we have also heard from north—west ambulance service. difficult conditions. they have confirmed 59 casualties being treated in six hospitals, and they also said there has been a number of walking wounded coming in. and also a theme which is coming through, a picture which is emerging, everyone we have spoke spoken to are passing on their thanks to emergency services, who it appears responded extremely quickly, working in a difficult situation. and they have been on the scene fast to respond to this. it is something, u nfortu nately, this. it is something, unfortunately, they do have the plan for, rehearse, almost, and as we have heard, this is being treated as a terrorist incident. earlier we saw a device that turned

we had a briefing from a senior official at north west ambulance service and a senior health officialss the region. those 59 patients are spread across eight hospitals, nine are here at manchester royal. we asked how many of them were children, how many were adults. they were not able to confirm that, or say much more but we know 12 are at royal manchester children's hospital and there is at least one of the trial at another hospital. they pay tribute to the emergency services in what they said was a terrible night for manchester. they expressed their condolences for the bereaved, but said there had been a veryjoined up plan put into action. they had, in effect, written the plan beforehand. they talked of getting documents out and enacting it very quickly in terms of coordinating ambulance help from other parts of northern england, getting doctors and

we had a briefing from a senior official at north west ambulance service and a senior health official here in greater manchester summing up the nhs response across the region. those 59 patients are spread across eight hospitals, nine are here at manchester royal. we asked how many of them were children, how many were adults. they were not able to confirm that, or say much more but we know 12 are at royal manchester children's hospital and there is at least one of the trial at another hospital. they pay tribute to the emergency services in what they said was a terrible night for manchester. they expressed their condolences for the bereaved, but said there had been a veryjoined up plan put into action. they had, in effect, written the plan beforehand. they talked of getting documents out and enacting it very quickly in terms of coordinating ambulance help from other parts of northern england, getting doctors and nurses into hospitals. there were 60 vehicles deployed with paramedics, about 300 staff were involved overnight. they said some of the 59 are seriously ill. they wouldn't say ho

ambulance services, pleading with people, really, not to bother them with anything less than an absolute emergency, given how overstretched this is making all the services in the area? that is right. the north—west sent out service m essa g es to emergency. they've sent out service messages to their personnel telling them how to get in contact. that suggest this is being treated as a very serious incident with many casualties. —— that suggests that there is. these images were somewhat later. a lot calmer. we just saw enormous loads of people try to get as far away as quick as they could from the venue? yes. a lot of panic. confusion inside. people were rushing for the actors. some of the eyewitnesses said there was no order in that. —— rushing for the exits. people were rushing to get out. we heard about scuffles, we heard about fights. we heard about people receiving injuries in the hurried to get out of the arena and the panic and hysteria that followed. so there could have been some injuries in the evacuation, but many caused by the explosion. —— the hurry. evacuation, but many caused by the explosion. -- the hurry. and we're hearing from our home affairs correspondent that this could be a te

we know the north west ambulance service has told people not to call them unless it isa told people noting emergency. so, that gives you an indication of how many staff are involved in dealing with this incident at the moment with such high catch of the figures. it is not surprising. —— with such high casualty figures. officials are meeting in whitehall as we speak to discuss how to deal with the situation. a terrorist attack. some people are talking about a suicide bomber, but we have no information on that from uk sources. thank you. ed thomas is in manchester. tell us the latest of what is happening around you. this is where it is usually the biggest place. beyond this in the your rights is the arena. —— cordon. inaudible. parents are trying to get out with their children. 19 people have died in this blast at least. further details to add. we have spoken to one eyewitness close to the blast. he said he went down on the blast. he said he went down on the floor and his leg was bleeding and he was holding onto his wife. and while he was there, he could see nuts and bolts on the floor. h

the north—west ambulance service have said they sent 60 ambulances to the scene in the aftermath of thisreater manchester police that 19 people have died and at least 60 more are injured. it has of course been an incredibly busy night the emergency services. six hospitals in the greater manchester area are treating those who are injured, including the walking wounded. just on the line for us as charlotte campbell. her daughter, olivia, was at the concert. charlotte has not been able to make contact with her so far. we would like to help in getting the word out. i just like to help in getting the word out. ijust wonder like to help in getting the word out. i just wonder what your arrangements were with your daughter. what you understood she would do at the end of the concert. she was going to go down into victoria station, get the tram with herfriend and victoria station, get the tram with her friend and she was going to be picked up by herfriend ‘s parents and dropped off home. she was with a group orjust one friend? just one brand. i presume you haven't been able to speak to the friend

the sense i get from the emergency services, from north west ambulance service and from the local nhse shock and the horror and sadness at something like this. there is a quiet sense of relief, i think, that the disaster plan they had drawn up and they had worked very carefully on, they could put into practise. they had planned for an incident just like this, and that meant that individual hospitals like this one, very quickly called in staff, overnight, lots of staff came in as part of that plan, and lots more did as well who were off duty. some of who were told they weren't actually needed. the ambulance service made clear there were 300 of its staff, including the control room, who were involved in this. they had support from other ambulance services — the west midlands and yorkshire and so on. and one point that staff are wanting to make, some of them have come out to tell us is they have been overwhelmed by the gratitude of local people. they want to thank local people for coming in with cakes and drinks. there has been a stream of people coming in. 0ne elderly patient, a woman i

also heard from north—west ambulance service.hey of course will have had an extremely busy night working in difficult conditions. they have confirmed 59 casualties being treated in six hospitals, and they also said there has been a number of walking wounded coming in. and also a theme which is coming through, a picture which is emerging, everyone we have spoke spoken to are passing on their thanks to emergency services, who it appears responded extremely quickly, working in a difficult situation. and they have been on the scene fast to respond to this. it is something, u nfortu nately, this. it is something, unfortunately, they do have the plan for, rehearse, almost, and as we have heard, this is being treated as a terrorist incident. earlier we saw a device that turned out to be nothing. manchester is on edge. it reflects the current climate. if you hear a bang, u nfortu nately, climate. if you hear a bang, unfortunately, people think the worst because of terror attacks around the world. i think there are ripple effects across t

north—west ambulance service has said they are working obviously flat out.to call into ambulance services unless it is a life—saving emergency. we have also heard from the fire service in manchester. they are issuing a similar sort of message, saying they are helping the police and ambulance service. so again the messages going out to people not to call the fire is nervous unless it is absolutely necessary. and that is an indication, isn't it, of the level and severity of some of these injuries, let alone the casualties that have actually happened. you mention the nature of some of these injuries, shrapnel and things like that. there is a distinct possibility here that the casualty numbers could rise as patients are triage as we speak outside the venue. triage as we speak outside the venue. that's right, the update from the police that lease 19 killed, —— at least 19 killed, 50 injured. in the last 20 minutes or so we have heard emergency services are still working at the scene and they are asking the public to avoid the area. so certainly an ongoing inciden

the sense i get from the emergency services, from north—west ambulance service and from the local nhsave made it clear that nothing can prepare you for the shock and horror and sadness at something like this, that there is a quiet sense of relief, i think, that there is a quiet sense of relief, ithink, that that there is a quiet sense of relief, i think, that the disaster plan they have drawn up, and they work very carefully on, they could put into practice, they had planned foran put into practice, they had planned for an incidentjust like this and that meant individual hospitals like this one very quickly called in staff overnight, lots of staff came in as part of the plan and lots more did who were off duty, some of whom we re did who were off duty, some of whom were told they were not needed. the ambulance service made clear there was 300 of its staff in the control room who were involved, had support from other ambulance services, at one point, —— one point staff are looking to make, they have been overwhelmed by the gratitude of local people, they really want to thank local peop

unfolded, and they declared a major incident in greater manchester, a decision made by north west ambulance service networks, major trauma centres including here at the manchester royal infirmary to coordinate their response and then each of the eight hospitals declared their own major incident and that involves calling in clinicians, doctors, nurses and other staff and thatis doctors, nurses and other staff and that is a well rehearsed procedure by the hospitals. talk to us about the level of preparedness for incident like this. you have got the hospitals preparing and it was made clear that they do rehearse these scenarios, both on paper in terms of planning, and they do have rehearsals such as can be arranged, so rehearsals such as can be arranged, so that every member of staff knows how to respond if a major incident is declared and they can call in doctors, nurses and other staff at all times of day. that appears to have happened as effectively as could be expected. 0k, thank you very much for that. we've had statement from the nhs blood and transplant service. they say their thoughts are with

donate blood, ambulance staff volunteering to come in and help, the ambulance service in particular, 300 people involved in the north—wests, coming in even though they were not due to be on shift. huge response from the medical teams here. let's talk to hugh pym our political editor. what are you hearing about the medical response? we learned from the comments made by the greater manchester health care chief that the response was as good as it could've been. the plan envisaged a scenario like this and that enabled them to direct paramedics and ambulances very quickly and taken to the eight hospitals, including a major trauma centres. manchester royal and salford royal. it had gone off in a way that they were proud of. we talk of one nhs, this squad operation between the ambulance staff on the front line and then each hospital having its own major incident plan, bringing in clinicians overnight, doctors, nurses, coming in to ensure that the right staff are in the right places. some of the 59, some of them are intensive care and will be in hospital for quite awhile, some severely injured. tell us more about the level of pr

i would also give special thanks to colleagues in north—west ambulance service and greater manchestero are and have been integral members of the team dealing with this incident. finally i would like to repeat again our most and they condolences to those who have lost loved ones in this incident and our continuing support for those who remain in our care. iam support for those who remain in our care. i am happy to take a few questions but i cannot get into any detail on the condition, treatment or in degrees of individual patients. you mentioned some of the patients. you mentioned some of the patients being able to be discharged. might other patients be able to be moved closer to families? that is something we consider if patients are stable enough to tra nsfer patients are stable enough to transfer and choose to do so to enabling major trauma centre, we would try to facilitate that. generally can you tell us the type of injuries you're cheating? the injuries... people receive in this sort of situation are different to the normal sort of injury you would see in the nhs. these are blast

talking is north west ambulance service and nhs leaders, it has been made clear however much you plan this. but there is a quiet sense of relief that the disaster plan they drew up was put into practice and it gets delivered. and they say they spend money months planning forjust a scenario like this. a major incident was declared, hospitals were called m, was declared, hospitals were called in, the staff were called in overnight, the stuff they needed, and others came in who were not on duty, so many that some were sent back home. the ambulance service as well were greatly backed up. the point they want to make is the spirit of local manchester people. people donating blood over the road bringing in food throughout the day for staff. they say they are very thankful, another example, they say, of the spirit of manchester. many thanks. the latest at manchester royal infirmary. by noon today, the police had arrested a 23—year—old man in connection with the attack. he's thought to be from chorlton, in south manchester. one of the priorities for investigators is to find out if the suicide

manchester health and social care partnership and also from the medical director of the north west ambulance serviceighly specialised crews to the scene of the attack last night in an effort to stabilise the injured at the scene before transporting them to the eight hospitals. the doctor said that if ever you wanted to see the nhs in operation, last night and this morning, that was the time to experience it. from the most dreadful of nights and mornings, he said, we also saw some of the best greater manchester has to offer in terms of the response from people and the emergency services, members of the public, they were queueing up to donate blood and so on. the doctor from the ambulance service was able to give us this update a short while ago. the hospital behind me received nine patients, patients we took by ambulance, there were also walking wounded. another trauma centre received six patients. while manchester children's hospital received the most, 12 patients. university hospital south manchester received six patients. a hospital in stockport received six patients. bolton hospital received eigh

and i also give special thanks to colleagues in the north west ambulance service and greater manchesteral members of the team dealing with this incident. finally, i would like to repeat again our most sincere condolences to those who have lost loved ones in this incident, and our continuing support to those who remain in our care. professor bob pearson with the update that 32 people are still in hospital, five adults and five children still requiring critical ca re children still requiring critical care in light of what happened here in manchester on monday night. we will have more from here at 5pm. for now, simon, back to you. as we have been hearing, donald trump has been reacting to the leaks of information to the new york times. he has described them as deeply troubling. at the nato meeting earlier, he had a chance to chat, as you can see, to theresa may. the white house and downing street say they are trying to schedule a meeting, where theresa may is expected to protest strongly at those leaks. but clearly, the two of them had some time whilst on the podium to talk, relaxed talks,

certainly we‘ve had representatives from the north—west ambulance service and also the chief officero talk to the media here around lunch time, talking about the plans that they reverse, the physical rehearsals, the desktop exercises and so on that they go through to make them ready for a major incident like this, but we also heard that, not in the news conference, but in a tweet, that nothing can prepare them for the sorrow, the shock, the sadness, of dealing with the reality of something like this. so, i think what we saw in the news conference earlier was a very professional approach, of course, what you would expect, not wanting to go into too much detail because of the nature of the injuries that some of the people in this hospital and the other hospitals are being treated for, out of respect and sensitivity to them and their families but, of respect and sensitivity to them and theirfamilies but, you know, behind that very professional approach, you can sense the emotion thatis approach, you can sense the emotion that is there, that the emergency services are feeling in having t

that's right, the chief executive of north west ambulance service said, nothing can prepare you for theowever, i get the sense that there is quiet contentment that the plan they had in place was put into practice and delivered, it worked. one source told me, they were expecting something like this to happen, tragic as though that might seem, they had prepared for it, so within minutes of the attack taking place, the regional plan was put into action, it was declared a major incident, individual hospitals then got in touch, with staff that came in overnight, and they had all the doctors and nursing staff that they needed and more that came into work today, and the berlin service calling on a total of 300 people including control room staff with their response. there is a feeling that what was there was the best they could have offered. —— and the ambulance service. i know that at the other hospitals, is usually appreciative of the public response. one consultant came out and said, lee's convey to people in manchester how grateful we are, how touched we are, overwhelmed by the generosity,

derek cartwright is the chief executive of the north west ambulance service and joins us now.mething like 60 ambulances on the way, and i was very pleased we have that type of resourcing coming very quickly. how does that compare to a normal number of ambulances? on monday night, 11 o‘clock, we had about 200 ambulances. we moved resources in from as far away as blackpool, cheshire, up in the south cumbria, everyone was moving to manchester, which of course had a knock—on effect. our colleagues and friends in other ambulance service is backed up in those areas where we had from the ambulances from, so my role in the whole thing is about supporting our command teams are making sure they had everything they needed to do to do theirjob, and is above the star. because there were staff throughout this have been absolutely brilliant. i am always proud of them but this team took pride to a different level. so often when we talk to people involved in emergency services, they say in an emergency services, they say in an emergency like this you just concentrate on the job you have to do