Locked out? The debate over London’s bleed control cabinets

As London confronts a rising wave of violent crime, and a constant fear over traffic collisions, hundreds of bleed control cabinets, designed to save lives, are at the heart of a heated debate over accessibility, efficacy, and commitment.

These code-locked cabinets, containing life-saving equipment such as chest seals, tourniquets, and gauze, have been championed by campaigners as a vital resource for treating victims of stabbings and road traffic collisions in the critical minutes before emergency responders arrive. Yet, a lack of clear commitment from the London Ambulance Service (LAS) stoked fears that these potentially life-saving tools are going unused.

A Disjointed Approach

First aid equipment company Turtle Engineering estimates it has installed between 300 and 400 cabinets across the capital, many funded by local councils and businesses.

However, the LAS stance on locked cabinets has created friction. The News first started investigating this issue in March last year. After initially saying it was “not responsible” for bleed control cabinets, the ambulance service said it would participate in the programme.

But in August 2024, LAS and the Mayor’s Office reiterated their scepticism in a public statement, stating: “Dedicated bleed control kits are not essential for effective bleeding control. Where bleed kits are made available, specific training should be given for those who may use them.”

This position has left campaigners like Lynne Baird MBE, founder of the Daniel Baird Foundation, and Lisa Pearson, founder of the Peckham youth charity Let the Youth Live, frustrated. Both have worked tirelessly to expand access to bleed kits across the UK and empower communities to act swiftly in emergencies. “Bleed control kits have already been successfully used in real-world emergencies to save lives, demonstrating their importance,” said Ms Baird.

She added: "We have enormous respect for all of our emergency services, including the London Ambulance Service (LAS), and the exceptional work they do under immense pressure to save lives every day."

Ms Pearson, whose charity has installed three cabinets and distributed over 100 kits with the help of local funding, expressed her dismay: “I’m just absolutely shocked. The West and East Midlands ambulance services are committed, so it doesn’t make any sense. Why wouldn’t they want communities to be empowered by using the right equipment?”

The situation is made more difficult by the fact that LAS does not have a system for recording when , if ever, call handlers direct emergency callers to these bleed cabinets, and give them a code. Lisa Pearson’s bleed cabinet was found unlocked in Rye Lane last year, with the equipment missing. But she has no idea whether this was used on LAS’ direction, or if it was merely an act of vandalism. Without such data, it is very difficult to know how effective these cabinets are, and could be, as a life-saving solution.

Contrasting National Commitment

In contrast to LAS, ambulance services in the West and East Midlands have embraced bleed control kits, facilitating seamless communication and support for their rollout. Mike Dowson, managing director at Turtle Engineering, noted: “The way it works with East and West Midlands Ambulance Service is you email them, and nine times out of ten you’ll get an email back to clarify stuff. In London, it’s just a bit of a black hole. We never hear anything back and it’s not much reassurance.”

Professor Anthony Marsh of West Midlands Ambulance Service has previously been a vocal supporter of publicly accessible bleed kits. Four years ago, he called their rollout “absolutely the right thing to do,” emphasising the importance of equipping bystanders and first-aiders with the tools to act in those critical first moments.

Lynne Baird believes that LAS might be put off by the messaging around the cabinets. She launched her campaign after her son Daniel Baird was fatally stabbed in the early hours of 8th July 2017, aged 26. It was outside The Forge Tavern, Digbeth in Birmingham following a night out with friends. There was no first aid or bleeding control kit available. Dan died shortly after arriving at hospital due to catastrophic bleeding.

This, she explained, may have led to a perception that these kits are only useful in the event of stabbings, which could give them a negative perception, especially when there is an emphasis on tackling the root causes of knife crime.

Challenges of Locked Cabinets

The locked nature of many cabinets remains a worry for LAS. The capital’s ambulance service, alongside the Association of Ambulance Chief Executives, has expressed concerns that such barriers may hinder timely access. “It’s vital that any first aid and lifesaving equipment are easily accessible and are not kept in locked cabinets,” their statement reads.

It has also stated that such equipment often requires specialist equipment. A statement from LAS and the Mayor’s Office said: “Dedicated bleed control kits are not essential for effective bleeding control. Where bleed kits are made available, specific training should be given for those who may use them. Bleed control kits should contain only standard gauze for pressure and an easily applied tourniquet.”

Despite this, campaigners argue that the issue can be mitigated with proper public education and collaboration. Ms Baird stated: “We understand LAS’ concerns about training and access to locked cabinets, but we believe these challenges can be addressed through collaboration, public education, and practical solutions.”

When an emergency incident is life-threatening, LAS will share the details with the GoodSAM mobile application. Volunteers with the GoodSAM app downloaded will then be notified and given access to the cabinets. But only volunteers with LAS-standard training can register with the app - roughly 5 per cent of the population, according to the British Red Cross.

Funding and Accountability

Freedom of information requests reveal that London councils have collectively spent approximately £25,000 on 16 locked cabinets and 47 kits from Turtle Engineering. Yet this is just a fraction of the estimated total across the capital, suggesting many installations lack central oversight. The Mayor of London, while indirectly funding cabinets through the Violence Reduction Unit (VRU), has criticized their locked design, leading to questions about consistent support for the initiative. The Mayor’s Office confirmed it had funded their roll-out for the Met Police service but failed to say how many and how much it had spent.

Campaigners Call for Standardisation

The fractured approach across ambulance services has spurred campaigners to demand a unified strategy. They’ve called on the Home Office to standardise UK ambulance services’ collaboration with the bleed kit campaign. Ms Baird’s message to LAS is clear: “Bleed control kits save lives. The evidence is there. It’s time for LAS to reconsider their stance and work with us to empower communities.”

For now, Londoners face an unsettling reality: life-saving equipment is in place, but systemic barriers and mixed messages could be preventing it from fulfilling its potential. As violent incidents continue to dominate headlines, the question remains—could more lives be saved if these cabinets were fully embraced?