The UK Health Security Agency (UKHSA) visited St Helena from 21 to 25 September 2026 to help Health and Social Care and partner agencies strengthen the island’s response to a mass casualty incident.
The visit followed the approval of Health and Social Care’s new Mass Casualty Plan, which sets out how the island will respond when the number or needs of casualties exceed available capacity. The plan complements St Helena’s wider Major Incident Response Plan and takes account of the challenges of delivering an emergency response in a small, geographically isolated community.
During the visit, staff took part in familiarisation sessions covering major incident command arrangements, joint working, casualty triage and movement, hospital capacity, communications and recovery.
An operational exercise tested the plan in practice. The programme concluded with Exercise Black Dog, a strategic tabletop exercise involving senior staff and partner agencies.
Exercise Black Dog tested the island’s transition from business-as-usual arrangements to a coordinated major incident and mass casualty response. It considered gold, silver and bronze command arrangements, casualty management, limited clinical resources, communications, multi-agency working and recovery planning.
Emergency Operations Manager, Michael Gaga-Hale, said:
“These workshops followed the development and approval of our new Mass Casualty Plan. We are grateful to UKHSA and SHG’s Emergency Planning Department for helping us develop a plan that reflects the needs and capabilities of the Health and Social Care Portfolio, and for supporting us to test it at both operational and strategic levels. The sessions and exercises were informative and well organised. They highlighted strengths across SHG and identified lessons that will help us further improve the plan and its implementation. I would also like to thank everyone who took part during the week and our partner organisations, including the St Helena Red Cross, for their support and contribution. Effective emergency preparedness depends on agencies working together, and the programme provided a valuable opportunity to strengthen those relationships and our collective response.”
Head of Social Care, Tracy Poole-Nandy, commented: “I found the whole exercise an excellent opportunity to test the updated mass casualty plan from an operational and strategic perspective. The week was really well planned and executed by Anel, Michael, Peter, Lizzy and Grace as part of the ongoing partnership work with the UKHSA. Thank you to everyone who attended and contributed to the overall learning”
Head of National Response Centre, Peter Daividson, commented: “As part of the UKHSA UK Overseas Territories (UKOT) Health Security Programme, we have been working with SHG over the past three years to support the development of health resilience through a range of activities. This has included reviewing past incident responses to identify areas of good practice and where improvements can be made, delivering training, workshops and briefings. We have had the pleasure of working with teams across SHG, at operational, tactical, and strategic levels and with Ministers.
During this visit we have been able to build upon previous work with the Health and Social Care portfolio and SHG’s Emergency Planning Department to develop the Mass Casualty plan by supporting the delivery of mass casualty briefing sessions to SHG colleagues and the Table-Top Exercise Black Dog. During the exercise we examined how well the plan supported multi-agency partners to respond to a simulated scenario that overwhelmed normal operational activity and required implementation of different ways of working. The exercise provided the opportunity for SHG colleagues to consider and review their roles and responsibilities within the plan, set out the response priorities, whilst maintaining service delivery.
It has been a rewarding experience to work with the dedicated team from SHG to support the development of both the Mass Casualty plan and Exercise Black Dog. This has given our team an insight into the unique challenges faced in a small island context and allowed our experience and resource to support SHG’s work, providing external challenge to help strengthen preparedness and response arrangements for future emergencies. The UKOT Health Security Programme is funded by the Foreign, Commonwealth and Development Offices’ (FCDO) Resilient Economies Programme”
The programme increased understanding of the new arrangements, tested the plan at operational and strategic levels, and identified priorities for further development.
The Health and Social Care Portfolio extends its thanks to the UKHSA team, the Emergency Planning Department, partner organisations and everyone who participated during the week.
Photos:
Attendees of Exercise Black Dog
Trainers of Exercise Black Dog
Exercise Black Dog
Emergency Planning and Trainers
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