Confusion and communication issues hindered emergency service efforts to help injured victims after the London Bridge terror attack, an inquest has heard.

Giving evidence at the Old Bailey, Paul Woodrow, director of operations at the London Ambulance Service (LAS), said his team initially struggled to get “overall situational awareness” at the “chaotic” scene of the attack.

He told the inquest it took “too long” to make a decision to commit specialist teams to treat patients at the scene.

The inquest heard that shortly after the attack, armed police officers stopped medics entering the courtyard area around the Boro Bistro, where some of the attack victims died, due to reports of shots being fired nearby.

LAS medics were aware of patients requiring treatment in the courtyard, but were unable to reach them as a high security “hot zone” was placed over the Borough Market area.

Jonathan Hough QC, counsel to the inquests into the attack victims’ deaths, said that information was not relayed to those waiting for help.

Mr Woodrow said the “chaotic” aftermath of the attack had contributed to “confusion” and “issues around communication”.

He admitted it “took too long to make a decision to commit” specially trained ambulance intervention teams, made up of ambulance, fire brigade and armed officers, to search for victims.

Gareth Patterson QC, representing the families of some of the victims, told the inquest that paramedics had not entered the courtyard area until after 1am, despite the attackers being shot dead at 10.16pm.

Mr Woodrow said the area had been deemed unsafe, that the “hot zone” had been established by police and was changing as the attack’s aftermath unfolded.

He said the LAS could not make an independent decision to deploy specialist teams, requiring input from police and fire services.

Mr Patterson said there was no evidence whether the courtyard area specifically had been designated as a “hot zone” or not.

The inquest heard that under normal procedures, ambulance crews would never enter a high risk hot zone, but the rules were broken to send in volunteers on the night of the attack.

Mr Woodrow said: “I’m proud of my staff who put themselves in harm’s way.”

Khuram Butt, 27, Rachid Redouane, 30, and Youssef Zaghba, 22, killed eight people and injured 48 others in a van and knife attack on 3 June 2017.

They drove into pedestrians on London Bridge before stabbing innocent bystanders at random in nearby Borough Market.

Xavier Thomas, 45, Christine Archibald, 30, Sara Zelenak, 21, Sebastien Belanger, 36, James McMullan, 32, Kirsty Boden, 28, Alexandre Pigeard, 26, and Ignacio Echeverria, 39, all died.

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