With Martyn's Law in its statutory 24-month waiting period, hospitals are one of the many large capacity venues across the country reviewing their emergency procedures, including communication and evacuation plans. The new law, also known as the Terrorism (Protection of Premises) Act, is coming into effect in 2027 and introduces new expectations for public protection against attacks.
Split into two tiers – standard, for venues with over 200 people, and enhanced, for venues exceeding 800 people - Martyn's Law means venues now must evaluate risk, train staff and prepare safety plans, with stricter requirements for the enhanced tier venues. As the law comes as a response to the 2017 Manchester Arena attack, most hospitality venues, like stadiums or concert halls, have begun preparation for the changes. However, hospitals, which frequently exceed 200 people, also fall into scope for Martyn's Law requirements and will need to comply with the new legal requirements.
When it comes to public protection, one of the biggest hurdles hospitals face is having an effective communication plan in place should an incident occur. Hospitals will already have emergency plans prepared under the NHS Emergency Preparedness, Resilience and Response (EPRR) Core Standards, which outline the actions needed for evacuation or lockdown. Despite these standards providing the foundations of protection, they do not fully cover the conditions set out by Martyn's Law, which require better traceability of actions, meaning more flexible communications systems that allow different alerts can be sent to the right place at the right time. As a result, many hospitals may be partially prepared, but not yet fully compliant, which can result in enforcement action, including financial penalties and, in serious cases, criminal sanctions.
In an emergency situation like a terrorist attack, hospitals have a unique challenge of finding a solution that can provide safety to all patients and staff inside the building, even if they are not in a position to evacuate. Hospitals have 24/7 public access and a high footfall of visitors who will not be used to any emergency evacuation procedures, meaning they rely on staff to guide them. Also, not everyone can respond to an alert in the same way, especially if they are a vulnerable patient receiving care or are immobile. Depending on the nature of the attack, some people will be safer invacuating or entering lockdown, rather than trying to evacuate a building and possibly running directly into the line of threat. This naturally makes communication and co-ordination much more complex than you would expect from a traditional public venue.
In addition to varying patient mobility, emergency communication can become difficult operationally due to hospital sites having multiple buildings. Hospitals comprise wings, wards, specialist departments and public spaces, like pharmacies or cafes. As a result, responsibility of these areas may be shared between multiple parties, such as NHS trusts, third-party operators or individual departments. Changes under Martyn's Law will mean these parties must co-ordinate terror attack plans across the whole site to ensure compliance, however, in practice, these multi-space environments increase the risk of inconsistent responses during an incident. During an incident, different parts of the same hospital may require entirely different responses at the same time, which is why a cohesive communication plan is so vital for both Martyn's Law compliance and the safety of the public.
For hospitals, generic site-wide alerts are likely to create confusion. Without clear, targeted communication there is a risk that individuals rely on instinct, for example, evacuating a building like they would in a fire drill, potentially putting themselves and others in danger, rather than following the correct procedure. Traditional alarm systems alone may not provide enough clarity during fast-moving incidents. With this in mind, it's important hospitals invest in smart communication systems capable of delivering zoned messaging, real-time updates and scenario-specific instructions to different parts of the estate simultaneously. Systems that can provide clear differentiation between alarm types are also essential, ensuring staff can quickly understand the nature of the threat and direct patients and visitors appropriately.
Carrying out comprehensive risk assessments can also help reduce confusion as they can help identify high-risk or public-facing areas across the site, while also clarifying who is responsible for each area between trusts, departments and third-party operators. Hospitals also need to review whether existing alarm infrastructure can support a co-ordinated response under pressure. Smart communication systems that provide zoned messaging, differentiated alarm signals and clear, scenario-specific instructions can help reduce confusion during fast-moving incidents. Staff must also be trained in initiatives such as ACT (Action Counters Terrorism) and SCaN (See, Check and Notify), combined with routine drills and a clear understanding of different alarm meanings.
When Martyn's Law is enforced in 2027, hospitals must have a solution in place that has both real-time response capabilities and the ability to dynamically send alerts in what might be a rapidly changing situation. Moving forward, having the ability to communicate the right message, to the right people, at the right time, will prove invaluable to hospitals in both compliance and protecting lives.
