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5. The emergency response

This chapter includes witness accounts, images and descriptions of scenes that may be distressing.

What was investigated?

Under the terms of reference for the managed investigation, Operation Resolve investigated:    
Response of the police to the disaster, including:

a) the early police response to the crush at the Leppings Lane end, including allegations that the police were slow to respond/failed to act when it was obvious the people were in distress
b) alleged failures/refusals on the part of the police to open perimeter gates, and allegations that officers pushed supporters back when they were trying to climb to safety—this aspect of the investigation will specifically consider complaints made against PC Peter Smith and PC David Illingworth, as well as any other officers who may have been involved
c) subsequent police command and control of the disaster
d) the communication between the police and the other emergency services
e) the activation and implementation by the police of any pre-planned responses and emergency procedures for such disasters
 

What was found?

• Accounts from supporters describe a sudden change in the situation in the pens at around 2.55pm, when the pressure from the back suddenly intensified. This is consistent with the influx of supporters into the centre pens after the 2.52pm opening of Gate C. Officers and supporters in the West Stand recalled seeing a huge surge of people coming into the pens around this time.

• Officers from Serial 1, stationed in their usual positions on the perimeter track, did not immediately realise the severity of the situation. When Gate 3 in the perimeter fence burst open at 2.57pm, the officer there (PC Smith) immediately sought to close it again and prevent supporters coming through, assuming it was a pitch invasion. When Gate 3 burst open a second time, it was left open and officers allowed supporters through onto the perimeter track. 

• At around this time, a serial of officers from D Division, who were not normally involved in policing Hillsborough Stadium, arrived at the West Terrace. Some of them instantly saw there was something wrong and opened Gate 4, to try to free supporters from Pen 4 towards Pen 6. The evidence indicates that Police Constable David Illingworth (PC Illingworth) from Serial 1 had not yet done so. Other members of the D Division serial have stated that they did not immediately think there was a problem inside the pens, but within a matter of seconds they realised there was. By 2.59pm, all the perimeter gates to the West Terrace were open.

• When the officers in the PCB saw supporters on the perimeter track, they initially assumed it was a result of disorder, and their first request was for dog handlers to be sent to the stadium. At 3.04pm, they saw Supt Greenwood signalling to them that the match should be stopped but still did not know why. Supt Murray was sent down to the pitch, but by the time he had got there, Supt Greenwood had reached the referee to stop the match. Supt Murray returned to the PCB but was sent back down to find out what was happening.

• As soon as the match was stopped, Ch Supt Duckenfield called for Operation Support—a request for all available officers to be immediately deployed from across SYP to assist. However, he did not have the authority to do this; it required ACC Jackson to confirm it, which he did a couple of minutes later.

• At almost the same time, the PCB sent a radio message instructing all available officers at the ground to make their way to the perimeter track at the Leppings Lane end. Neither request included any details as to what officers were responding to. 

• Most officers who did respond initially assumed that they were dealing with some kind of crowd trouble or pitch invasion. However, as they got closer to the West Terrace, their views changed. Most SJA volunteers and the first SYMAS staff present indicated that their first thought had been the same.

• SYP and SYMAS did not respond in line with their emergency procedures or incident plans. Duties identified as pivotal to the correct allocation of resources and directing the response were not fulfilled. No police officer declared a major incident, so the other emergency services were not correctly alerted to the severity of the situation. 

• At first, SYP’s Force Control Room merely advised SYMAS that ambulances may be needed; the Force Control Room received a request from the PCB for a “fleet of ambulances” to be dispatched. This was in response to a message from Supt Murray on the pitch at 3.08pm. However, the Force Control Room was only able to give SYMAS limited information about what had happened, so SYMAS rejected the request for multiple ambulances, instead authorising a limited initial response.

• When further ambulances did arrive, police officers outside the stadium did not know why they had been called or where they were needed. The same issue recurred when teams from SYCFS arrived a few minutes later.

• Rescue efforts were initially hampered by a combination of the narrowness of the perimeter gates, the pressure from the crowd and a lack of organisation. Several officers have described getting in each other’s way as they frantically tried to free trapped supporters. The situation changed after Ch Supt Nesbit arrived at around 3.11pm. He organised officers into chains at each gate, to enable supporters to be carried to safety. Around the same time, other officers, including PS Morgan, entered the pens through the central tunnel at the back, to encourage supporters to move away and help free those at the front. 

• There was no central organisation of the rescue effort and no instruction from the PCB. Instead, it was left to those on the pitch to make decisions as best they could. This included SYMAS and SYCFS staff. The PCB did issue requests for help, such as a request for the local radio station to broadcast an appeal for doctors to attend. However, its communications remained poor: at one point, the PCB asked the Force Control Room to set up a “Major Incident Bureau”, confusing two separate functions: a Major Incident Room and a Casualty Bureau. There was also a lack of clarity as to who was in charge.

• Supporters, including some off-duty medical professionals sought to assist, but also received little or no instruction. Numerous supporters helped carry the injured while medical professionals at first attempted resuscitation but were increasingly asked to certify death. There was no police coordination of this, as the SYP Major Incident Manual stipulated there should be. The sole focus appears to have been rescue, with no consideration of how the injured would be managed. The PCB did not offer any direction around this, which also meant that medical resources were not well deployed.

• By 3.31pm, the front of Pen 3 was clear of casualties. However, supporters were still being treated or taken to ambulances. A growing number were confirmed to have died.

• Some of the actions of officers—such as forming cordons rather than assisting in the rescue effort—appeared inappropriate to supporters. 

• Evidence has not been found of officers using their truncheons on supporters and there is insufficient evidence to substantiate allegations of officers physically preventing supporters from escaping the pens.
 

Significant new evidence

There was already a wealth of existing evidence about the emergency response. Operation Resolve enhanced this by time-synchronising it, then using specialist technology to analyse it frame by frame. This provided further insight into the sequence of events and also assisted in the investigation of specific issues, such as the allegations that police officers had used truncheons on supporters.

Operation Resolve also examined in detail recordings and transcripts of police radio communications and telephone conversations, including those between the PCB and SYP’s Force Control Room at Police HQ, and between the different emergency services—some of which had not previously been open to scrutiny.

 

  1. This chapter focuses on Operation Resolve’s investigation into the short period of time from around 2.45pm, shortly before the exit gates were opened, to 5.15pm when Ch Supt Duckenfield left the stadium. It examines the effectiveness of the SYP response to the situation, comparing what officers did with what—according to SYP’s own Major Incident Manual and Major Incident Plan—they should have done. 
     
  2. It also includes evidence from supporters, police officers and other witnesses describing the situation in the pens, along with some images of the rescue effort. Some may find these accounts and images distressing.
     
  3. There are, understandably, numerous inconsistencies in witness accounts about precise timings and the exact sequence of events. Where possible, Operation Resolve has used time-synchronised video footage and time-stamped photographs to provide accurate timings.