Manchester Arena bombing victim would have survived but for ‘inadequate’ emergency response, inquiry finds
A victim of the Manchester Arena bombing would likely have survived had it not been for the inadequate emergency response, an inquiry has found.
John Atkinson’s injuries were “survivable” but he did not receive the “treatment and care he should have”, said Sir John Saunders, chairman of the Manchester Arena Inquiry.
Mr Atkinson, a 28-year-old healthcare worker, was one of 22 innocent people who lost their lives following the suicide bombing at the end of an Ariana Grande concert in May 2017.
A report examining the emergency response to the attack found that “significant aspects… went wrong” and “the performance of the emergency services was far below the standard” it should have been.
“Some of what went wrong had serious and, in the case of John Atkinson, fatal consequences for those directly affected by the explosion,” Sir John said.
The inquiry has heard that firefighters did not arrive at Manchester Arena until two hours after the bombing; only one paramedic entered the blast scene in the first 40 minutes, and Greater Manchester Police (GMP) did not declare a major incident for more than two hours.
The father of the youngest victim – eight-year-old Saffie-Rose Roussos – described the emergency response as “shameful” and “inadequate”, with some experts telling the inquiry she could have survived had the response been different.
Saffie-Rose Roussos was the youngest victim of the attack
However Sir John concluded that “there was only a remote possibility that she could have survived with different treatment and care”.
“On the evidence that I have accepted, what happened to Saffie-Rose Roussos represents a terrible burden of injury,” he said.
“It is highly likely that her death was inevitable even if the most comprehensive and advanced medical treatment had been initiated immediately after injury.”
Emergency response ‘prevented victim’s survival’
In the second of three reports into the Manchester Arena bombing, Sir John found that 20 of the 22 people who died in the attack suffered injuries that were “unsurvivable”.
However in the case of Mr Atkinson, the retired High Court judge said that had the victim “received the treatment and care he should have, it is likely that he would have survived”.
“It is likely that inadequacies in the emergency response prevented his survival,” Sir John added.
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Arena bombing victims ‘let down’
Mr Atkinson, a fitness fanatic whose family described him as their “heart and soul”, had received tickets to the Ariana Grande concert as a Christmas present and went with a friend.
He was standing just six metres away from Salman Abedi when the bomber detonated his device at about 10.30pm on 22 May 2017, causing severe injuries to Mr Atkinson’s legs.
Read more:
How emergency crews responded to arena bombing
Security failings that led to Manchester attack
The inquiry heard Mr Atkinson, from Bury, Greater Manchester, lost a significant amount of blood as he laid in agony on the foyer floor for 47 minutes before he was carried downstairs by police on a makeshift stretcher to a casualty clearing area at Victoria station.
More than 20 minutes passed – as ambulances queued outside – before he went into cardiac arrest at 11.47pm and was finally rushed to Manchester Royal Infirmary at midnight, where he was pronounced dead about 25 minutes later.
A member of the public, Ronald Blake, held an improvised tourniquet on Mr Atkinson’s right leg for up to an hour before paramedics reached him.
Only three paramedics entered the area known as the City Room, where the bomb went off, on the night – two of them just a few minutes before Mr Atkinson was evacuated.
He was not triaged, assessed or assisted by North West Ambulance Service (NWAS) personnel during his time in the foyer.
In his report, Sir John said he accepted the conclusion of experts that Mr Atkinson “would have survived if given prompt and expert medical treatment”.
He concluded that medical tourniquets should have been applied to Mr Atkinson’s legs and dressings applied to his wounds earlier.
The inquiry chairman said “responsibility for that failure” rested with the arena’s operator SMG and the management of Emergency Training UK, which was contracted to provide healthcare at the venue.
He added that more paramedics should have been in the City Room earlier and they would likely have “identified the need for urgent treatment and evacuation” of Mr Atkinson.
Police at the scene of the bombing on 22 May 2017
“That did not occur,” Sir John said. “Responsibility for that failure rests with NWAS.
“Such treatment would, I am satisfied, have enabled John Atkinson to arrive at hospital prior to having a cardiac arrest and would probably have saved his life.”
Sir John also said that Mr Atkinson should have been moved from the City Room promptly and if firefighters had been at the scene at the time, the victim would have been “prioritised for evacuation”.
He also pointed out that if more ambulances had been at the scene shortly after 11pm, Mr Atkinson would have received treatment and he would have been taken to hospital sooner.
“Either way, he would have reached hospital before having a cardiac arrest and is likely to have survived,” Sir John said.
“John Atkinson would probably have survived had it not been for inadequacies in the emergency response.”
The victims of the Manchester Arena bombing
‘Mistakes’ made by emergency services
In his report, Sir John said “significant aspects of the emergency response on 22 May 2017 went wrong” and “this should not have happened”.
The inquiry chairman said he had “no doubt that lives were saved by the emergency response”, but added: “Looked at overall, and objectively, the performance of the emergency services was far below the standard it should have been.”
He said GMP “did not lead the response” the way it should have; Greater Manchester Fire and Rescue Service (GMFRS) “failed to turn up at the scene at a time when they could provide the greatest assistance”; and NWAS “failed to send sufficient paramedics” into the City Room and “did not use available stretchers to remove casualties in a safe way”.
The inquiry heard that police officers, arena staff and members of the public were forced to carry injured people using advertising hoardings, crowd barriers and tables due to the lack of stretchers, which Sir John said was “a painful and unsafe way of moving the injured”.
He added that “one of the most emotional and upsetting parts of the inquiry” was hearing of the “despair” of those injured, who could hear ambulance sirens outside but saw few paramedics arrive.
Among the failures identified in the report:
• Inspector Dale Sexton, the force duty officer at GMP’s headquarters, became “overburdened” and made a “significant mistake” in failing to declare a major incident in the early stages of the emergency response. GMP only declared a major incident close to 1am – two and a half hours after the bomb went off
• After inaccurate reports of gunshots, Insp Sexton declared Operation Plato – the emergency response to an attack by a marauding terrorist with a gun – but failed to communicate this to other emergency services
• GMFRS station manager Andrew Berry sent firefighters to Philips Park fire station, three miles away from the scene, meaning some firefighters were driving away from the incident and past ambulances travelling in the opposite direction
• Inspector Benjamin Dawson, from British Transport Police (BTP), declared a major incident around 10 minutes after the attack but did not tell GMP or GMFRS
• There was “substantial confusion” over the location of a rendezvous point for emergency services, with each service choosing their own
• NWAS declared a major incident about 15 minutes after the attack but this was not shared with any other emergency service
Sir John said “there was the failure of anyone in a senior position in GMFRS to take a grip of the situation during the critical period of the response”.
He acknowledged he had “criticised a large number of people” who he considered had “made mistakes on the night”, adding that “some of those criticisms may seem harsh, particularly given the situation that those individuals were faced with”.
“They were trying to do their best,” he added. “I do understand the enormous pressures that they were acting under.
“They had to do many things in a short time and it may not be surprising that things went wrong. I am not unsympathetic to them.
“But I need to identify mistakes where they have been made because otherwise there is no prospect of preventing them in the future.”
Read more:
The missed opportunities to stop Salman Abedi
Manchester Arena lives could have been saved – but warning was ‘fobbed off’
Salman Abedi carried out the suicide bombing
Among a series of recommendations, Sir John said that “in the event that public funding cuts are in the future considered necessary by the government, the Home Office should consider whether some funding arrangement for police services different from that applied in the post-2010 period is necessary”.
Responding to the report, Home Secretary Suella Braverman said it was “a devastating reminder of the Manchester Arena attack and the horror of that night”.
“Without doubt, our emergency services show incredible courage when responding to incidents of this magnitude,” she said.
“It’s right that we reflect and work together to learn from this tragedy. I will carefully consider the recommendations made so far to strengthen our response.”
Sir John’s first report on security issues at the arena venue was issued last June and highlighted a string of “missed opportunities” to identify Abedi as a threat before he walked across the City Room foyer and detonated his shrapnel-laden device.
The third and final report will focus on the radicalisation of Abedi and what the intelligence services and counter-terrorism police knew, and if they could have prevented the attack. It will be published at a later date.
A grief-stricken family has told Sky News they want “someone to take accountability” for the death of Lewis Stone, a retired butcher who was killed by a secure psychiatric unit patient released 10 days earlier.
In her first TV interview, Mr Stone’s step-daughter Vicki Lindsay said they were calling for an internal NHS Trust report to be made public so that lessons can be learned.
“The thought of anybody going through what we’ve gone through for the last six years… We’re living a life sentence,” she said.
On 28 February 2019, Lewis Stone was where he loved being most – the remote town of Borth on the west coast of Wales near Aberystwyth. It’s where he and his wife, Elizabeth, had a holiday home and planned to retire.
Lewis’s step-daughter, Vicki Lindsay, says the family wants an apology and accountability
That morning, Lewis left for his daily pre-breakfast walk with his beloved dog Jock along the River Leri and never came home.
He had been stabbed multiple times, and despite repeated attempts to save his life, he died in hospital three months later.
Lewis’s killer, David Fleet, was sectioned under the Mental Health Act after admitting manslaughter with diminished responsibility.
Sentencing, Judge Paul Thomas QC said Lewis had been in the wrong place at the wrong time.
Lewis’s family disagrees: “I just want somebody to say, ‘Yes, we messed up, we’re sorry. It doesn’t change things but we’re sorry’.
“We’ve had none of that. Mum’s had nothing, no support, she’s had nothing. That’s all we want, an admission.”
Elizabeth and Lewis Stone, with their step-daughter Vicki Lindsay (centre), in happier times
Lewis Stone and his grand-daughter Sammy
Fleet was suffering from paranoid schizophrenia at the time of the attack and told psychiatrists if he had not stabbed Mr Stone, the voices in his head “were going to kill him”.
Four months earlier, he had been detained under the Mental Health Act, but despite concerns raised by his own family, it was decided he should be treated at home.
The Hywel Dda health board told Sky News they don’t intend to release the internal report into Fleet’s care.
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Sharon Daniel, the Interim Executive Director for Nursing, Quality and Patient Experience, said: “The Duty of Candour for patients came into force in Wales in April 2023. At the time of this incident and concern, we fulfilled our duties to be open.”
When asked if they would be willing to apologise to both affected families, Ms Daniel said: “In the event of serious incidents, we have robust processes in place for reviewing internally, identifying any issues, and where appropriate preparing an improvement plan to prevent such an occurrence in the future. We regret such incidents and always seek to learn from them.”
In February, victims’ families in Nottingham won their fight for an NHS review into the care of paranoid schizophrenic Valdo Calocane, who killed three people, to be made public. It exposed a catalogue of errors and systemic failings.
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In February, Sky’s Sarah-Jane Mee spoke to two mothers of two people killed by paranoid schizophrenic Valdo Calocane
The family’s adviser and former NHS lawyer Radd Seiger, who also advised the Nottingham families, told Sky News the two cases have striking similarities: “Sunlight is the best disinfectant when there are problems in the NHS.
“Let’s have these things out in the open. Yes, they’re uncomfortable, but that’s the only way the NHS is going to learn from its mistakes.
“It’s no good them marking their own homework in private where journalists, or lawyers, or families don’t get to scrutinise these things because we see that these things keep happening over and over and over.”
David Fleet’s family declined an opportunity to speak to Sky News for this report.
The Welsh government said: “We are fully committed to openness and transparency in line with the Duty of Candour to ensure lessons are learned. We have also invested in improving both the quality and safety of mental health care in Wales.”
A host of local and mayoral elections will be taking place across England on Thursday 1 May – the first voting day since the general election last year.
There will also be a new Member of Parliament.
Here is everything you need to know – from what’s at stake to how you can vote.
Local elections
There will be local elections in 23 of England’s 317 local authorities on 1 May.
Some are slightly different to others, depending on the type of authority.
Here is the full list:
County councils
• Cambridgeshire
• Derbyshire
• Devon
• Gloucestershire
• Hertfordshire
• Kent
• Lancashire
• Leicestershire
• Lincolnshire
• Nottinghamshire
• Oxfordshire
• Staffordshire
• Warwickshire
• Worcestershire
Unitary authorities
• Buckinghamshire
• Cornwall
• County Durham
• North Northamptonshire
• Northumberland
• Shropshire
• West Northamptonshire
• Wiltshire
Metropolitan district
• Doncaster
The Isles of Scilly, which has a unique governance structure, is also holding a local election of its own.
Additionally, about 1,270 parish councils will be holding elections.
What is the difference between the types of authorities?
A county council is part of a two-tier local government system, taking care of things that affect the whole county, such as:
• Education
• Transport
• Planning
• Fire and public safety
• Social care
• Libraries
• Waste management
• Trading standards
They work alongside the other, lower-tier councils – district, borough or city – that take care of things on a smaller scale, such as:
• Rubbish collection
• Recycling
• Council tax collections
• Housing
• Planning applications
A unitary authority is a one-tier local government, where the services of a county council and the other smaller councils listed above are combined.
A metropolitan district has a council that oversees all services, similar to a unitary authority – but has a mayor with a role similar to that of local councils.
The mayors for Doncaster and North Tyneside are single authority, making them the political leader of the council and leaving them responsible for delivering local council services.
Metro mayors chair combined authorities made up of several local councils.
Metro mayor election
There are six mayoral elections taking place on 1 May, two of which are the first ever in their areas.
One of them is for the West of England, where the current mayor is Dan Norris, who was elected as a Labour MP when he defeated Jacob Rees-Mogg to win the seat of North East Somerset and Hanham in last year’s general election.
Labour MP Dan Norris. File pic: PA
Mr Norris, who has been mayor since 2021, has to vacate the role because the Labour Party introduced rules to prevent serving MPs from standing as mayoral candidates.
There is another mayoral election in Cambridgeshire and Peterborough, while the first mayors for Hull and East Yorkshire and Greater Lincolnshire will be chosen after devolution deals were agreed in 2023, bringing together local councils in both areas to create larger authorities.
There will also be elections for the next mayor of Doncaster and North Tyneside.
New MP for Runcorn and Helsby
A by-election is also being held in Runcorn and Helsby after Labour’s Mike Amesbury agreed to stand down following his conviction for punching a man in the street.
Amesbury, who was suspended from the Labour Party, was jailed on 24 February for 10 weeks after he pleaded guilty to assault by beating of 45-year-old Paul Fellows in Main Street, Frodsham, Cheshire, in the early hours of 26 October.
However, following an appeal, his sentence was suspended for two years.
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Amesbury steps down as MP
His resignation means Karen Shore, the deputy leader of Cheshire West and Chester Council, will run for Labour in the by-election, while the Conservatives are putting forward Sean Houlston, a membership services manager for the National Federation of Builders, and Sarah Pochin, a former Cheshire East councillor, is Reform’s candidate.
Amesbury came first in Runcorn and Helsby with 22,358 votes at the 2024 general election – equating to 52.9% of the electorate.
Reform UK came in second with 7,662 votes (18.1%) and the Tories in third with 6,756 votes (16%).
Outcomes could have significant national impact
The elections will be the first big test of all the parties since the general election, which fundamentally redrew the UK’s political landscape with a new world of multiparty politics.
The Tories have the most to lose as they hold 20 of the 23 local authorities up for grabs on 1 May.
And for the first time in a long time, Labour and the Conservatives are facing a genuine threat from other parties.
YouGov conducted exclusive polling for Sky News to get a sense of how the country was feeling ahead of the elections, surveying 2,178 adults in the UK on 6 and 7 April.
Here is the voting intention poll:
• Labour: 24% (no change)
• Reform UK: 23% (no change)
• Conservatives: 22% (+1)
• Liberal Democrats: 17% (+3)
• Green Party: 9% (-2)
It suggests that Nigel Farage’s Reform UK could be Labour’s closest competitor, with Kemi Badenoch trailing as she leads the Conservatives through elections for the first time, while the Lib Dems have closed the gap on the three top parties.
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How do I register to vote?
You have until 11.59pm on Friday to register to vote if you haven’t already.
You must be aged 16 or over (or 14 or over in Scotland and Wales) to register to vote – but to vote for a new MP you must be at least 18.
You can register if you are:
• A British citizen
• An Irish or EU citizen living in the UK
• A Commonwealth citizen who has permission to enter or stay in the UK, or who does not need permission
• A citizen of another country living in Scotland or Wales who has permission to enter or stay in the UK, or who does not need permission
• You can be an overseas voter if you previously lived in the UK and are a British citizen.
The easiest and quickest way to register is online.
Alternatively, you can use a paper form – though it may be too close to the deadline for you to complete this by the deadline.
You can do it by contacting your local Electoral Registration Office and asking them to post a form to you. Or you can print your own form off. You’ll then need to return the completed form to your local Electoral Registration Office.
How can I cast my vote?
There are three ways to vote:
In person at your local polling station
You’ll be sent a poll card just before an election or referendum telling you when to vote and at which polling station. It will usually be in a public building, such as a school or local hall, near your home.
You can only vote at the polling station allocated to your address. This will be shown on your poll card. You can also enter your postcode on this website to find out where your polling station is.
You will be able to cast your vote any time between 7am and 10pm
You must bring a form of photo ID with you in order to vote. There are 22 accepted types of ID.
At the polling station, you will need to give your name and address to staff and show them your photo ID.
There will be instructions in the polling booth telling you exactly how to cast your vote.
Postal vote
You can register to vote by post for any reason, including that you simply don’t want to go to a polling station on the day.
You need to apply for this by 5pm on 14 April and can do so by clicking here.
Postal votes now expire every three years, so if you registered to do so more than three years ago, you will need to re-apply.
By proxy
This is where you apply for someone to vote on your behalf if you cannot go to the polling station in person and do not want to or can’t vote by post.
You and your proxy must both be registered to vote in the UK before you can apply.
The deadline to apply for proxy voting in the May 1 elections is 5pm on 23 April, and you can apply here.
Which elections have been postponed – and why?
Elections for county councils in the following areas have been postponed until May 2026:
• Norfolk
• Suffolk
• Essex
• Thurrock
• Surrey
• East and West Sussex
• Hampshire
• Isle of Wight
Most areas of the UK are now covered by one-tier systems such as unitary authorities, but there are still 21 county councils.
The government is pushing for a “devolution revolution”, meaning the remaining county councils are being encouraged to merge with other local authorities to become unitary authorities.
So in December last year, the government told county councils they could request to postpone their elections set for 1 May if they were trying to reorganise into one-tier systems.
While 16 county councils requested to postpone, only the eight listed above were successful.
A new spit test for prostate cancer which can be done at home may be better than current testing methods, a study suggests.
Experts have developed a simple saliva test which analyses genetic variants in a man’s DNA, which appears to perform better than the current method for assessing prostate cancer risk.
Currently, the prostate-specific antigen (PSA) blood test is used to check for prostate conditions, including prostate cancer or an enlarged prostate.
Routine testing is not currently available on the NHS, but patients may be offered a PSA test if a GP suspects they have prostate cancer. Men over 50 can ask their GP for a PSA test even if they do not have symptoms.
But experts have said the new saliva test could be used as an additional screening tool, as it reduced the number of false positive results and detected a higher proportion of aggressive cancers than the PSA test.
It could lead to fewer men being sent for unnecessary testing, according to researchers at The Institute of Cancer Research, London, and The Royal Marsden NHS Foundation Trust.
They tested the effectiveness of a new tool they had developed called a polygenic risk score, which uses spit to assess 130 genetic variants known to be associated with an increased risk of prostate cancer, which can then determine whether or not a person is at high risk of the disease.
The new spit test for prostate cancer. Pic: PA
Test saved lives of two brothers
Taking part in the trial saved the lives of two brothers.
Dheeresh Turnbull said traditional methods to assess prostate cancer deemed he had a low risk of disease, but the new spit test helped the 71-year-old discover he actually had a life-threatening tumour in his prostate.
After finding out the news, his brother Joel Turnbull also took part in the study and discovered he had an aggressive prostate tumour.
“It’s incredible to think that because of this study two lives have now been saved in my family,” Dheeresh said.
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How the tool was assessed
The brothers were among 6,300 men aged 55 to 69 in the UK who were assessed by the tool as part of the study.
Of those, 745 (12%) were deemed to have a high risk score and were invited to have prostate cancer screening, including an MRI scan and a biopsy.
Prostate cancer was detected in 187 of the 468 who took up the offer, and of those, 103 had cancer that was deemed to be “higher risk”, so treatment was offered.
Of the 187 men, 118 had a PSA level below 3.0ug/L – which is considered “normal” and would typically indicate no further screening is required.
Test could ‘turn the tide on prostate cancer’
Writing in the New England Journal of Medicine, the researchers said cancer “would not have been detected” in 74 of the men using the “diagnostics pathway” currently in use in the UK – which includes a high PSA level and an MRI.
They concluded that for the men with the highest genetic risk, the test falsely identified fewer people with prostate cancer than the PSA test and picked up people with cancer who would have been missed by the PSA test alone.
It detected a higher proportion of aggressive cancers than the PSA test and also accurately identified men with prostate cancer who were missed by an MRI scan.
Professor Ros Eeles, from the Institute of Cancer Research, London, and The Royal Marsden NHS Foundation Trust, said: “With this test, it could be possible to turn the tide on prostate cancer.
“We have shown that a relatively simple, inexpensive spit test to identify men of European heritage at higher risk due to their genetic make-up is an effective tool to catch prostate cancer early.
Some 55,000 cases of prostate cancer are diagnosed each year in the UK, with around 12,000 men in the UK dying from the disease annually, according to Cancer Research UK.
It comes after Health Secretary Wes Streeting suggested he would support a national prostate cancer screening programme for men at higher risk of disease if it is backed by the evidence. The UK’s National Screening Committee is currently assessing whether or not such a programme should be rolled out.
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