LONDON AMBULANCE SERVICE ANSWERS DIFFERENT CALL
November 21, 2012
By James Thalman
The number of calls to 9-9-9, the threedigit emergency services number in the United Kingdom, was down substantially during the Opening Ceremonies of the London Olympic Summer Games the evening of July 27. That’s good, because several dispatchers for the London Ambulance Service (LAS) weren’t at the console that night anyway.
They weren’t at home watching the celebration along with more than a billion viewers worldwide who had tuned into the gala kickoff of the 30th Modern Olympiad, they were being watched.
Near the center of the world’s attention that night was Emergency Medical Dispatcher Meryn Crocker- London. She was in uniform, but instead of the white shirt and shields of her occupation, she wore the more hands-on healthcare attire of a nurse, complete with the vintage stiff-as-a-pin nurse’s cap.
On her mind at that moment wasn’t the call center console screens but traffic of a different sort—dozens of iron-frame beds, each complete with a child/patient from the Great Ormond Street Hospital. Crocker-London and her 10,000 or so fellow volunteers comprised the National Health Service’s (NHS) portion of the Opening Ceremonies. It took center stage as the nurses portrayed settling the youngsters down for a group bedtime story—a passage from the famous Peter Pan tales written by hospital benefactor J.M. Barrie and read live and aloud by Harry Potter creator J.K. Rowling.
Crocker-London told The Journal that participating in the rehearsals for the Opening Ceremonies was a lot of work, but fun. Being a part of the festivities the first night showing off England’s worldwide influence through the ages was “an amazing, exhilarating, and magical experience,” she said.
The occasion was almost as exhilarating as some of the 9-9-9 calls she’s handled recently, including the child-centered event of delivering a baby over the telephone, which she managed deftly thanks to Protocol F: Childbirth–Delivery in the Medical Priority Dispatch System. The call was one of the 1.4 million calls the London Ambulance Service (LAS), which is an Accredited Center of Excellence (ACE) with the International Academies of Emergency Dispatch (IAED), handles in a normal year.
“The telephone delivery was highly gratifying, but a little lower on the appreciation scale compared to performing in front of tens of thousands of people at the stadium,” Crocker-London said. “I have to say it was a wonderful feeling when you are performing and you hear the roars of appreciation and the audience clapping when they love your performance.”
The call center atmosphere can turn a bit electric at times, as well, she said. But by being in the ceremony, “I was part of history and felt really proud showing the world what we have done and what we can achieve. I still get a bit high just thinking about it.”
Dispatcher Sean Fullerton, another LAS staffer who volunteered to be in the Opening Ceremonies, said being one of 1,000 drummers who played as the athletes entered the stadium gave him a hint of what fellow Brit and musician Mick Jagger feels as the singer of the durable-as-the-Crown- Jewels rock band, The Rolling Stones.
“It must be what it’s like to be at the center of attention at a stadium concert,” Fullerton said. “It was an amazing night—a cross between a great party and a concert. I can now boast that I have shared a stage with both Paul McCartney and the Arctic Monkeys.”
The ambulance staffers also praised ceremonies and Oscar-winning film director Danny Boyle. “He’s an amazing man,” dispatcher Robert Walsh said. Walsh managed to attend the weeks of rehearsals despite having back surgery. “[Boyle] singled me out and thanked me personally for my effort in still coming in to rehearse. That meant a lot. He was great to work with and made it a great show, as he was involved in every aspect and always made sure all us volunteers knew where the hot drinks were and had a poncho if it rained.”
For their efforts, all of the performers got to keep their costumes as a souvenir.
Let the games begin
Days before things were to get under way in earnest, the importance of being well-prepared in the LAS control room at the Waterloo dispatching center was clearly the event of the games to Peter Thorpe, LAS head of Olympic Planning.
“We’re very well-practiced at covering large-scale events, such as Notting Hill Carnival and the London Marathon,” he said. “However, it will be a challenge for us to be so busy over such an extended period of time.”
To put the effort in proper Olympian scale, take the 2012 Notting Hill Carnival, held over two days starting Aug. 27, which attracted more than 1 million people, times it by eight London Marathons that annually include 35,000 runners and 1.5 million spectators and you’ll have grasped the size of the public safety job posed by the Olympics.
“Formidable,” was the wildly understated British way dispatchers, police officers, and their supervisors used most often when describing the effort to The Journal.
“A bit daunting, too, you’d have to say,” Thorpe said. “By any measurement or scale, it was the biggest event we’ve ever been involved in—and we know big. But we had been at this seven years—from Day 1 in 2005 when it was announced that London would be the 2012 host city.”
The quadrennial summer games is the biggest sporting event in the world. The Paralympics, the world-class competition for athletes with disabilities that comes two weeks after each Summer and Winter Olympics, is the second-biggest sporting event, larger by far than the World Cup soccer tournament.
Maintaining the public’s health and safety was the fundamental planning issue for the London Olympic Summer Games, which had gotten off to a grim start: On July 7, 2005, the day after the capitol city was named the Olympics host city for 2012, a series of four suicide attacks targeting civilians at rush hour killed 52 and injured 700. The British refer to the bombings now as “7/7.”
In ramping up for the events, the NHS spent an additional $1.4 million just on private ambulances to cope with the extra demand, adding up to 50 vehicles to the 300 LAS has on duty every day, along with their famous cadre of bicycle and foot-borne responders.
The service’s dispatching staff at the communications center in Waterloo did their part to handle the extra demand by working 12-hour shifts to handle an estimated increase of at least 350 calls a day, or an increase over normal traffic of around 10%.
The LAS spent an additional $1.1 million to bring in 220 dispatchers from other NHS ambulance services located throughout England. It also offered frontline staff working extra hours double their usual daily pay plus work differentials of $80, $161, or $241 for early, late, or overnight shifts.
On the security front, the Olympics were the biggest peacetime security operation in Britain’s history—an $877-million civilian to military strategy to protect athletes and visitors from any harm, natural or man-made.
The firework-festooned exterior shown on television worldwide on opening night obscured one of the most foreboding security measures taken at the games—more than 11 miles of razor wire-topped electric fencing. Every entrance, the surrounding streets, and area shopping malls were patrolled by police carrying 9 mm semi-automatic weapons—an unusual sight in Britain, where armed patrols are normally found only at airports.
On the busiest days, 12,500 police officers were to be on duty while 12,200 soldiers carried out the venue security searches assisted by at least 7,000 contracted civilian security workers. An additional 5,500 military personnel were added for good measure.
In final assessments of the planning strategy, emergency medical and police response supervisors said they were as prepared as they could be, though none would go so far as to promise the event would be free of a major or marring incident.
Get ready, get set
The gamut of possible threats to security and public safety of the games ranged from terrorist attacks to food poisoning. To help keep all those agency communications staticfree whatever the incident, a completely new communications radio network was built, the second since one was installed after the 2005 bombings.
It was added to ensure that the existing emergency services radio network could handle the increased call load, especially in extremely crowded areas such as the Olympic Stadium for both the Opening and Closing Ceremonies and the track and field events.
Law enforcement administrators said radio communications upgrades replaced the mobile phone network that was quickly and constantly overloaded during the 2005 bombings. The new network had already had a real-life test during the 2011 London street riots during which communications across the city and the outlying venues was reportedly static-free and without “cross-talk” or other interference from other two-way systems.
The LAS staff and those from other ambulance services were assigned a variety of roles during the Olympics. There were four zone commanders in charge of overseeing any incidents in their areas. Dozens of venue commanders were based in each site along with frontline medical staff ready to treat any patients attending celebrations all over town.
Londoners were being urged to think carefully before dialing 9-9-9 since the previous May 22 when the LAS responded to 1,345 seriously ill and injured patients due to extreme heat. That’s a 29% increase in the number of calls from the previous week, and apart from New Year’s Day, was the busiest weekday on record.
The period of hot weather was a realtime test of the communications center, said LAS Assistant Chief Ambulance Officer John Pooley. “We saw an unprecedented increase in demand from patients suffering potentially life-threatening conditions, such as chest pain and difficulty in breathing.”
As was the case during the heat wave, “we urged Londoners with less serious illnesses such as sore throats, skin complaints, earaches, or minor injuries to consider other healthcare providers in the community, for example your local pharmacy or walk-in center,” he added.
Londoners were advised by the LAS through the news media and its website that the essential services they receive from the NHS, police, fire service, and other emergency services would still be available to them during the 2012 Olympic Games.
At the heart of it all and on the minds of Olympic organizers since the city first bid on the games 20 years ago was a single element mission—risk management.
That sums it up in two words, and the lesson learned from previous games or any large event for public safety communicators and responders, risk management expert Will Jennings said in assessing the run-up to the London Olympics.
“When threats materialize at large-scale events, the damage often spills over,” he said. “Even before the official opening of London 2012, a mix-up with the flag of the North Korean women’s football (soccer) team had organizers scrambling to resolve a diplomatic spat.”
One key to effective risk management is the ability to distinguish between phenomena that cannot reasonably be foreseen and dangers that are “self-inflicted” because they could be avoided by thorough planning and careful execution, he said.
“Managing risk involves a judicious mix of preventing the risks that can reasonably be controlled, learning to recognize the ones that can’t be prevented, being prepared to react to limit damage, and having the resources to recover from the problems that do occur,” he said.
Crossing the finish line
In a news release issued Sept. 14, LAS Deputy Director of Operations Jason Killens summed up the service’s sense of how things went when the world was watching: “Pleased.”
“Satisfying as well,” he added, “for all staff involved. A massive amount of work has gone on in planning our level of support at venues throughout both the Olympics and Paralympics, as well as ensuring that we have been able to continue to provide the best service we could to the rest of the capitol.”
The single lesson learned, Killens and others told The Journal, is that the best way to handle communications planning for any mass event is to carefully examine every possible internal channel of communication, make sure they’re operating at their best, walk through every possible scenario and test it—on the tabletop or in real life—and then do it again and again.
Citing good luck, prudent planning, and excellent execution, Chris Allison, National Olympic Security Coordinator for the London Olympics and Paralympics, was delighted to report: “security services continued its excellent track record of successfully delivering major events safely and securely.
“That is one of the main reasons the U.K. won the Olympic bid in the first place,” he continued. “Avoiding any kind of intentional attack or potential disruption in an event that is a prime target for terrorist attacks and crowd mayhem becomes the chief goal of any event safety protection strategy. That’s the one big thing that just can’t happen, but has all the same—not for a good long time— and fortunately didn’t mar these games.”
Perhaps the most minor yet practical point of preparation was the directive to security personnel and responders to medical emergencies not to run toward any site of an emergency, he said. An officer or medical emergency personnel in uniform can be spotted a mile away by a spectator and can rile up large groups of spectators into a stampede away from the scene. A crowd rushing in panic is as chaotic as a cattle rush in any Old West movie and about a hundred times harder to stop.
On a larger scale, the planning for the London Games might make a working template for public safety agencies that have mass events scheduled in their future. As Allison put it: “Dealing with huge concentrations of people in tight spaces is like a household painting job: It’s 99% preparation.”
Security gives gold medal performances
The final toll of people arrested during the London Olympic Games was 242, a score worth a trip to the medal stand that will arguably be an impossible record to beat for Summer Olympics host cities in the future.
According to London’s Metropolitan Police (The Met), only seven of those arrests were made inside an Olympics venue. The total is about half of the number of people taken into custody near or around Olympic venues or events before and the games and after the Closing Ceremonies.
One teenager was arrested under section 58 of the 2000 Terrorism Act, which is invoked when police suspect that someone is collecting or is in possession of “information of a kind likely to be useful to a person committing or preparing an act of terrorism.”
The most serious suspected offenses included possession of a firearm (1), possession of an offensive weapon (2), robbery (5), and assault (16). There was one bomb hoax. The 17-year-old, who was picked up at Stratford railway station near the Olympic Park on Saturday, July 28, was released after questioning and “de-arrested”, according to a Scotland Yard statement.
One person who decided the Thames might be a good spot to cool off from a hard day of spectating got to dry off under the auspices of Olympics security officers.
Two people were arrested for impersonating a police officer. The most common arrest—some 140 people—was ticket scalping, or ticket touting, as they say in London. The offense carries fines of up to $32,000 per count if the person is convicted.
Two people were arrested for begging, 10 for drug-related offenses, one for assaulting a police officer, and 11 for disorderly conduct that included several racially-motivated scuffles.
The Met reports that the largest single arrest incident involved 182 people taken into custody for participating in an unsanctioned, traffic-clogging bicycle ride protest the night of the Opening Ceremonies. The police were criticized the next day for the abrupt manner in which the procession and riders were treated. But a spokesperson for the Met said the cyclists had abruptly ignored a police order prohibiting the protesters from traveling into the Olympic Park. Three cyclists have since been charged.
Security tightest in British history
London had already won the gold medal in mass event security well before the Olympic Torch reached town.
Several news organizations confirmed what London Ambulance Service (LAS) contacts had told The Journal—the games were the largest peacetime security operation on British soil. Status information kept flowing across London to the joint command and communication centers of the Metropolitan Police (the Met) and the government control center at New Scotland Yard via 1,850 closed-circuit television (CCTV) cameras trained on the Olympic Park.
The U.K. has 4.2 million such surveillance devices, more than any other country in the world. That number does not include cameras used by private companies and residences. The images as well as facial and license plate recognition were fed to Interpol and to U.S. security agencies including the CIA, FBI, and the Transportation Security Administration.
Emergency medical services and police were kept apprised by on-scene security officers. Every car entering the park was searched, as were their occupants and drivers.
Security had a big hammer to use should things at the games suddenly get out of hand— six temporary ground-to-air missiles stationed mostly at undisclosed locations. Two were mounted on the roofs of apartment blocks Bow and Waltham Forest. Residents of Waltham Forest lost their bid in court to have their building’s missile removed.
Britain’s terror level during the games was labeled “Substantial”—a notch below “Severe,” which has been the daily level for much of the past decade in London. A “Substantial” threat level indicates an attack is a strong possibility.
MSNBC reported the latest anti-terrorist weaponry being used in the Middle East was also part of the protection plan—unmanned drones. They hovered over the venues, along with helicopter-mounted cameras said to be able to identify the color of a suspect’s shoelaces from a mile away.
Britain’s biggest warship, HMS Ocean, was also stationed on the River Thames, while Royal Fleet Auxiliary vessel Mounts Bay spent the games near Weymouth, Dorset, where Olympic sailing events took place. Six helicopters—three Royal Navy Sea Kings and three Royal Air Force Pumas—were at the ready as well.
To top off the highest security ever in the country’s history, four Royal Air Force Typhoon fighter jets were on standby to intercept “with lethal force” aircraft that happened to venture into the flight-restricted air space above the venues.
Prior to the games, Paul Haskins, general manager of London Terminal Control—an air traffic control agency—told NBC News, “If an aircraft has not spoken to an air traffic controller for a long time and it’s becoming a concern to ourselves and the military, various different methods will be used to communicate with that aircraft. If all those fail then an intercept will be provided by the military to ascertain exactly what is going on.”
Although other Olympics have taken place since 9/11—Salt Lake City, Athens, Turin, Beijing, and Vancouver—London offered a different breed of security challenge. Many events took place at venues as far away as Scotland, creating a further security risk—that terrorists could avoid locked-down London and choose less high-profile targets instead.
A cadre of bomb-sniffing dogs were also on patrol throughout the Olympics and Paralympics.
Combined, the two events were an enormous test of all city services but especially the vaunted National Health Service (NHS), the name shared by three of the four publicly funded healthcare systems in the United Kingdom. The British are quite proud of the system, and having a section of the Opening Ceremonies at the Olympics celebrating the 64-year-old network to showcase the influence of England on the world was a natural to games’ organizers and ceremonies director, Danny Boyle, who is probably best known in the United States as the director of the Oscarwinning film Slumdog Millionaire.
That staff members of the emergency services sector of the NHS would be among the centerpiece performances that got the games officially up and running made perfect sense to ceremonies’ organizers.
Although healthcare and its skyrocketing costs is a source of constant debate in the United States and what many state and federal elected officials cite as the definitive example of healthcare run amok, the British say by every comparison, including emergency dispatching services, the NHS is as good if not better than any healthcare system in the world. It is funded through heavy general taxes and not from insurance premium payments and medical billing for services as it is in the United States.
The NHS is the world’s fifth-largest employer, with 1.7 million staff members.
“It would have been a gap in the story of British influence we were trying to portray not to have something about the NHS,” Boyle said more than once during interviews with the news media in the days after the Opening Ceremonies.“We were showing off, and so we wanted to show off our system as something we’re very proud of. It is very expensive, but after World War II, we as a country decided on a system in which everybody pays and everybody benefits.”