Cheshireandmerseyside.nhs.uk 

A24

Chief Constable 

Police Headquarters 
Carleton Hall, Penrith 
Cumbria 
CA10 2AU 

Dear Sir,  

26 January 2024 

Please find below a response to the Regulation 28 Report into the death of Claire Nicole Briggs.  

We have been working with NWAS and other regional police forces to agree a regional Information 
Sharing Agreement (ISA) as requested which has been signed by ACC Stalker on behalf of Cumbria 
Constabulary.  

We have been working under this Joint Operating Procedure (JOP) since the 12th October 2023. The 
JOP outlines the roles and responsibilities of each agency, how we share information and how to 
escalate any incidents through the command structure.  

We also have clinical support within Cumbria through our “treat and hear” facility which allows officers 
on the front line to provide updates direct to a member of NWAS. 

If you need any more information, please do not hesitate to contact me 

Regards 

Deputy Chief Constable  

A13

GREATER MANCHESTER

Deputy Chief Constable b POLICE

Mr Adrian Farrow

HM Assistant Coroner,

Greater Manchester (South) Coroner’s Court
1 Mount Tabor Street

Stockport, SK1 3AG

26" January 2024

Dear Sir

Re: Regulation 28: Report to Prevent Future Deaths concerning the inquest into the
death of Claire Nicole Briggs

Thank you for your letter enclosing the Regulation 28 Report to Prevent Future Deaths arising
from the inquest into the death of Claire Nicole Briggs, dated 8 December 2023. | have had
the opportunity to review the progress that has been made since Ms Briggs’ inquest concluded
in July 2023 and provide the following update, which | hope addresses the concerns that you
had identified about delays in the rollout and implementation of the Joint Operating Protocol
between Northwest emergency services.

Steps to develop the Joint Operating Procedure

The Northwest Ambulance Service (‘NWAS’) is the lead agency for the development of the
Joint Operating Procedure (‘JOP’).

Since Greater Manchester Police (‘GMP’) commenced Project Aurora — a project to implement
the principles of Right Care, Right Person (‘RCRP’) into its operating model — the lead branch
for progression of the JOP has been the Force Prevention Branch which took ownership of the
JOP in mid-2023. Prior to this change of ownership, the JOP was owned by the Force Contact,
Crime and Operations Branch (‘FCCO’). The reason for this change of ownership was to
ensure the JOP aligned with the RCRP proposals being progressed within GMP and to make
sure service delivery by GMP and NWAS would not negatively impact the communities of
Greater Manchester by having two potentially contradictory processes in place.

NWAS currently chairs bi-weekly meetings in relation to the JOP, which are attended by all
Northwest police forces and representatives from the relevant fire and rescue services and
Northwest Fire Control (‘NWFC’). GMP is represented at these meetings by personnel from
both the Force Prevention Branch and the FCCO (as the main business area affected by the
JOP), to ensure the details contained within the JOP are accurate and reflective of correct
working practices.

Al4

Further progress has been made to finalise, agree, and implement the JOP since the inquest
touching upon the death of Claire Briggs concluded. Version 1.0 of the JOP went live on 12
October 2023 with four of the five North West police forces, namely Cheshire Constabulary,
Cumbria Constabulary, Lancashire Constabulary and Merseyside Police.

Other partner organisations, including GMP, have yet to agree to the JOP. GMP considers the
wording contained within the section on ‘/dentifying the Lead Agency’ creates ambiguity and
could cause confusion. The current wording is not clear as to which organisation would be the
lead agency in certain circumstances, particularly in instances when there may be scene safety
concerns, and what such a designation would mean in practical terms. This section of the JOP
also suggests that two organisations could be considered the lead agency at the same incident
for different purposes (“the lead for the policing purpose would be the Police, NWAS would
remain the Lead Agency for the health matter’). |t is felt this current wording may create
confusion between organisations, such as with regards to who is expected to deploy resources
in the first instance which, in turn, may result in delays in deploying the right resources to the
scene, thus putting service users at risk. The wording as currently drafted is also at odds with
GMP’s RCRP proposals, specifically in relation to when GMP will deploy resources to medical
incidents and when GMP would be acting as a lead agency or in support of NWAS.

GMP recognises the importance of the JOP and is committed to working with NWAS and the
other Northwest police forces to produce a JOP that is fit for purpose and provides a high level
of service from the most appropriate agency to people in need. To this end, GMP is continuing
to work closely with all relevant partners, including NWAS, in order to reach a mutually
agreeable solution which not only works within the current working environment but aligns with
the future operating model of RCRP in Greater Manchester and across the Northwest region.

GMP and the four North West police forces which have signed up to the JOP are liaising with
one another via the bi-weekly JOP meetings, at the Northwest regional RCRP meetings and
via separate conversations between each force to understand our respective positions with
regards to the current version of the JOP. It is hoped that a mutually agreeable solution can
be reached that would see GMP sign up to the JOP by the end of February 2024.

It is envisioned that once the ‘Identifying the Lead Agency’ section is amended, it will align to
the current and proposed RCRP working practices for all contributing police services, meaning
the JOP would not need further updates to align with the RCRP processes of each police
service, nor would the content of the JOP be superseded by RCRP policies.

GMP is currently working closely with NWAS in respect of the RCRP project. Work is ongoing
in relation to the response to be provided by police and ambulance resources to incidents of a
physical health concern. To ensure an appropriate response is provided by both blue light
services, a partnership agreement specific to Greater Manchester is currently in development.
This partnership agreement will formally outline each organisation's roles and expectations at
incidents of Concern for Welfare (‘CFW’) where the primary or sole nature of the incident
relates to a physical health concern, and will ensure that GMP’s response to matters of physical
health concern, in conjunction with NWAS, is aligned to the principles of RCRP and the
regional JOP and that organisations meet their legal obligations under ECHR legislation.

A15

It is envisioned that the Greater Manchester specific partnership agreement and the regional
JOP will work in cohesion and ensure processes specific to Greater Manchester is clearly
understood by both organisations.

It is anticipated that this partnership agreement will be complete by the end of April 2024.

Communicating and explaining the JOP

Once the JOP has been agreed for launch in Greater Manchester, and before the
implementation stage, there will be a process within the FCCO to ensure that all staff are made
aware of the document and that they understand its purpose and aims, its relevance to GMP,
and how it should be used by them. This message will be distributed by the senior leadership
team within the FCCO to all supervisors within the branch for further cascading to all staff
members.

In the interim, as the JOP has now been launched with all Northwest police forces except for
GMP, to ensure there is no misunderstanding or incorrect application of the JOP within Greater
Manchester, contact has been made with NWAS to ensure there is a mutual understanding
that the JOP is not currently in place within Greater Manchester.

An interim protocol

In November 2022, communication was distributed throughout the FCCO outlining the
escalation process between GMP and NWAS. This message was reinforced in June 2023 via
internal messaging and is recirculated, as necessary, to ensure consistent compliance. What
was initially introduced as an interim measure in 2022 is now considered “business as usual”
and, through regular liaison with NWAS, is regarded as appropriate practice for both
organisations. These escalation processes are outlined below:

e For GMP to obtain further information or an estimated time of arrival (‘ETA’) for an
ambulance, a call to NWAS should follow normal process by a police dispatcher using
the non-urgent ICCS hotkey (a system that is used to report an incident/pass
information to partner agencies).

e The Hear and Treat service is an option for the officer on scene to discuss the
circumstances with a clinician. An ambulance may not always be required, and advice
can be passed. It is highlighted to officers that this service is not to be used to try and
upgrade the ambulance response or to give information that the patient’s condition has
deteriorated or worsened in any way. In such circumstances, NWAS must be called on
999 or ICCS for the incident to be triaged again.

A16

e Should GMP experience any issues, such as significant delays in ambulance
attendance when police are already on scene, and contacting NWAS using the non-
urgent number has failed to resolve the issue, GMP can contact the NWAS Emergency
Operations Centre (‘EOC’) performance manager via agreed telephone lines which
have been distributed within the FCCO. This number is only to be used by
supervisors/duty managers and is not to be used to report a change in the patient’s
condition.

e If there is a requirement for further escalation, the GMP duty manager/inspector only
can contact the NWAS GM EOC duty manager via an agreed telephone number. This
number is not to be made available to anyone outside of the FCC and is only available
to inspectors or above to ensure the integrity of the service.

e Any further escalations will be via the Force Duty Officer (‘FDO’) as per current
processes.

e GMP now also has access to the NWAS cancellation line in order to cancel an
ambulance. This bypasses the NWAS call handlers and is a direct number to their
dispatch room. It may also be used to discuss any particular concerns where officers
have remained on scene, but escalation is not yet required. This number is available
for use by GMP dispatchers but must not be used to give updates to NWAS about the
patient’s condition.

e GMP is also working on a process for NWAS to escalate to GMP via the dispatch duty
inspector prior to making contact with the FDO, as a resolution can often be found
without FDO intervention.

e The Hear and Treat service has been relaunched across GMP. This was
communicated to officers and staff forcewide on 4 October 2023 via the Force intranet.
An article has been published on the intranet which outlines the purpose and benefits
of the Hear and Treat service alongside the contact telephone number for use by
frontline officers.

e The Force Operations Centre collates daily data regarding any delays between the two
services and reports to FCCO senior leadership every Monday.

e Weekly meetings between senior GMP, NWAS and Greater Manchester Fire and
Rescue Service (‘GMFRS’) colleagues are held to discuss demand and any issues that
have occurred during that week.

Whilst work with partners to implement a mutually agreeable JOP in Greater Manchester

continues, the above measures are in place to ensure GMP and NWAS can communicate and
escalate concerns via agreed processes where necessary.

Al7

| trust that the above demonstrates that a considerable amount of work is underway to agree
and implement the JOP in conjunction with the work to roll out the Right Care, Right Person
programme. Both of which are aimed at ensuring a more consistent and joined-up approach
is taken across all emergency services in the Northwest when deploying resources to

incidents.

Yours sincerel

Deputy Chief Constable
Greater Manchester Police

n

A18

E: 

Date: 31 January 2024 

Mr A Farrow 
HM Assistant Coroner 

Dear Mr Farrow 

Re: Regulation 28 Prevention of Future Deaths Notice 2023-0513 – Claire Nicole Briggs  

Thank you for your Regulation 28 Report dated 8 December 2023 concerning the sad death of Claire 
Nicole Briggs on 28 November 2022. On behalf of NHS Greater Manchester Integrated Care (NHS 
GM), we would like to begin by offering our sincere condolences to Claire’s family for their loss. 

Thank you for highlighting your concerns during the inquest.  On behalf of NHS GM, we apologise that 
you have had to bring these matters of concern to our attention.  We recognise it is very important to 
ensure we make the necessary improvements to the quality and safety of future services.   

Following the inquest, you raised concerns in your Regulation 28 Report that there is a risk a future 
death will occur unless action is taken. We have worked with the 2 other ICBs in the Northwest who 
also use North West Ambulance Service particularly Lancashire ICB who act as a lead commissioner 
for the provider to review the concerns and ensure steps are taken to progress the concerns raised. 

I hope the response below demonstrates to you and Claire’s family that NHS GM has taken the 
concerns you have raised seriously and will learn from this as a whole system.  

This letter addresses the issues that fall within the remit of NHS GM and how we can share the learning 
from this case. 

The evidence heard was that a Joint Operating Protocol between the North West Ambulance 
Service and the five regional police forces designed to address the issues of which emergency 
service should take responsibility for incidents involving drug overdoses and the method by 
which the police officers attending such incidents prior to the arrival of the ambulance service 
can escalate their concerns over a person suspected to have taken a drug overdose, was in an 
advanced stage of completion, but was stalled in July 2022. 

Whilst the court heard that discussions have recently recommenced, they now encompass the 
Right Care, Right Person model, the findings of the Manchester Arena Bombing Enquiry and 
that additionally, the Fire and Rescue Service and the British Transport Police have now 
become involved. 

Pending agreement of a Joint Operating Protocol, there does not appear to be any consistent 
and reliable understanding in place across the police forces and the North West Ambulance 
Service to provide clarity as to the roles of the respective services and the method by which 
concerns about individual patients can be escalated to the ambulance service by police officers 
dealing with those who are suspected to have taken drug overdoses. 

4th Floor, Piccadilly Place, Manchester  M1 3BN   
www.gmintegratedcare.org.uk 

A19 
  
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 As mentioned in your concern during the time of the inquest NWAS had engaged with all the North 
West Police Forces and were advanced in the development of a Joint Operating Protocol (JOP) for the 
opening, updates and closures of logs between NWAS and Police Forces. I can now confirm that four 
of the North West forces have now agreed and gone live with their JOPs and NWAS are making some 
slight amendments to the wording of the JOP with Greater Manchester Police (GMP) with the intention 
for this to be completed and signed off on the 1 February 2024. It will then go live in this area.   

The main aims of the JOPs are to: 

•  Ensure clear process for sharing of information between agencies, understanding of primacy 

and a clear escalation process for any operational issues. 

•  Set out the process to follow for requesting open lines. 
•  Detail the key principles for establishing a lead agency. 
•  Detail the process to follow for contacting NWAS’ clinical hub. 

The JOP should mitigate the gap in process that you highlighted and the learning from Claire’s tragic 
death and progress updates on the implementation of the Joint Operating Protocol will be overseen by 
the NWAS Regional Clinical Quality Assurance Committee which has representation from the 
Lancashire and South Cumbria Integrated Care Board (LSC ICB) as a commissioner of ambulance 
services.  

Actions taken or being taken to share learning across Greater Manchester: 

1.  The Regulation 28 and our response to be presented/shared with the Greater Manchester 

System Quality Group on 21 March 2024. This meeting is attended by commissioners, including 
commissioners of specialist services, localities, regulators, Healthwatch and NICE. Through 
sharing in this forum, we expect members to review and ensure learning is incorporated into 
their commissioned services. 

2.  Progress updates on the implementation of the Joint Operating Protocol will be overseen by the 
NWAS Regional Clinical Quality Assurance Committee which has representation from the 
Lancashire and South Cumbria Integrated Care Board (LSC ICB) as a commissioner of 
ambulance services.  

In conclusion, key learning points and recommendations will be monitored to ensure they are 
embedded within practice. 

We hope this response demonstrates to you and Claire’s family that the North West ICBs have taken 
the concerns you have raised seriously and are committed to working together as a system including 
our service users, carers and families to improve the care provided.  

Thank you for bringing these important patient safety issues to our attention and please do not hesitate 
to contact me should you need any further information. 

Yours sincerely 

Interim Deputy Chief Executive Officer  
 and Chief Nursing Officer 
NHS Greater Manchester 

4th Floor, Piccadilly Place, Manchester  M1 3BN   
www.gmintegratedcare.org.uk 

A20

From: 
To: 
Sent: Thu Feb 01 2024 23:34:46 GMT 
Subject: External: FW: RE: Regulation 28 Report into the death of Claire Nicole Briggs 

F.A.O Adrian Farrow – HM Assistant Coroner. 

Dear Mr Farrow,  

In response to the Regulation 28 Report into the death of Claire Nicole Briggs sent to our Assistant Chief 
Constable on the 8th of December 2023, please see below response on behalf of Lancashire Police: 

Lancashire Police have been working with North-West Regional Forces and NWAS to finalise, 
agree and implement a Joint Operating Protocol (JOP). This was initially agreed and the final 
version V1.0 of the Regional Standard Operating Procedure – Information Sharing in 
Relation to Incident Logs went live on Thursday 12th October 2023. It was also agreed with the 
regional Forces and NWAS that monthly meetings will continue until North-West Fire and GMP 
were able to proceed with the agreement.   

Lancashire Police are already working closely with North-West Regional Forces and North-West 
Ambulance Service in relation to agreed processes in the Joint Operating Protocol. The 
document will provide clarity and guidance to Control Room staff regarding escalation of 
incidents due to delays. It will also give operational officers at the scene of an incident guidance 
and information to obtain direct clinical advice from Northwest Ambulance Service prior to them 
arriving on the scene of an incident. Implementation was initially via email/briefing to all Force 
Control Room Supervisors and Force Incident Managers.  

Rollout via email briefing was due to take place to operational officers and Control Room staff to 
be made aware of the purpose and aims of the JOP, how it applies to that agency and how it 
should be used by staff. However, this has been delayed due to GMP having issues with the 
wording in the document about the responsibilities of the lead agency. Further meetings have 
now taken place with all regional forces to agree the wording. Version 1.3 was due to go live on 
31/01/2024, however this is still waiting sign off from GMP and Fire and Rescue. Lancashire 
Police are happy and have signed off with the Version 1.3 document, and we are just waiting for 
confirmation of go live from Northwest Ambulance Service who are leading on the document.  

If you require any further detail, please do not hesitate to contact me.  

Kind regards 

. 

Operations Manager - West 
Force Control Room 
HQ – Contact Management 
Lancashire Constabulary 

m: 

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A26

Mr Adrian Farrow 
Coroner’s Court 
1 Mount Tabor Street 
Stockport 
SK1 3AG 

Dear Mr Farrow 

Please ask for:  
Telephone:  
Email: 
Date: 

Area Manager 

30 January 2024 

REGULATION 28 REPORT INTO THE DEATH OF CLAIRE NICOLE BRIGGS 

Thank you for raising the concern in relation to the death of Claire Nicole Briggs on 28 November 
2022.   It  is  with  great sadness that  I  read about the  circumstances  of  Claire’s  death  and I,  on 
behalf of Lancashire Fire and Rescue Service (LFRS), wish to pass on our condolences to the 
family and friends of Claire Nicole Briggs. 

LFRS were not involved in this tragic incident but we are committed to a culture of improvement 
and learning from lessons identified.  LFRS actively supports and works to the Joint Emergency 
Services Interoperability Programme (JESIP) doctrine, promoting effective interagency working 
through its principles of Co-Location, Communication, Co-ordination, Joint Understanding of Risk 
and Shared Situational Awareness.  LFRS regularly review policies, procedures and training in 
line with JESIP.  LFRS has adopted the National Fire Chief Councils (NFCC) National Operational 
Guidance,  which  is  considered  good  practice;  this  guidance  has  been  incorporated  into  LFRS 
Standard Operating Procedures (SOP). 

The  LFRS  Immediate  Emergency  Care  SOP  clearly  outlines  a  number  of  areas  in  relation  to 
operational practice, dealing with casualties suffering from mental health issues, transportation of 
casualties, consent when responding to adults and casualty information.  It is acknowledged that 
there  are  occasions  when  LFRS  resources  may  arrive  at  an  incident  prior  to  North  West 
Ambulance Service (NWAS).  All operational personnel within LFRS are trained and assessed in 
immediate emergency care which is clinically governed by an external provider.   Should an LFRS 
resource arrive prior to NWAS, LFRS personnel will assess the casualty and initiate care where 
necessary. 

Within numerous SOP’s (Communications, Gaining Entry, Immediate Emergency Care), guidance 
is provided for personnel to access remote clinical support.  If there is a delay in NWAS response, 
or  if  the  casualties  condition  appears  to  be  deteriorating,  personnel  are  directed  to  utilise  the 
clinical support lines provided by NWAS Clinical Support Hub or Trauma Cell.   All front line fire 
appliances and officers have access to these numbers via fallback telephones.  Clinical advice 
and guidance will be provided over the phone with the potential for the NWAS response to be 
upgraded.  

Through  North  West  Fire  Control  (NWFC),  LFRS  personnel  can  request;  NWAS  resource 
estimated  time  of  arrival,  NWAS  categorisation  of  an  incident,  contact  from  NWAS  Clinical 
Support Hub or Trauma Cell.  LFRS personnel can also provide NWFC with updated casualty 
information which will be passed to NWAS with the potential for an upgraded response.  

There  is a  tri-service  communication  link between  NWFC and  the other  blue-light emergency

1 

A21 
 
 
 
 
 
 
 
 
 
 service control rooms. This is achieved via an Emergency Services Inter-Control Talk-Group. This 
line of communication is robust, resilient, practised and tested regularly. 

The Lancashire Resilience Forum (LRF) Emergency Radio Area Link (ERAL) is a resilient radio 
network which provides wide area coverage across the county of Lancashire and partial cross-
border coverage into Cumbria, Yorkshire, Greater Manchester and Merseyside.  ERAL has the 
capability  to  provide  encrypted  secure  communication  over  voice  and  text  and  enables  all 
Lancashire Category 1 and 2 responders (and their authorised partners) (as defined in Schedule 
1 of the Civil Contingencies Act 2004) to communicate with each other during an emergency on 
a common radio network.  The ERAL network is the preferred backup mode of communication, 
as detailed within the LRF Resilient Telecommunications Plan. It allows responders to maintain 
interoperability during events where normal communication modes are disrupted e.g., during the 
loss of power. 

Through these communication modes, there are a multitude of ways LFRS personnel can contact, 
(and maintain contact) with, NWAS to determine the best and most appropriate care, and advice 
from clinicians. 

NWAS update LFRS and NWFC regarding operational pressures they are facing. When NWAS 
REAP  (Resource  Escalation  Action  Plan)  levels  are  escalated  and  demand  increases,  this 
information  is  shared  therefore  allowing  LFRS  personnel  to  consider  making  early  use  of  the 
NWAS Trauma Cell. 

Although LFRS vehicles should not be used for the transportation of casualties, in exceptional 
circumstances,  if  it  is  deemed  that  transporting  a  casualty  would  potentially  be  a  lifesaving 
intervention, there is a clearly defined process.  This includes contacting the NWAS Trauma Cell, 
undertaking an on scene risk assessment and seeking authorisation from an LFRS duty officer.  

In  response  to  the  recommendations  made,  LFRS  believes  that  appropriate  guidance  and 
processes  are  available  and  in  place,  and  I  trust  this  response  addresses  the  matters  raised. 
LFRS  will  continue  to  adopt  existing  JESIP  principles  and  operational  guidance,  promoting 
collaborative working between blue-light partners, whilst striving to develop guidance and process 
to ensure the most effective response is delivered.  

Yours sincerely 

Area Manager 
Head of Service Improvement 
Lancashire Fire and Rescue Service 

Headquarters 
Lancashire Fire and Rescue Service 
Garstang Road, Fulwood 
Preston 
PR2 3LH 

2 

A22

Please contact:

Email: 

24 January 2024

Mr A Farrow
HM Assistant Coroner
HM Coroner Manchester South

Dear Mr Farrow

Re: Regulation 28 Prevention of Future Deaths Notice 2023-0513 – Claire Nicole Briggs 

Thank you for your letter dated 8th December 2023 sent following the conclusion of your inquest into  the 
death of Claire Nicole Briggs.

I  understand  that  you  will  share  our  response  with  Claire’s  family  and  I  wish  to  pass  on  our  sincere 
condolences for their loss.  

Through the Regulation 28 letter you have raised a concern which involves North West Ambulance Service 
(NWAS):

‘A Joint Operating Protocol between the North West Ambulance Service (NWAS) and the five regional 
police forces designed to address the issues of which emergency service should take responsibility for 
incidents involving drug overdoses and the method by which the police officers attending such incidents 
prior to the arrival of the ambulance service can escalate their concerns over a person suspected to have 
taken a drug overdose, was in an advanced stage of completion, but was stalled in July 2022.

Whilst I heard that discussions have recently recommenced, they now encompass the Right Care, Right 
Person model, the findings of the Manchester Arena Bombing Enquiry and that additionally, the Fire and 
Rescue Service and the British Transport Police have now become involved.

Pending agreement of a Joint Operating Protocol, there does not appear to be any consistent and reliable 
understanding in place across the police forces and the North West Ambulance Service to provide clarity 
as to the roles of the respective services and the method by which concerns about individual patients can 
be escalated to the ambulance service by police officers dealing with those who are suspected to have 
taken drug overdoses.’

As mentioned in your concern during the time of the inquest NWAS had engaged with all the North West 
Police Forces and were  advanced in the development of a Joint Operating Protocol (JOP) for the opening, 
updates and closures of logs between NWAS and Police Forces. I can now confirm that four of the North 
West  forces  have  now  agreed  and  gone  live  with  their  JOPs  and  NWAS  are  making  some  slight 
amendments to the wording of the JOP with Greater Manchester Police (GMP) with the intention for this 
to be completed and signed off on the 1st February 2024. It will then go live in this area.  

The main aims of the JOPs are to:

 Ensure clear process for sharing of information between agencies, understanding of primacy and 

a clear escalation process for any operational issues.

 Set out the process to follow for requesting open lines.
 Detail the key principles for establishing a lead agency.

A3 
 
  Detail the process to follow for contacting NWAS’ clinical hub.

The JOP should mitigate the gap in process that you highlighted and the learning from Claire’s  tragic 
death  and progress updates on the implementation of the Joint Operating Protocol will be overseen by 
the NWAS Regional Clinical Quality Assurance Committee which has representation from the  Lancashire 
and South Cumbria Integrated Care Board (LSC ICB) as a commissioner of ambulance services. 

I am grateful to you for raising these issues with the LSC ICB and I hope that this response has addressed 
the concerns raised. Should you require any further clarification or information, please do not hesitate to 
contact me.

Yours sincerely

Chief Nursing Officer

A4

Adrian Farrow 
HM Assistant Coroner 
Manchester South Coroner's Court 
1 Mount Tabor Street 
Stockport 
SK1 3AG 

Sent by email: 

Solicitor 
Fire Service Headquarters 
Bridle Road, 
Bootle, 
Merseyside 
L30 4YD 

Telephone:  

Web Site: 
www.merseyfire.gov.uk 

Date: 15th October 2024 

Dear Sirs 

Regulation 28 Report into the death of Claire Nicole Briggs 

Upon receipt of the Regulation 28 referred to above Merseyside Fire and Rescue 
Service reviewed its current procedures and standards of communication with its blue 
light partners, in particular with North West Ambulance (‘NWAS’). 

Whilst Merseyside Fire and Rescue Service (‘MFRS’) has a Memorandum of 
Understanding in place with NWAS for specific types of incidents for example a concern 
for welfare which details the actions of both parties there are also additional established 
procedures for communicating casualty information. There are written instructions 
employees must adhere to when relaying casualty information. This casualty information 
is transmitted in the following format. 

• 

Gender 

A35 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 • 

• 

o 
o 
o 
o 

• 

o 
o 
o 
o 

• 

o 

Age – if unknown Incident Commander should confirm if child, youth, adult or 
elderly 

Level of consciousness, breathing and presence of pulse: 

Breathing and conscious 
Breathing but unresponsive 
Unresponsive, not breathing 
Unresponsive, not breathing, no pulse 

Suffering from: 

Smoke inhalation – slight or severe 
Bleeding – severity and location of bleed 
Burns – severity and location of burns 
Other injuries/condition 

Activity of MFRS crews: 

e.g. giving CPR, administering oxygen, bleeding control, burns treatment, etc. 

Operational crews on scene are instructed to note any changes in the condition of 
casualties and report these using the same format as above to MFRS Fire Control as 
soon as observations change. As well as this information being passed on to NWAS’s 
control room, the MFRS Fire Control will also relay back to crews on scene the 
estimated time of arrival for a NWAS resource. Where crews on scene feel that a swifter 
response is required they can escalate by asking MFRS Fire Control to contact the 
NWAS emergency operations centre direct and speak to the senior paramedic who can 
expedite an attendance if needed. 

For situations where the casualty condition appears initially less serious there is also the 
option of providing a phone number to the emergency operations centre to allow a 
clinician to remote triage the casualty. 

We believe the measures already in place are sufficient to prevent future deaths arising 
from the circumstances outlined in the Regulation 28 notice. 

Yours faithfully, 

Head of Legal and Democratic Services   

A36

Adrian Farrow 
Manchester South Coroner’s Court 
1 Mount Tabor Street 
Stockport 
SK1 EAG  

Dear Coroner, 

National Medical Director  
NHS England  
Wellington House 
133-155 Waterloo Road  
London 
SE1 8UG 

2nd February 2024  

Re: Regulation 28 Report to Prevent Future Deaths – Claire Nicole Briggs who 
died on 28 November 2022.  

Thank  you  for  your  Report  to  Prevent  Future  Deaths  (hereafter  “Report”)  dated  8 
December 2023 concerning the death of Claire Nicole Briggs on 28 November 2022. 
In advance of responding to the specific concerns raised in your Report, I would like 
to express my deep condolences to Claire’s family and loved ones. NHS England are 
keen to assure the family and the coroner that the concerns raised about Claire’s care 
have been listened to and reflected upon.  

Your Report  raises the concern that there is no national guidance as to how high-risk 
drug overdoses should be identified by ambulance services. Ambulance Emergency 
Operation  Centres  (EOCs)  follow  specific  principles  to  ensure  clinical  oversight  for 
patients calling and presenting with overdose and suicidal ideations. On 2 April 2019, 
Professor  Jonathan  Benger  –  then  National  Clinical  Director  for  Urgent  and 
Emergency Care at NHS England – wrote to ambulance trusts and NHS 111 providers 
to mandate that robust clinical oversight was in place in control rooms to monitor self-
harm and suicidal patients safely and effectively.  

In  2020,  the  Healthcare  Safety  Investigation  Branch  (HSIB),  investigated  the 
potentially under-recognised risk of harm from the use of propranolol. They made a 
safety  recommendation for NHS England to  evaluate current  approaches to clinical 
oversight of overdose calls within ambulance control rooms, and to develop a national 
framework  to  describe  requirements  for  appropriate  clinical  oversight  of  overdose 
calls.  

NHS  England  issued  guidance  for  Ambulance  Services  relating  to  overdoses  and 
suicidal intent in April 2021.  The internal guidance sets out that, where an overdose 
is  declared,  further  clinical  intervention  should  take  place,  or  the  case  should  be 
automatically upgraded if this does not occur within a specified time (30 minutes). To 
enable  this  process,  NHS  Pathways  introduced  a  distinct  disposition  code  in  April 
2019: Emergency Ambulance Response for Risk of Suicide (Category 3). This means 
these cases can be more effectively and rapidly picked out by clinical advisors at the 
ambulance service.    

The overdose guidance was updated in November 2023 to include callers who reach 
a Category 5 code for overdose/accidental ingestion or a potential threat of suicide to 

A27                                                                                                                       
 
 
 
 
 
 
 
 
 
 
 
  
  
  
 
 
 ensure that the control room have a similar process to that for Category 3 requirements 
for  overdose  and  suicidal  intent  patients.  This  followed  a  review  by  the  Emergency 
Call  Prioritisation  Advisory  Group  (ECPAG,  NHS  England)  and  the  National 
Ambulance  Service  Medical  Director’s  Group  (NASMeD,  Association  of  Ambulance 
Chief Executives) to ensure it remained fit for purpose.    

Ambulance response dispositions within primary triage systems (e.g. NHS Pathways) 
are  reached  based  on  symptom  assessment,  and  where  this  relates  to  a  suicide 
attempt, or where there is a finding of suicidal intent, the lowest disposition that can 
be reached within NHS Pathways is a Category 3 emergency ambulance response. 
More  urgent  ambulance  dispositions  may  be  reached  where  immediately  life-
threatening symptoms or features are present e.g., loss of consciousness or difficulty 
breathing.  

NHS  England  recognises  the  significant  pressure  on  ambulance  services  since  the 
Covid-19 pandemic, which has seen longer response times across all categories than 
before the pandemic. That is why NHS England have continued to focus on improving 
ambulance performance for 2023/24, supported by the Delivery Plan for Recovering 
Urgent and Emergency Care Services, published in January 2023. The plan outlines 
the actions and steps that we are taking across England to recover and improve urgent 
and  emergency  care  services,  including  improving  ambulance  response  times, 
increasing  ambulance  capacity  through  growing  the  workforce,  speeding  up 
discharges from hospitals, expanding new services in the community, and taking steps 
to tackle unwarranted variation in performance in the most challenged local systems. 

I would also like to provide further assurances on national NHS England work taking 
place around the Reports to Prevent Future Deaths. All reports received are discussed 
by  the  Regulation  28  Working  Group,  comprising  Regional  Medical  Directors,  and 
other clinical and quality colleagues from across the regions. This ensures that key 
learnings and insights around preventable deaths are shared across the NHS at both 
a national and regional level and helps us pay close attention to any emerging trends 
that may require further review and action.  

Thank you for bringing these important patient safety issues to my attention and please 
do not hesitate to contact me should you need any further information. 

Yours sincerely, 

Yours sincerely,   

National Medical Director  

A28

LADYBRIDGE HALL 
399 Chorley New Road 
Bolton 
BL1 5DD 

T:  

nwas.nhs.uk 

Adrian Farrow  
Assistant Coroner 
Manchester South Coroners Court 

BY EMAIL ONLY 

6 February 2024 

Dear Mr Farrow, 

NWAS Response: Regulation 28 Report 

Thank you for your letter dated 8 December 2023 sent following the conclusion of the inquest touching the 
death of Claire Nicole Briggs which commenced on 11 July 2023. I know that you will share my response 
with her family and I firstly want to express my sincere condolences to them.  

I understand you have issued two Regulation 28 reports. This response is prepared in solely in response 
to the Regulation 28 report addressed to NWAS (and others) in relation to the Joint Operating Protocol 
(JOP).  

I note you have requested NWAS:-  

Provide clarity as to the roles of the respective services and the method by which concerns about 
individual patients can be escalated to the ambulance service by police officers dealing with those 
who are suspected to have taken drug overdoses.  

You  have  raised  your  concern  having  heard  evidence  relating  to  the  preparation  of  a  Joint  Operating 
Protocol  (JOP)  between  the  North  West  Ambulance  Service  and  the  five  regional  police  forces  which 
stalled in July 2022 but was at an advanced stage of completion at the time of the inquest.  

This  Joint  Operating  Protocol  was  designed  to  improve  communication  between  the  North  West 
Ambulance  Service  and  the  Police  forces  at  all  incidents  including  those  involving  drug  overdoses.  It 
addresses the issues of which emergency service should take responsibility for incidents and the method 
by  which  the  police  officers  attending  such  incidents  prior  to  the  arrival  of  the  ambulance  service  can 

A31 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 escalate their concerns. For instance, this could be in relation to a person suspected to have taken a drug 
overdose.  

As confirmed in the evidence provided by the Trust during the inquest, the JOP implementation process 
was recommenced with all Police partners on 6 July 2023 and involved fortnightly meetings with all parties. 
The aim of these meetings was to agree a standard format and wording for the JOP to be used across the 
North West. 

On 12 October 2023, the JOP went live within NWAS in conjunction with Cheshire, Cumbria, Lancashire 
and Merseyside Police Forces. This version was not adopted by Greater Manchester Police and although 
discussions were still ongoing with them, it was considered important that the process and implementation 
was not delayed. 

We have continued to work closely with Greater Manchester Police to overcome any remaining barriers 
and an updated version of the JOP has now been agreed with Greater Manchester Police who are in the 
final stages of sign off. It is anticipated the updated version of the JOP will be implemented and “go live” 
across the whole North West following the next meeting with police partners, scheduled for the latter part 
of February 2024. 

Following the conclusion of the inquest, the Trust has also engaged with British Transport Police, North 
West Fire Control, Fire and Rescue Services from Lancashire, Greater Manchester, Cheshire and Cumbria 
and  encouraged  them to  sign  the JOP.  Extending the  JOP to  include these  partner  agencies  will bring 
additional  benefits  to  the  whole  of  the  North  West.  British  Transport  Police  and  Merseyside  Fire  and 
Rescue have signed off the updated version of the JOP. North West Fire Control and Lancashire, GM, 
Cheshire  and  Cumbria  Fire  and  Rescue  Services  are  to  review  the  document  at  the  Operations 
Management Committee scheduled to take place in early February 2024. 

I am grateful to you for highlighting your concern to me. Your concern has reaffirmed the need for joined 
up  working  and the  importance  of  the Joint Operating  Protocol.  It  has  been  extremely  useful  in driving 
forward the work outlined in this letter. 

I hope that by this letter, I have addressed your concerns, but should you require any further clarification 
or information, please do not hesitate to contact me or the Trust’s Assistant Director of Legal Services, Ms 

.  

Yours sincerely,  

Chief Executive 

A32 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 A33

Lingley Mere Business Park 
Lingley Green Avenue 
Great Sankey, Warrington 
Cheshire,WA5 3UZ 

T: 
E: 

Date: 26th January 2024 

Mr Adrian Farrow 
Coroner’s Court 
1 Mount Tabor Street 
Stockport 
SK1 3AG 

Dear Sir 

RE: Regulation 28 Report into the death of Claire Nicole Briggs 

1.  North West Fire Control 

1.1. 

I write to you regarding the Regulation 28 notice issued to North West Fire Control (NWFC) 

on 8th December 2023 regarding the death of Claire Nicole Briggs.  It is with great sadness 

that I read about the circumstances of her death. 

1.2.  NWFC  was  not  involved  in  this  tragic  incident  but  is  committed  to  learning  and 

improvement from lessons identified.  The response below explains the processes that

the organisation currently has in place or planning to implement to reduce the risk of any 

future event that may involve NWFC. 

NWFC  is  a  shared  control  room  for    Lancashire,  Greater  Manchester,  Cumbria  and 

Cheshire fire and rescue service.  It was established in May 2014 after amalgamation of 

the  above  four  fire  and  rescue  service  control  rooms  and  is  based  in  Warrington.    It 

operates 24 hours a day, 365 days per year. 

1 

A5 
 
          
 
 
 
 
 
 
 
 
          
  
 
 
 
 
 
 
 
 
 
 
 
 
 
                       
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
           
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 1.3.  NWFC is responsible for receiving emergency calls, mobilising fire engines and other 

resources to incidents, liaising with the incident ground, and liaising with other 

emergency services and recording this information.  During the 12 month period of 

2022/23 year, it dealt with 135,455 emergency calls. 

1.4.  NWFC will deal with emergency calls in accordance with the call handling policy and 

procedures supplied to it by the fire and rescue service as set out in our service level 

agreement. 

2.  Multi-Agency Interoperability 

2.1.  NWFC supports the consistent and robust embedding of the Joint Emergency Services 

Interoperability Programme (JESIP), which promotes effective inter-agency working 

through its principles of Co-Location, Communication, Co-ordination, Joint 

Understanding of Risk, and Shared Situational Awareness.  We ensure we follow the 

JESIP doctrine and use clear speech when liaising with other agencies and avoid using 

fire service terminology. 

2.2.  NWFC interacts with North West Ambulance Service (NWAS) and four police authorities 

in the North West region, as well as British Transport Police, sharing key information 

about multi-agency incidents to maintain situation awareness between each service. 

2.3.  After the Manchester Arena terrorist attack and subsequent recommendations from the 

Inquiry, the recommendations have been implemented and reviewed by NWFC and 

overseen through a Ministerial board.   

2 

A6 
 
 
 
 
 
 
 
 
 
 
 2.4.  Part of the work linked to the Ministerial Board, led by the National Fire Chiefs Council 

(NFCC) and other blue light partners is to establish a process of providing additional 

assurance about the application of JESIP. Download the Joint Doctrine - JESIP Website.   

2.5.  NWFC was an Interested Person during the Manchester Arena Inquiry and fully accepts 

the recommendations of the report and continues to embed the recommendations, 

including R28 and R29 (see below). 

2.6.  R28: North West Fire Control should take steps to ensure that it is involved in multi-

agency exercises, particularly those that test mobilisation and the response to a Major 

Incident in line with the Joint Emergency Services Interoperability Principles (JESIP).  

2.7.  R29: North West Fire Control should ensure that if regularly tests how it operates, by 

ensuring that its staff participate in regular exercises and practical tests.  These should 

include multi-agency exercises. 

2.8.  NWFC has recently established an Organisation Improvement Team to compliment the 

audit and assurance process. 

2.9.  This is supported with daily testing of our inter-agency communication channels and also 

through ‘real life’ incidents and exercising. 

2.10. NWFC adheres to the Multi Agency NFCC National Operational Guidance using agreed 

terminology. 

3 

A7 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 2.11. To further enhance these principles and multi-agency working with the fire and rescue 

services, police and NWAS, on 1st April 2023, NWFC secured funding for the 

appointment of a temporary ‘Inter-Agency Liaison Lead’ with specific responsibilities for 

the following: 

2.12. Ensuring that NWFC is involved in a programme of multi-agency training and exercising 

to test mobilisation and response to incidents including major incidents. 

2.13. To ensure that operating standards set out in NFCC endorsed National Operational 

Guidance and JESIP related to inter-agency working are embedded and being met. 

2.14. To establish a framework for identifying shortfalls in performance relating to inter-agency 

working and feeding these back into internal organisational improvement processes and 

external multi-agency forums 

2.15. To establish a multi-agency control room forum with clear Terms of Reference to, among 

other things, improve joint working between control rooms. 

2.16. The Inter-Agency Lead has successfully established the Multi-Agency Tactical Control 

Communications Group which has control room representation at senior level from 

NWFC, Merseyside Fire Control, all North West regional Police Services, NWAS, British 

Transport Police and the Coastguard. 

2.17. The  Multi-Agency Tactical  Control  Communications  Group  has  met  four  times  and  has 

already  made  positive  practical  change  to  interoperability  ways  of  working,  including 

sharing lessons identified from incidents, joint training and exercising. 

4 

A8 
 
 
 
 
 
 
 
 
 
 
 3.  Trauma Cell 

3.1.  NWFC will support its partner fire and rescue services in dealing with incident support in 

accordance with the mobilising policy and procedures supplied to it by the fire service. 

3.2.  NWFC have supported fire and rescue services in relation to managing a request from 

resources at the incident ground when requesting advice from the NWAS Trauma Cell.  

This has been in situ since 2014. 

3.3.  The process ensures there is the provision for a timely assessment and prioritisation of 

people who require medical attention.  Fire service crews at the scene of an emergency 

can access clinical support during protracted delays for an ambulance resource via a 

NWAS paramedic on the Trauma Cell.  This is supported by NWFC via the following 

route: 

•  NWFC contact NWAS emergency control room and request Trauma Cell member of 

staff contact fire service crews at scene immediately. 

•  Trauma Cell member of staff contacts fire service crews on appliance mobile phone 

3.4. 

In addition, NWAS updates NWFC regarding operational pressures they are facing.  

When NWAS REAP (Resource Escalation Action Plan) levels are escalated and 

therefore even higher demands than usual are placed on the ambulance service, this is 

shared with our partner fire and rescue services, and allows them to consider making 

early use of the NWAS Trauma Cell. 

5 

A9 
 
 
 
 
 
 
 
 
 
 
 4.  NWAS Triage System 

4.1. 

In 2022, NWFC and its partner fire and rescue services updated their standard radio 

procedure to adopt the triage requirements from NWAS to enable them to make the 

most appropriate clinical response and assist in conveying the seriousness of any 

casualty’s condition, which will allow NWAS to re-categories the priority of incidents. 

5.  Right Care, Right Person 

5.1.  Right Care, Right Person (RCRP) is a framework for assisting police with decision-

making about when they should be involved in responding to reported incidents involving 

people with mental health needs.  When adopted the aim is to successfully reduce 

inappropriate police involvement in care and support better access to mental health 

specialist services.  

5.2.  NWFC are aware of the framework and will work with the four fire and rescue services to 

understand the impact on the fire services and subsequently NWFC, who will handle such 

calls in accordance with the fire services call handling policy and procedures. 

6.    Multi-Agency Incident Transfer 

6.1.  Multi-Agency Incident Transfer (MAIT) is an electronic means of sharing information with 

other agencies subscribed to the MAIT hub. 

6.2.  NWFC have agreed to be an early adopter of MAIT within the national fire and rescue 

service community and aim to have this tool in place by March 2024.  When the different 

police services and NWAS adopt this protocol, this will speed up the information sharing 

between emergency services using electronic data and reduce the amount of time taken 

for sharing information verbally via telephone/radio communications. 

6 

A10 
 
 
 
 
 
 
 
 
 7.  Regional Standard Operating Procedure – Information Sharing 

7.1. 

In July 2023, The Multi-Agency Tactical Control Communications Group was presented 

with a draft version of an information sharing document produced by NWAS to enable 

collaboration between NWAS and the Police.   

7.2.  The document was initially created in November 2021 for the Police and NWAS, and 

therefore based upon their own operating models, which are different to the NWFC 

operating model.  

7.3.  NWFC has provided feedback to NWAS on the document and has conducted a gap 

analysis of its ability to comply with the ways of working.  The governance is being 

overseen by the NWFC’s Operations Management Committee, whose membership 

includes senior managers from NWFC and our four fire and rescue partners. 

7.4.  The principles of the document relate to gathering information and sharing situational 

awareness between emergency control rooms, which are also covered in the Joint 

Emergency Services Interoperability Principles as referred to in section 2.1 

7 

A11 
 
 
 
 
 
 
 
 
 8.  NWFC wishes to pass on its condolences to family and friends of Claire Nicole Briggs and 

trusts this response addresses the matters raised in your regulation 28 report.  NWFC will 

continue to adopt the JESIP principles with a view to promoting collaborative working 

between all emergency services.   

9.  Please note that as part of best practice and sharing lessons identified, I will be sharing my 

response with all our partner fire and rescue services. 

10. If NWFC can assist the Coroner’s service any further please don’t hesitate to contact. 

Yours faithfully 

Senior Operations Manager  

North West Fire Control 

8 

A12