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Overhaul of major UK trauma centres leads to significant improvement in patient safety

Posted: 21/08/2018

A research paper has identified the crucial improvement in care that has been achieved by the creation of designated major trauma centres in the UK since 2012.

Every year, many patients experience severe injuries following incidents such as road accidents, shootings, stabbings or even terror attacks. The injuries sustained are often life-threatening and may encompass multiple broken bones and ruptured arteries which could result in severe bleeding. Treatment is often complex and requires input from trauma specialists as soon as possible after the injuries were sustained.

A research paper, published in The Lancet, has identified the benefits of trauma centres. The study analysed the outcome of more than 110,000 patients admitted to 35 hospitals between 2008 and 2017. Patient outcome data between 2008 and 2011 was used to determine the baseline survival statistic and researchers then compared these statistics for patients with traumatic injuries treated in NHS hospitals with those treated in designated trauma centres between 2012 and 2017.

There are now 27 designated major trauma units across the UK and once the patient arrives at the centre, they are more likely to be cared for by senior doctors who specialise in treating traumatic and life-threatening injuries. The patient will have faster access to imaging equipment and theatre rooms, should urgent treatment be required.  

The study found that the baseline outcome of patients treated at NHS hospitals between 2012 and 2017 was the same as it was between 2008 and 2012, whereas the outcome of patients treated at designated trauma centres during this period was markedly improved. The chance of survival at a designated major trauma centre is approximately one fifth higher than if the care was provided solely at a non-specialist NHS hospital.

It is estimated that these designated centres have led directly to the survival of a further 1,600 people in the UK between 2012 and 2017. The standard of care now, therefore, is for patients with life-threatening traumatic injuries to be transferred to a centre – even if it is significantly further away than the hospital nearest to where the injury occurred.

Arran Macleod, an associate in the clinical negligence team at Penningtons Manches LLP, commented: “It is excellent to read about the improvements that designated major trauma centres offer to patients who have suffered serious and life-threatening injuries. This type of research vindicates the NHS’s decision to reorganise how certain types of care are delivered, particularly when such reorganisations are often unpopular.

“We act in a number of cases where patients have suffered serious and traumatic injuries, but have not been transferred to designated trauma units when they should have been and were therefore treated in non-specialist units. As a result, the treatment can often be delayed while waiting for availability of imaging equipment, or consultants to arrive on-call. Theatre rooms can often be unavailable, and the standard of care can be poor if the treatment is not provided by a traumatic injury specialist. We have sadly seen a number of examples of how the failure to appropriately treat traumatic injuries has led to tragic consequences for the patient, sometimes even requiring amputation.

“It is encouraging to read about the number of lives that have already been saved by designated trauma units, and I applaud the NHS for reorganising care in this way. We look forward to seeing further innovation in the NHS to streamline care for certain types of injuries and improve patient safety.” 

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