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Thu Nov 22 09:08:09 GMT 2007

The full report can be seen at  http://213.198.120.192/ . The media
have, of course, picked up on all the bad things. 795 ISS > 16 patients
(3 months of trauma in the UK) were studied in detail by a panel of
clinicians, and services in 183 hospitals were evaluated.

Overall about half of the patients had good care according to the
clinical assessors, in about 45% there was room for improvement and in
5% care was poor.

Good care was associated with a consultant being involved from the
outset and units that received more than 80 IIS > 16 patients per year.

The high level recommendation is indeed that the UK should regionalise
trauma care into Regional Trauma Systems. This has of course been
recommended before, but the background political situation at the moment
makes me slightly more hopeful (but only slightly) that this suggestion
from the clinicians might now be taken up by the politicians.

Tim.

Prof TJ Coats
Professor of Emergency Medicine
Leicester University

-----Original Message-----
From: Tony Joseph [mailto:tjoseph at ihug.com.au] 
Sent: 21 November 2007 10:39
To: Trauma &amp; Critical Care mailing list
Subject: Re: Trauma care report UK

Sounds like the UK needs a Trauma System?

Regards
Tony Joseph
Sydney
Australia

On 21/11/07 8:51 PM, "Richard van der Kleyn" <vdkleyn at hotmail.com>
wrote:

> Trauma patients' care 'deficient'
> An inquiry has called for urgent improvement in the care of severely 
> injured patients as it releases new figures showing fewer than half
receive good care.
> 
> Significant improvements must be made in both organisational and 
> clinical aspects of care for patients severely injured in events such 
> as road accidents, the National Confidential Enquiry into Patient 
> Outcome and Death
> (NCEPOD) said in its report.
> 
> Many of the drawbacks in clinical care, it said, related to a lack of 
> seniority and inexperience of staff involved in the immediate 
> management of trauma patients.
> 
> Medical staff often fail to appreciate the severity of illness, 
> display little urgency in caring for patients, and make incorrect 
> clinical decisions, the report noted. The failures do not just cover 
> in-hospital care, it said, but the care of severely injured patients
before they reach hospital.
> 
> The report, Trauma: Who Cares? recommends that the health service 
> should look at how trauma care can be organised on a regional basis to

> make sure severely-injured patients receive the best possible care.
> 
> This should include measures to allow ambulance crews to bypass the 
> nearest hospital if appropriate for a particular patient. A doctor 
> could be a member of the ambulance crew for trauma cases, it said.
> 
> Currently there are between 3,000 and 4,000 cases of severe trauma a 
> year with the majority of hospitals in England, Wales and Northern 
> Ireland seeing less than one such severely injured patient a week, it 
> said. Where care was delivered to more than 20 severe trauma cases in 
> a week there were more cases of good quality care, the report found.
> 
> The report said hospital trusts must ensure that a trauma team is 
> available 24 hours a day with a consultant as team leader in managing 
> the care of a severely injured patient.
> 
> Currently 20% of hospitals do not have a dedicated trauma team, it 
> said, and one third of patients were not seen by a consultant in the 
> emergency department.
> 
> The study selected 795 cases in England, Wales, Northern Ireland and 
> the Isle of Man, together with Ministry of Defence and independent
sector facilities.
> --
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