Introduction

Many people work to make our society a safe place to live and do so, directly and indirectly, in a wide variety of roles. We depend on those who clean and maintain our environment, design safer vehicles, buildings and equipment, as well as those who protect us from hostility and respond to emergencies. Almost all of us have a part to play. Unfortunately we cannot always be successful in preventing harm or, in extreme cases, the premature loss of life. But even when this happens there are steps that can be taken and practices put in place to avoid additional suffering by those who remain: providing support for the bereaved, caring for the deceased's body and pregnancy losses appropriately and respectfully, and investigating the circumstances and causes of death so as to minimise the risk of similar adverse circumstances harming others. How we respond to and learn from the deaths of our fellow men and women therefore has a direct effect on the wellbeing of the living, sometimes immediately, when resources are diverted in response to an emergency, and sometimes more gradually as changes take place to ensure increased safety.

This guidance is concerned with preparing for the aftermath of events which result in the deaths of large numbers of people and specifically with the management of the fatalities that have occurred. It seeks to assist agencies which have duties in this area under the Civil Contingencies Act (2004) and other legislation. It recommends both preparations that are required now and actions that will be needed immediately following mass fatality emergencies. It is particularly relevant to the Police, Local Authorities, National Records of Scotland (NRS) and NHS Boards, who, in their various capacities, will be involved with incident scene management, incident investigation, provision of mortuary and pathology services, the registration of the death, and the burial or cremation of the deceased. It also considers some private organisations, funeral directors and faith groups, who will have a significant role during and after a mass fatality emergency.

The guidance assumes that the established principles of IEM, set out in the Preparing Scotland guidance on Philosophy, Principles, Structure and Regulatory Duties, are being applied and does not repeat generic advice that is available elsewhere and will be familiar to most readers. References to some of the most important information sources are given in Appendix 1.

In this guidance, the term 'mass fatalities' is used to mean:

• deaths in larger numbers than can be managed under the normal procedures of one or more of the agencies involved; or
• deaths where the number or fragmentation of bodies, taken together with the circumstances of the incident, require special arrangements for criminal, forensic or other statutory investigations, or where the condition of bodies makes victim identification difficult; or
• deaths requiring the implementation of NEMA

The number of deaths constituting a mass fatalities emergency will therefore depend on the type and location of the emergency as well as the requirements for local responders to provide capacity.

Responding to such emergencies, and planning to reduce their likelihood and impact, has many aspects. This guidance is concerned only with those relating to the management of bodies, from their release from the place where the death occurred to the time of cremation or burial. It begins by distinguishing emergencies requiring little or not forensic pathology from those where this is a central part of the response. It then notes some generic aspects of resilience planning: business continuity, prioritisation of activity and communications with the public. Finally, it comments briefly on the deaths arising from chemical, biological, radiological and nuclear (CBRN) emergencies.