By Judith Moritz
North of England correspondent
The Manchester Arena Inquiry was a mammoth undertaking. Evidence was heard implicit 196 days, presented and pored implicit by 18 ineligible teams, and culminating successful 3 reports moving into hundreds of pages.
I went to galore of the hearings and, portion overmuch of what I heard did formed caller airy connected the May 2017 bombing, I listened to a batch of the grounds with a sinking bosom and a consciousness of familiarity and deja vu.
As the BBC's North of England Correspondent, I've besides spent galore years covering the aftermath of the Hillsborough catastrophe successful Sheffield - sitting done 2 years of inquest hearings, and 3 transgression trials.
The much I heard astatine the Arena inquiry, the much it reminded maine of Hillsborough.
And I wasn't the lone one. Several Hillsborough families told maine that they had an uncomfortable consciousness of past repeating itself.
Margaret Aspinall's son, James, died successful the April 1989 catastrophe - 1 of 97 Liverpool supporters to person mislaid their lives. She says seeing what happened astatine Manchester Arena brought backmost achy memories. "You saw radical were near again without getting CPR. The main happening is… lessons person not been learnt."
I started to support a grounds of the ways the 2 tragedies seemed to overlap - and rapidly realised the seeds of catastrophe had been sown good earlier each fateful day.
Failures successful lawsuit planning
At some Hillsborough and Manchester Arena, associated moving betwixt the organisations liable for assemblage information failed. The Hillsborough Inquests recovered that successful the years earlier the disaster, Sheffield Wednesday FC had not agreed immoderate meaningful contingency program with South Yorkshire Police - and the nine had not been portion of a moving party, whose different members included South Yorkshire Police, the occurrence work and section councils.
At Hillsborough, the club's information certificate was 10 years old, and hadn't been updated contempt changes to the crushed which had impacted connected capableness and stewarding. A papers called The Green Guide was relied connected by the club. It was a voluntary codification with nary ineligible unit and unfastened to interpretation.
In Manchester - British Transport Police (BTP), Greater Manchester Police, North West Ambulance Service and Greater Manchester Fire and Rescue Service were expected to enactment unneurotic connected a associated planned effect to an exigency done a section "resilience forum", with meetings each six months.
The Arena enquiry heard that successful the 2 years starring up to the attack, officers from BTP were lone contiguous astatine a 3rd of those meetings, and those who had attended weren't elder enough.
The Manchester enquiry besides recovered the venue's relation SMG UK, and its information contractor Showsec, some had inadequate hazard assessments. It besides ruled that a breach of the Arena's premises licence - a nonaccomplishment to hold a minimum fig of stewards - whitethorn person contributed to the information the onslaught wasn't prevented.
Companies moving astatine the Arena were besides meant to comply with a papers called The Purple Guide, which provides important guidance astir wellness and information astatine euphony and different events. The Manchester enquiry recovered the Arena's backstage aesculapian supplier ETUK "fell a agelong mode abbreviated of the guidance provided by the Purple Guide".
Virtually nary paramedics
At Hillsborough, ambulances lined up extracurricular the ground, but lone 1 South Yorkshire Metropolitan Ambulance Service (SYMAS) conveyance was allowed onto the transportation with lone 1 paramedic astatine the Leppings Lane end.
At Manchester Arena, lone 1 paramedic was wrong the foyer for the archetypal 40 minutes. Ambulances arrived outside, but a casualty clearing presumption was acceptable up distant from the country wherever the weaponry went off, and the injured had to beryllium lifted there, alternatively than being offered assistance wrong the Arena.
At some Hillsborough and Manchester, important life-saving assistance was fixed by members of the public.
Not capable stretchers
One of the astir enduring images of the Hillsborough catastrophe is that of Liverpool fans carrying the dormant and injured connected advertizing hoardings utilized arsenic improvised stretchers, successful the lack of the existent thing.
The aforesaid happening happened astatine Manchester - with graphic grounds astatine the nationalist enquiry astir what happened to 1 of the fatalities, 28-year-old John Atkinson, who astir slid disconnected an advertizing committee and was past carried retired connected a conception of metallic railings.
Pete Weatherby KC is simply a barrister who has represented some Hillsborough and Arena families. He told maine immoderate of the similarities were "pretty shocking".
"Something arsenic basal arsenic stretchers successful some Hillsborough and the Arena. People who were very, precise severely injured and successful immoderate cases died, were carried retired connected advertizing hoardings successful some cases, 30 years apart. There has to beryllium a rethink here".
Radio problems
At Hillsborough, the constabulary vigor systems failed and officers extracurricular the crushed could not perceive instructions oregon communicate. There was a nonaccomplishment to get done to the constabulary power room.
The Manchester enquiry heard grounds that not each stewards had radios, and determination was disorder astir the functionality of the radios issued to immoderate Showsec staff. Their grooming successful however to usage the radios was not adequate.
Wild goose chases
At Hillsborough, families hopeless for accusation struggled to get done connected jammed telephone lines. Many drove to Sheffield to hunt for loved ones. But connected arrival, it was arsenic intolerable to find relatives - and the mode they were treated, added to their trauma.
Barry Devonside was astatine the match, but not connected the Leppings Lane terraces wherever his son, Christopher, was crushed. Mr Devonside went to the impermanent mortuary to look for the 18 twelvemonth old, but constabulary sent him away. He spent 7 hours checking astatine hospitals and a reception centre earlier being sent backmost to the mortuary wherever his son's assemblage had been lying each along. He past had to look astatine Polaroid photos of each the deceased successful bid to place Christopher.
Twenty-eight years later, the communicative of Andrew Roussos astatine Manchester Arena bears a horrible resemblance to that of Barry Devonside. Andrew's woman Lisa - and their children Ashlee, 26, and Saffie-Rose, 8 - had been connected a "girls night" astatine the arena to ticker popular prima Ariana Grande.
When the weaponry exploded astatine the extremity of the concert, the 3 of them were successful the arena's foyer. Andrew and his lad Xander had been waiting extracurricular adjacent to cod them - and were rapidly astatine the scene. But though they recovered Ashlee consecutive away, they couldn't find Lisa oregon Saffie.
The brace walked circular and circular the perimeter of the arena, leaving their details with constabulary officers and asking for help. They didn't cognize that they were yards from Lisa, who was lying wrong connected the foyer level - oregon that Saffie had been carried retired of a adjacent exit and enactment into an ambulance.
They were sent from pillar to post, travelling betwixt 3 hospitals, until they yet recovered Lisa successful the aboriginal hours of the adjacent morning. But Saffie remained missing for 14 hours, until they were yet told that she'd died successful the explosion. At the nationalist inquiry, they learned that she was live erstwhile she was taken retired of the arena, and had really died astatine hospital.
Survivability
In 2012, the Hillsborough Independent Panel published a study which recovered that 41 of the victims had the imaginable to person survived, if the exigency effect had been different. Barry Devonside's lad Christopher was amongst them. Inquests aboriginal recovered helium whitethorn person lived for 2 hours aft the lucifer was stopped.
This year, the Manchester Arena Inquiry established that 20 of the 22 radical killed successful the bombing had died from unsurvivable injuries - but it ruled that it was apt that exigency services' inadequacies had prevented John Atkinson's survival. Inquiry Chairman Sir John Saunders besides said helium could not regularisation retired the anticipation that Saffie-Rose Roussos could person been saved with amended treatment.
From impersonal, to personal
The Hillsborough families person endured the treble calamity of the catastrophe itself, and besides a three-decade-long ineligible aftermath which has included a nationalist inquiry, 2 sets of inquests and 4 trials.
The Manchester Arena bombing has generated respective reviews and reports, and a nationalist enquiry which lasted 2 years. The Arena enquiry included learning which came straight from Hillsborough. After the archetypal acceptable of Hillsborough Inquests successful 1990, which referred to the victims by number, determination was a determined effort to enactment the victims astatine the bosom of the process 2nd clip around.
That's why, successful 2014, the caller Hillsborough inquests successful Warrington began with a "pen portraits" process - with each bereaved household invited to talk successful tribunal astir their loved ones' lives and characters. The acquisition was seen arsenic positive, and has since been utilized elsewhere, including astatine the Grenfell Tower Inquiry.
The Manchester Arena Inquiry besides began with idiosyncratic pen representation household tributes to each of the 22 victims - an attack welcomed by the Mayor of Greater Manchester, Andy Burnham, who has besides worked with Hillsborough families for galore years.
"I deliberation the acquisition of the Arena families astatine the enquiry was amended than it would person been had it not been for what was revealed astir what was truthful incorrect with the archetypal Hillsborough inquests - and however impersonal that was."
Legal hurdles for families
However, not each measurement of the ineligible process has been affirmative for survivors and relatives.
At some the Hillsborough inquests, and the Manchester Arena Inquiry, survivors applied to beryllium fixed "core participant" status, which would person afforded them ineligible representation. In some cases, they were denied.
Anne Eyre survived the crush astatine Hillsborough and it changed her beingness forever. She went connected to go a advisor successful exigency readying and catastrophe management. She established a adjacent enactment programme for radical affected by the Manchester bombing.
She says utilizing her lived experiences to assistance others, who aren't legally halfway participants, is her mode of "paying it forward".
"Regardless of your ineligible status, it's a changeless happening of trying to marque consciousness of an acquisition wherever immoderate radical astir you person died, and you person lived. The randomness of it ne'er leaves you".
Those affected by some tragedies besides talk of their acquisition of enduring months of courtroom argument, arsenic organisations progressive astatine some Hillsborough and Manchester Arena sought to blasted each other.
"We spot a repetition of this inclination of nationalist bodies not to consciousness capable to archer the information astatine the archetypal clip of asking," says Andy Burnham, "and sadly, that has repeated, not to the aforesaid degree, but to immoderate grade with the Manchester Arena Inquiry."
The Greater Manchester politician is 1 of those starring the run for a "Hillsborough Law" - which would springiness families bereaved done nationalist tragedies fiscal enactment for ineligible practice astatine inquiries.
"It's thing we request precise urgently. People cognize that mistakes get made - that's life. What radical won't forgive is the covering up of those mistakes.
"And past the pushing of people, already traumatised by their loss, into a wilderness wherever they're near conscionable trying to combat for change, truth, and answers for years and years to come."
This week, the Government announced the instauration of a caller relation - that of Independent Public Advocate. It's portion of an effort to amended attraction of survivors and families of radical killed successful large disasters, including by supporting them done the inquiries that follow.
But it stops abbreviated of the afloat bundle of measures which immoderate would similar to see.
"The evident occupation with inquiries and inquests is that precise often you get a fantastic study and large recommendations - but past it sits connected a shelf," says Pete Weatherby KC.
Both Hillsborough and Manchester Arena person resulted successful aggregate enquiry reports. One happening that everyone progressive successful some disasters has successful communal is the anticipation that they'll beryllium utilized arsenic the ground for existent alteration - truthful no-one other has to spell done akin suffering successful future.