We recently undertook a project for the Health Protection Agency in the UK. They are a special class of NHS Trust and their role is "to protect the community (or any part of the community) against infectious diseases and other dangers to health" (HPA Act 2004).

At the UK level, the Agency is responsible for providing information and services to support a coordinated and consistent UK public health response to national level emergencies – natural and terrorist.

To achieve this the HPA is constantly evaluating and checking systems and procedures. This is done via ‘desktop’ exercises and also ‘live’ exercises. The later really tests the interfaces, processes and systems in an operational setting to the ultimate level. ‘Desktop’ exercises do much of this but ‘live’ exercises just have that ‘operational’ edge.

We were recently asked to make a video documentary on the planning and undertaking of one the largest and most complex multi-emergency services exercises organised in the last few years. In fact it was two scenarios in one. A double emergency which stretched both the operational commanders and emergency services staff both logistically and physically. The value of such ‘stress’ testing of the processes, operations and people cannot be under-estimated. One can speculate if BAA and BA had really ‘stress tested’ T5 they would have not had the ‘go-live’ problems they did have. The lessons from such tests are invaluable which is why a full video recording of all stages of the exercise is so important.

Our own logistics and management of 12 video cameras and crew plus 2 stills photographers and video from a police helicopter were dwarfed by the effort by the HPA to plan and manage the project. They worked for many months with a big group of stakeholders to ensure that the exercise could replicate a real life scenario as closely as possible. Realism is the key.

With over 400 people and 100+ vehicles involved from across the whole of the UK it was no wonder the HPA’s planning took months. The equipment and rescue scenarios were carefully scripted but once the exercise started it took on a life all of its own. The script on the day simply said ‘10am start. 4pm ends if not everyone rescued before then’. For all intents and purposes it was real. The emergency services command structure ran it as a real exercise. Many observers were on hand to monitor what was happening as well as our crews videoing the action and the observers as they undertook ‘hot debriefs’.

The ‘final’ icing on the cake as far as reality was concerned was the work of the Casualties Union and Amputees in Action. Their members participate in these exercises. But it is not just their participation that is important it is the lengths that they go to in replicating injuries that the emergency services would face in a similar real life situation. They are a self-help group doing their own make up. The quality of it has to be seen to be believed. (Have a look at my flickr picture feed - please note: Some images contain graphic make-up). Without a doubt the level of realism of the injuries and the accompanying role play acting of moans and groans plus placement under rubble and in awkward areas really does stretch the emergency services as if they were in a real emergency.

Being the Producer for the documentary was like nothing I have ever experienced before. I was involved in the later stages of planning. I also had to evaluate and select the locations of the fixed crews and plan for the crews who followed the action. We even had a camera operator under the rubble filming some of the rescues from a 'worms eye view' as it were. My role meant I was far closer to the action compared to any television or newspaper reporter would be able to. Not a ‘behind-the-scenes’ look but really an ‘in-the-middle-of-the-action’ one. It was amazing.  I was able to see how the unsafe areas have to be physically shored up before the rescuers are even allowed on the site to start (no point risking rescuers lives whatever the urge they may feel to get into action). I saw first hand how multiple teams of people  – police, fire service, ambulance and medical staff - have to all work together in a coordinated way to focus on the injured. You can see in some of the pictures the team extracting a casualty from below the rubble by first having to use ‘jack’ hammers and cutters to open a space to reach them. The emergency teams often do not have enough room to stand up or easily move around. They literally have to crawl to reach the injured, comfort them, stabilise them and then extract them. This can take a long time. In some cases it was hours. Canned noise, smoke and simulated burst water pipes add to the realism of the situation.

In the end we had over 70 hours of video to distill into a production the HPA would be using for internal debriefing and education.