Lives at stake as cities battle to home firstWelsh trauma centre
CREATING a new major trauma centre in Cardiff rather than Swansea would be “unacceptable”, the leader of Swansea council has said, while top medics believe Cardiff is the ideal location as it’s already a UK leader in several other specialities.
The University Hospital of Wales (UHW), based in the capital’s Heath area, is set to battle it out with Morriston Hospital in Swansea to land the specialist centre.
Major trauma centres (MTC) treat the most severely injured patients with critical cases usually taken directly there instead of the nearest A&E department.
The state-of-the-art centre would feature neurosurgery, plastics, interventional radiology, paediatrics, cardiothoracics, and maxillo-facial services.
England has 27 of these centres, while Wales has none – but that is set to change following a recommendation from an expert panel.
It is now assessing bids from both Morriston and UHW, which both want to house the facility which would treat patients from south Wales, west Wales, and south Powys.
Rob Stewart, Swansea’s council leader, said he believed Morriston Hospital’s case for the specialist facility was compelling because it offered superior geographical coverage, whereas people in Cardiff and Newport were not too far from a similar centre in Bristol.
“This is not a Swansea-versus-Cardiff situation – this is what is best for the people of South Wales and how we ensure we give the best coverage and therefore the best chance of survival of a major trauma to our people,” he said.
Pushing the Swansea case, Mr Stewart added: “Geographically there can be no other choice. The population in Cardiff and south-east Wales area are in close proximity to the Bristol major trauma centre — there is no reason why that cannot work. That is not true for the people of south-west Wales.
“The added risks to life the extra journey time that people from Pembroke, Ceredigion, Carmarthen, Powys and Swansea would face, it is simply unacceptable for it to be in Cardiff.
“I will be lobbying the Welsh Government hard to make not only the right choice but the only choice.”
Morriston Hospital and its Cardiff competitor both have specialist services which put it in the frame for major trauma centre recognition.
The former has a burns and plastic surgery centre, while the latter has adult and children’s neurosurgery. Spinal neurosurgery takes place at Morriston, however. There are proposals to create a new health science campus on 55 acres of land adjacent to Morriston Hospital, incorporating a regional stroke centre and orthopaedic centre, a new cardiology unit and a third Institute of Life Science in Swansea, among others.
Health campaigners in Swansea have repeatedly voiced concerns about hospital services at Morriston moving to Cardiff. Having a major trauma centre in Wales’ second city could help ease stubborn recruitment challenges for Abertawe Bro Morgannwg University Health Board.
Mr Stewart, ward member for Morriston, described his local hospital as “a world-class facility” with the ability and ambition to expand.
Professor Ian Pallister, consultant and major trauma lead at Morriston Hospital, added: “The odds of survival since they (major trauma centres) were established in England are up to 30% higher now than at the beginning. There’s every reason we can make the same gains.”
Cardiff and Vale University Health Board (UHB) already manages a significant proportion of major trauma patients from across mid and south Wales.
This number has risen since the commencement of the Emergency Medical Retrieval Service (EMRTS), also known as the “Welsh Flying Medics”.
Cardiff and Vale UHB’s medical director, Graham Shortland, believes Cardiff has the edge because of its great track record in other specialities.
He said: “Cardiff and Vale UHB is the flagship health board for delivering neurosurgery and paediatrics specialities such as paediatric intensive care.
“We have a world-class new purpose-built children’s hospital and redesigned emergency unit with a helipad that ensures a patient is treated as quickly as possible, increasing their chance of survival.
“We have a significant number of committed senior clinicians and managers to deliver a coordinated service in Cardiff.”
Despite being the largest A&E in Wales, UHW boasts the best waiting times with fewer patients waiting 12 hours than any major unit in the country.
Figures for February revealed 2.3% of patients at UHW spent 12 hours or more before being admitted, transferred to another ward or discharged.
Morriston, on the other hand, is regularly one of the worst performers.
In February 9% of patients spent longer than 12 hours in emergency units and just over half (55.3%) spent four hours or less.
The NHS Wales Collaborative Leadership Group is the body in charge of making a recommendation on the preferred location of the MTC for the region. Its decision is likely to be made this autumn.
The preferred option will go out to consultation and if no agreement can be reached, the final decision could rest with Cabinet Secretary for Health, Vaughan Gething.