Burns and plastic surgery ‘should move to Cardiff’
THE head of an independent panel which has recommended Cardiff as the site of a new major trauma centre said that Morriston Hospital’s top-class burns and plastic surgery department should “ideally” move there.
Professor Chris Moran’s panel of experts has concluded that Cardiff’s University Hospital of Wales (UHW) is a better option than Morriston Hospital for Wales’s first major trauma centre, although it has also recommended that Morriston should lead a wider major trauma network.
In its report about the pros and cons of each hospital, Professor Moran noted Morriston’s “excellent” plastic surgery department and burns centre, which treats patients from the south west of England as well as Wales.
Cardiff’s UHW lacks this speciality, which would need resolving if the decision was finally made to site the major trauma centre there, he said.
Prof Moran, who is professor of orthopaedic trauma surgery at East Midlands Major Trauma Centre, said in the report: “Ideally, this could be achieved by transferring the entire service to Cardiff.
“However, the panel recognise that this may produce major operational problems in the provision of the burns service for Wales and south west England.
“If this is not feasible, the panel recommends a collaborative approach between both hospitals.
“It will take time for this service to develop, but it should be possible to put a safe clinical pathway in place so that the activation of the network is not delayed by this development.
“Joint consultant appointments between the two hospitals could achieve this with the establishment of routine orthoplastic operating lists at the MTC (major trauma centre) with the appropriate equipment and facilities.”
Major trauma centres for life-threatening injuries have been shown to have better outcomes for patients. England has 27 of them, but Wales has none.
Morriston Hospital has lost services such as neurosurgery to Cardiff in recent years, although Abertawe Bro Morgannwg University (ABMU) Health Board chiefs plan to develop a new “neurotrauma unit” at the Swansea site.
Considering the various issues, Professor Moran said that while Morriston Hospital was more central and had better coverage of west Wales, UHW was closer to a larger urban population.
“Overall, the panel concluded that both sites give good access to the population and that geographical factors should not be a major issue in designating the site of the MTC,” he said.
Representatives from each health board, he said, gave excellent presentations outlining their case to host the major trauma centre.
But UHW appeared to swing it because of its advanced rehabilitation service, its neurosurgery, and paediatric intensive care unit.
Several politicians in Swansea have been vocal in their backing of Morriston Hospital’s bid, with council leader Rob Stewart even saying that rejecting it would be “unacceptable”.
An ABMU spokesman said the board, which will discuss the major trauma centre proposal at a meeting on Thursday, was disappointed with the UHW recommendation but pleased that Morriston was tipped to run the wider major trauma network.
The hope is that doing so will help retain and attract clinical staff.
It is estimated that UHW will need an investment of around £23 million to host the major trauma centre, and then nearly £11 million per year to run it.
The Welsh Government has stressed that no formal decisions had been made yet.
A spokesman said: “It is for health boards to make the final collective decision in considering the outcome of the independent review.
“The Welsh Government would only be involved if health boards were unable to make a decision collectively after engagement, or if any final decision was referred to it.”
Cardiff and Vale University Health Board is also considering the recommendations on Thursday.
The board’s medical director Dr Graham Shortland said: “We will look forward to working very closely with our colleagues at Abertawe Bro Morgannwg Health Board as the trauma network lead, and working with them to ensure that all patients who need it get appropriate access to the specialist services of burns and plastic surgery provided through Morriston Hospital.”