How trauma network could help improve emergency care
Plans have been put in place to introduce a major trauma network to south Wales. Here, health correspondent Mark Smith describes what it is and how it will benefit patients
PLANS to develop a “major trauma network” across hospitals in south Wales will greatly improve emergency care for critically-ill and injured patients, it is claimed.
A 12-week consultation period has now been launched on proposals to introduce the network to people living in south and west Wales and south Powys.
It is the only region across England and Wales that is not part of a major trauma network and does not have access to a major trauma centre which often houses the most specialised treatment.
During the recent terror attacks in London and Manchester, experts claim major trauma networks proved vital in treating patients quickly and in the right setting.
An independent panel of experts has already recommended that the University Hospital of Wales (UHW) in Cardiff should be the site of the major trauma centre which will be open 24-7 and feature highly-specialised trauma care.
UHW will be supported by a number of trauma units based at other hospitals – including Morriston Hospital in Swansea – which will also offer immediately life-saving services.
But some patients may need to be transferred to UHW if the treatment is particularly complex or specialised.
It is thought establishing the network could cost around £2m, but research carried out by Sheffield University found that it could end up saving the NHS money due to improved patient outcomes.
The consultation report states: “There is a significant amount of evidence to show that patients who suffer a major trauma have a greater chance of survival and recover better if they are treated within a major trauma network.
“The reports consistently show that better care and outcomes are achieved when a formal major trauma network is in place.
“Across south Wales, major trauma cases are currently managed through informal arrangements across the health boards,with some more complicated cases either admitted directly or transferred to the bigger regional centres – mostly University Hospital of Wales or Morriston Hospital.
“While this clearly benefits patients, it does not have the proven advantages of an established major trauma network.”
A major trauma is defined in the report as “multiple and serious injuries that could result in disability or death”.
These may include serious head injuries, multiple injuries caused by road traffic accidents, industrial accidents, falls, mass casualty events, attempted suicide, knife and gunshot wounds.
Less than 0.2% of people attending their nearest emergency department will have suffered a major trauma, with most hospital staff treating only one or two major trauma cases a week.
In 2016-17 in south Wales, approximately 1,234 people attended a local emergency department with a major trauma compared with 617,000 people attending emergency departments overall.
“Evidence shows that if you are severely injured, you are 15% to 20% more likely to survive if you are admitted to a major trauma centre,” the report states.
“You are less likely to have a longterm disability and need less longterm NHS care.
“The NHS is able to better plan for and respond to major incidents, improving the care patients receive.
“And local emergency departments are less likely to be disrupted by inappropriate major cases being admitted that can affect the ability of the department to manage its routine work.”
Authors of the report claim a major trauma network allows staff between hospitals to share expertise and make the Welsh NHS more effective in dealing with emergencies.
They also decided that UHW would be best-placed to house the major trauma centre, ahead of Morriston, because it had more trauma services already in place.
The report states: “After looking at the evidence, the panel decided that providing specific highly specialist services such as neurosurgery and paediatric neurosurgery on the same site as the major trauma centre was the main factor in deciding where to base the major trauma centre.
“This is because it is important to have these specialist services available immediately if you suffer a major trauma.
“Approximately 60% of trauma cases need support for head injuries and providing this service on-site is a minimum requirement.”
It is proposed that Morriston Hospital, which features a specialised burns and plastic surgery service, will become a “large” trauma unit and will manage some conditions that other trauma units will not.
The report added: “Morriston Hospital will also have a lead role in the major trauma network.
“This follows what happens in England where the major trauma network is led from a hospital other than the hospital where the major trauma centre is located.
“A lead hospital is necessary to make sure the major trauma network is co-ordinated and that the patients are the main focus.”
The independent panel, chaired by Professor Chris Moran, the National Clinical Director for Trauma to the NHS in England, did not discuss where other trauma units should be based.
North Wales and north Powys were not part of the consultation as they are already part of the West Midlands major trauma network.
The major trauma centre for the region is in Stoke, North Staffordshire.
The public consultation began at 9am on November 13 and will run until 9am on February 5, 2018.
The consultation is asking the public three questions:
1. Do you agree or disagree that a major trauma network should be established for south and west Wales and south Powys?
2. Do you agree or disagree that the development of the major trauma network for south and west Wales and south Powys should be based on the recommendations from the independent panel?
3. If we develop a major trauma network for south and west Wales and south Powys, is there anything else we should consider?
For more information on the consultation, go to www.publichealthwales.org/majortraumaconsultation, email NHSWHC.strategicplanning@wales.nhs.uk or call 02920 502674.
Alternatively, people can contact their local Community Health Council.