Many of Lakeland victims were shot in face

Charles Brett, clinical director of emergency services at West Cumberland Hospital in Whitehaven, said it would be "speculation" to say Bird aimed deliberately for the face and head of his victims – but suggested that was the case.

"It appears this gentleman was firing out of a car window at head height.

"It is clear that he was directing at the face and head," Mr Brett told journalists at a Press conference at the hospital.

Mr Brett was asked directly if he thought that, given the injuries, Bird had targeted the faces of his victims.

"That would be speculation," he said, "but there's a predominance of facial injuries in what we have seen, more than 50 per cent of those that survived had some portion of facial injuries."

Of the patients taken to West Cumberland Hospital, five suffered gunshot wounds to the face, two victims were shot in the back, one was shot in the back and arms, and another was shot in the chest, Mr Brett added.

Two of those were in a stable but serious condition, while four others were described as "comfortable".

Mr Brett said it was rare for doctors and surgeons in the UK to have to deal with patients with gunshot injuries.

"This is an uncommon injury in any emergency services department in this country but their initial stabilisation was performed satisfactorily without major issues and we have specialist teams for ongoing care."

He added: "Of those that are injured there is varying severities, some patients will be in for a significant period of time."

Asked about the injuries to patients shot in the face, he said: "They vary from minor to the very severe and life-threatening."

Mr Brett praised fellow staff at the hospital, where some initial counselling has already been arranged for those who dealt with the trauma.

"This is a small community," he said.

"Adding to the fact that the incident happened over a wide area in west Cumbria, everybody knows someone who has been affected by this incident.

He went on: "This is the worst incident that I personally have ever had to deal with."