The Medical Emergency Response Incident Team (MERIT) forms an integral part of the NHS response to major, mass casualty and critical incidents, providing advanced medical advice at a range of emergency incidents.
MERIT doctors are dispatched through the NWAS emergency operation control structure and initially co-ordinated via the trauma cell with its dedicated advanced paramedic support.
The main focus of a MERIT doctor is to undertake the roles of medical advisor (MA) or forward doctor (FD) under the direction of the strategic medical advisor, providing a 24 hour on-call capability across the North West.
The strategic medical advisor is principally responsible for monitoring overall hospital capacity and ensuring the tactical level has access to the clinical resources it requires, particularly if national mutual aid is required from other sectors of the NHS.
Medical advisors are responsible for casualty distribution and are expected to provide medical advice to the tactical health command structure i.e. at a Tactical Coordinating Group.
If needed, an additional doctor can also be deployed to the scene of an incident to undertake the role of FD advising the incident’s operational commander. The FD is responsible for coordinating and directing clinical care at a casualty collection point (CCP) or casualty clearing station (CCS).
MERIT doctors derive from a range of backgrounds such as general practice, or a consultant in an appropriate hospital speciality such as emergency medicine, anaesthesia, critical care or a surgical speciality.
Training
MERIT doctors are formally trained and assessed in the performance of the MA and FD criteria stated in the NARU National Ambulance Service Command and Control Guidance. As a result, they can advise the on-call operational and tactical commanders to provide direct support to the regional coordination of major incidents.
Annual training and exercising for MERIT doctors includes:
- Face to face mandatory training plus on-line module
- MA training day
- FD training day
- Live exercises / site visits
- Operational training days with the Hazardous Area Response Team (HART) and/or advanced paramedics