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Managing Editor, IFSEC Insider

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James Moore is the Managing Editor of IFSEC Insider, the leading online publication for security and fire news in the industry. James writes, commissions, edits and produces content for IFSEC Insider, including articles, breaking news stories and exclusive industry reports. He liaises and speaks with leading industry figures, vendors and associations to ensure security and fire professionals remain abreast of all the latest developments in the sector.
March 2, 2023

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Manchester Arena Inquiry

Manchester Arena Inquiry latest: “Devastating conclusion” as Volume 3 report highlights significant missed opportunities

The latest updates from the ongoing Inquiry into the terrorist attack on the Manchester Arena , which claimed the lives of 22 people and injured hundreds of others on 22 May 2017. The Inquiry’s findings are being used to inform the incoming Protect Duty legislation in the UK, a new piece of anti-terrorism legislation, designed to ensure the public is better protected from a “multifaceted, diverse and continually evolving” terror threat.

Find out more about the Protect Duty, here. 

The Inquiry was led by Chairman, Sir John Saunders. The explosion in the arena was caused by Salman Abedi – referred to as SA throughout the report – detonating a bomb in the City Room close to one of the exit doors of the arena. 22 people died and hundreds of others were seriously injured.

Volume 1 of the report, which focused on the security for the arena, was published in June 2021.

Volume 2 of the report from the Manchester Inquiry, which focused on response of the emergency services to the attack, was published in November 2022.

Volume 3 of the report, which focused on the radicalisation of Salman Abedi and whether the attack might have been prevented, was published in March 2023. All three are summarised below, with links to the full reports available for each.

Manchester Arena Inquiry Volume 3: Radicalisation and Preventability

On 2 March 2023, Chairman of the Inquiry, Sir John Saunders, released his final volume of the report, comprising an open report and closed one – the latter being one which contains sensitive material to national security and can therefore not be made publicly available.

Volume 3 focuses on three topics: the radicalisation of the bomber, Salman Abedi; the planning and preparation for the attack; and preventability of the attack.

ManchesterArena-Volume3Report-23Experts and witnesses of the Inquiry relevant to this volume included representatives from local schools and colleges, Abedi’s friends and associates, as well as members of the security services (MI5) and Counter Terrorism Policing.

Overall, Saunders concludes that there was a “significant missed opportunity to take action that might have prevented the attack” – which included a failure of the Security Services to act swiftly enough and that actionable intelligence could have been obtained prior to the attack. The full details were not made available in the open report.

The report states that “no one should underestimate the very difficult job that the Security Service and Counter Terrorism Policing do… [which] has become more difficult with the emergence of lone actor terrorists”. However, Saunders says that mistakes were made, and that these should be identified and steps taken to make them right.

Saunders also notes that Salman Abedi’s family holds “significant responsibility” for the radicalisation of him and his brother, with assistance in the plot likely coming from someone in Libya.

A series of recommendations were made by the Chairman, which include:

  • A scheme be created to prevent extremist prisoners from radicalising those who visit them
  • Education department to consider whether significant behavioural problems should be noted on records if students move school
  • The Government should strengthen legislation on witnesses not complying with inquiries (Abedi’s family did not provide any assistance)
  • Home Office should consider and respond to the 2021 review on laws relating to hateful extremism

Security Minister, Tom Tugendhat, commented in response to the findings: “I share the sorrow that MI5 have expressed that this wasn’t prevented. All of us are working to make sure that the improvements that need to be made, are made.”

A statement representing 11 families of the bereaved outlined that the report provided less information than they wanted, but that the conclusion that there was a failure to assess key intelligence and act on it was “a devastating conclusion”.

Figen Murray, the mother of Martyn Hett who died in the attack, said that the findings are “for everyone concerned to learn from their mistakes and take heed of their recommendations”. She highlighted that any failure to implement recommendations risked further catastrophe.

Read the (open) Volume 3 Report in full, here: Manchester Arena Inquiry Volume 3: Radicalisation and Preventability

Manchester Arena Inquiry Volume 2: Emergency response

Volume 2 of the public inquiry into the Manchester Arena attack was published in November 2022. It examines the response of the emergency services, which was deemed at times to be uncoordinated and risk averse.

ManchesterArenaInquiry-Volume2Report-22Chairman of the Inquiry, The Hon Sir John Saunders noted that better co-ordination and communication between individual emergency services and a less risk-averse approach to some decisions ­may have helped saved the lives of one and possibly two victims, and helped the injured receive quicker treatment.

In the conclusion, Saunders added that the best risk assessment in such situations should be a joint one between all the emergency services on the scene.

The report also focuses on the Joint Emergency Services Interoperability Principles (JESIP), which came about in response to the recommendations made the at the inquest into the 7/7 bombings in London. It is designed to emphasise the need for co-ordination between emergency services, but the system was said to have failed at the Manchester Arena incident.

Other points made in the report included the response having started well initially, but due to an element of “risk averseness and a failure to co-ordinate and communicate” this quickly slowed. Meanwhile, there was said to be a lack of fire and rescue service support, which should have been realised much more quickly – it suggests a lack of appreciation of the part that fire and rescue services can and do play, said Saunders.

Sir John introduced the publication of the report by saying that although he was highly critical of many aspects of the rescue operation, “those criticisms must not overshadow our admiration for the courage of those who went into the City Room without any hesitation to help the dying and the injured.

“Having said that, many things did go badly wrong, and it has been the job of this Inquiry to identify them, work out if possible why they went wrong, and make recommendations to try and ensure that they don’t happen again.”

Read a full summary of the Volume 2 Report, here. 

Read the Report in full, here: Manchester Arena Inquiry Volume 2: Emergency response

Manchester Arena Inquiry Volume 1: Security for the Arena

Volume 1 of the public inquiry into the Manchester Arena attack was published in June 2021. It highlights several ‘missed opportunities’ in the security arrangements for detecting and stopping the bomber, Salman Abedi.

The explosion was caused by Salman Abedi – referred to as SA throughout the report – detonating a bomb in the City Room close to one of the exit doors of the arena.

ManchesterArenaInquiry-Report1-21The first volume focuses on the security arrangements in place at the arena, which Mr Saunders argues “should have prevented or minimised the devastating impact of the attack”, but failed to do so, with a “number of opportunities missed”. Those suggested to be principally responsible were SMG (operator of the arena), Showsec (contacted to provide crowd control and event security at the concert), and the British Transport Police (carried out policing in the area the attack was carried out).

Evidence was taken from 53 witnesses over a period of 32 days, with over 1000 documents examined.

In his comments to Parliament, Mr Saunders said: “I have concluded that there were serious shortcomings in the security provided by those organisations which had responsibility for it, and also failings and mistakes by some individuals.

“When the mistakes and shortcomings set out in the report are considered, it needs to be at the forefront of that consideration that responsibility for what happened and for causing so many deaths and serious injuries lies with Salman Abedi, the suicide bomber, and his brother, Hashem, who assisted with the preparations.”

In the report, it was noted that the threat level of a terrorist attack was ‘Severe’ in the UK at the time, and therefore an incident was ‘highly likely’ to occur at such an event, but the preparedness was not sufficient from security staff. Hostile reconnaissance was carried out several times by the bomber, it was found, and he was able to identify a CCTV blindspot where he hid for nearly an hour in the Arena Foyer on the night of the attack.

Hours of CCTV examined by the inquiry also showed the attacker bent under the weight of a “bulging rucksack, at one point fiddling with wires sticking out of his clothes.”

Noteworthy concerns the report highlights include:

  • A lack of staff preparedness
  • A lack of communication regarding suspicious behaviour between security employees
  • Insufficient sharing of information between those concerned with security in the arena

Recommendations following the first stage of the inquiry include:

  • Implementation of the Protect Duty (announced in the Queen’s Speech in early 2022) and that requirements are stringent for premises such as arenas
  • Continuous reminders to security staff and others whose job includes being alert to terrorism of the current terror threat level
  • Full briefings for those responsible for security at every event about the level of risk of terrorist attack
  • Any and all suspicious behaviour by the public should be noted and reported promptly for investigation purposes
  • The need for communication, coordination and co-operation between those responsible for keeping the public safe

Several points were made by Mr Saunders on the requirement of the Protect Duty to be stringent, commenting: “Having heard about the effect of the deaths of the 22 people who died on their families and friends and the effect on those left permanently injured, I consider that a rigorous duty is appropriate.”

Read the full report, here: Volume 1 of the Manchester Arena Inquiry: Security for the Arena


Comments from the security industry

Following Volume 1′ of the Report’s release, Acting Chief Executive of the Security Industry Authority (SIA), Michelle Russell, said: “Our thoughts today are with those who lost loved ones, suffered injuries, and had their lives shattered because of that terrorist attack at the Manchester Arena that night.

“Our priority in licensing individual security officers and working with suppliers of private security to improve standards, is always the protection of the public. The report findings provide learning and reflection for all concerned. It also makes some observations and recommendations about the regulatory framework and aspects of SIA’s approach to regulation in and prior to 2017.

“Whilst many things have changed since 2017, there is always more that can be learned, and more improvements that can be made. We are committed to working with the private security industry, law enforcement and other partners in a robust way to make sure the learning from the inquiry’s findings is taken forward.”

The British Security Industry Association (BSIA) has also responded. Highlighting that  “many security companies regularly go above and beyond the call of duty to maintain their integrity and the security services they provide, something that as an Association we promote within our recognised membership. However, we feel the time has come for security services to be purchased on a risk and professionalism basis and not purely on cost, and the industry to be seen for what it is, a profession and not a minimum wage job.” You can read the BSIA’s full response to the Inquiry’s findings, here.

Agreeing with the need for a Protect Duty, Iain Moran, Director at ATG Access, also added: “One of the most startling findings in the report is just how important it is to guard against complacency amongst security staff when it comes to the potential for terrorist activity. The number of ‘missed opportunities’ highlighted really underlines the crucial role that police, security staff, and other employees play in the prevention of devastating events such as these.

“However, it’s also clear that there were failings in the physical security measures at the arena too, with poorly planned perimeter security and CCTV blind spots making it harder for those involved to identify and apprehend the attacker. This emphasises the need for a holistic approach to security, where carefully implemented and maintained physical security solutions are in place that make it possible for security professionals to do their job as efficiently and effectively as possible.”


This article was first published in November 2021, and has since been updated several times to reflect the Inquiry’s findings. 

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