In terms of the broader context and immediate circumstances in which they occur and their short-term and longer-term aftermath, disasters involving multiple deaths and injuries are complex events impacting on the bereaved, survivors, rescuers, their families and their communities. To understand that complexity, in terms of causation and investigation, it has been suggested that disasters and their consequences should be considered as a sequence of distinct but inter-related 'phases'.
A three-part medical analogy is often used: 'incubation' phase; 'acute' or 'crisis' phase; 'recovery' phase. 'Incubation' considers the build-up during which the potential for disaster grows and develops, often hidden from view yet inevitable once certain circumstances coincide. The 'acute' or 'crisis' phase occurs as that potential, often quickly and irretrievably, becomes reality. The 'recovery' phase extends from rescue through to resignation.
While it is helpful to consider the progression of a disaster, its context and its aftermath as self-contained time periods, these periods cannot be precisely delimited, since human actions and reactions, involving the dynamics of personal, group and organisational responses, are not straightforward. Identifying phases that encompass a definable time-span, nevertheless, helps in analysing, planning for and responding to disasters.
Previous research into the context and consequences of the Hillsborough disaster considered eight phases: the historical context; the immediate context; the immediate circumstances; the 'moment'; rescue and evacuation; the immediate aftermath; the short-term aftermath; the long-term aftermath. This enabled an analytical approach to the key factors that contributed to the disaster, to what happened on the day and in the immediate aftermath, and to the investigations and inquiries that followed. As a framework this approach was adopted by the Panel in its analysis of the disclosed documents and other material and is reflected in the structure of the Report.
Terms of reference and scope
Within its terms of reference (see Appendix 1) the Panel was obliged to write a report demonstrating 'how the information disclosed adds to public understanding of the tragedy and its aftermath'. To achieve that end the Panel negotiated access to documents held by a diverse range of organisations and individuals (see Appendix 2).
The scope of material sought and disclosed covered: the decade prior to the disaster, focusing on the condition of the stadium and the arrangements for crowd safety and crowd management; the circumstances leading up to the FA Cup Semi-Final being held at Hillsborough in 1989; the 'moment' of the disaster; the immediate aftermath; and the investigations and inquiries that followed.
Once accessed, the documents and other material were catalogued and processed within the digital archive. While hard copies remained in key sites (The National Archive; the Sheffield Archives; the Liverpool Record Ofiice) or with their rightful owners, the digital archive provides a single, coherent repository of all disclosed documents.
The cataloguing process was time-consuming because many of the documents provided by the contributing organisations or individuals had not previously been catalogued or filed.
Within the first months of the Panel's work it became apparent that the sheer volume of documents would require a fully developed programme of research to provide an analytical review on which the Panel's Report could be based.
The research team was Dr Janet Clark, Dr Jo Doody, Dr Shaun McDaid and Ms Gemma Ní Chaoimh. Appointed by the Panel, the team was managed by Panel member Professor Phil Scraton and based at the School of Law, Queen's University, Belfast. Other Panel members also contributed significantly to the research process in accord with their specialist knowledge and professional expertise. The team was supported by members of the Panel's Secretariat.
As stated above, a priority for the Panel's work was to show how the disclosed documents contribute to public understanding of the disaster. It was important, therefore, to review 'what was known' in the public domain, from previous investigations, inquiries and research into and publications about the disaster. This review forms Part 1 of the Report.
Part 2 is concerned with 'what the disclosed documents add to public understanding', reflecting the context, circumstances and consequences of the disaster and its investigation. It also responds to the questions asked and issues raised by bereaved families in consultation with the Panel.
Having established the key focuses for the research, the Panel accessed, digitised and researched the documents accordingly. This involved a methodical content analysis of all documents and other material disclosed to the Panel. The documents, therefore, provided the foundation for the extensive, cross-referenced data that then formed the detail of the Report.
The Panel read all the disclosed documents in unredacted form. Redaction of documents, or their removal from public access, has been agreed by the Panel only in exceptional circumstances (see Appendix 2). The main reason for redaction or non-disclosure is privacy relating to personal information, particularly medical records. Names of junior members of staff within organisations have also been redacted.
Extensive primary data was drawn from the documents, then was further analysed and cross-referenced to present a detailed narrative within each chapter. Inevitably the chapters also rely on documents and material already in the public domain in order to provide a coherent, analytical narrative.
Regarding the circumstances and immediate aftermath of the disaster, cross-referencing of content was developed chronologically to construct a comprehensive sequence of events, reflecting the exchange of information between organisations prior to and after the disaster. This included detailed consideration of the decisions taken by relevant organisations regarding crowd management, crowd safety and structural modifications within the stadium throughout the 1980s.
The Panel also focused on issues concerning rescue and the emergency response. In examining the emergency response to the disaster, the Panel's approach was consistent with the analysis of disclosed documents as conducted for other chapters. Cross-referencing of a wide variety of sources in chronological order constructed a comprehensive sequence of events as the disaster unfolded. This enabled eye-witness accounts to be located in context.
Occasionally, timings of events in statements or other documents conflict with timings derived from radio transcripts. In these instances the transcripts, which are timed verbatim records of every telephone call and radio transmission, were considered definitive.