Press release - Major trauma care in England
5 February 2010
There is unacceptable variation in major trauma care in England
depending upon where and when people are treated, according to a
National Audit Office report published today. Care for patients who
have suffered major trauma, for example following a road accident
or a fall, has not significantly improved in the last 20 years
despite numerous reports identifying poor practice, and services
are not being delivered efficiently or effectively.
Survival rates vary significantly from hospital to hospital,
with a range from five unexpected survivors to eight unexpected
deaths per 100 trauma patients, reflecting the variable quality of
care. The NAO estimates that 450 to 600 lives could be saved each
year in England if major trauma care was managed more
effectively.
For best outcomes care should be led by consultants experienced
in major trauma; but major trauma is most likely to occur at night
and at weekends, when consultants are not normally in the emergency
department. Only one hospital has 24-hour consultant care, seven
days a week.
Major trauma care is not coordinated and there are no formal
arrangements for taking patients directly for specialist treatment
or transferring them between hospitals. CT scanning is very
important for major trauma patients; however, a significant number
of patients that need a scan do not receive one. Not enough
patients who need a critical care bed are given one.
Access to rehabilitation services, which can improve patients’
recovery, quality of life and reduce the length of hospital stay,
varies across the country and patients are not always receiving the
care that they need. The costs of major trauma care are not well
understood. The estimated annual lost economic output from deaths
and serious injuries from major trauma is between £3.3 billion and
£3.7 billion.
Collecting information on care is essential for monitoring and
improving services, but only 60 per cent of hospitals delivering
major trauma care contribute to the Trauma Audit and Research
Network (TARN). The performance of the 40 per cent of hospitals
that do not submit data to TARN cannot be measured.
Mr Amyas Morse, head of the
National Audit Office, said today:
"Current services for
people who suffer major trauma are not good enough. There is
unacceptable variation, which means that if you are unlucky enough
to have an accident at night or at the weekend, in many areas you
are likely to receive worse quality of care and are more likely to
die.
The Department of Health
and the NHS must get a grip on coordinating services through trauma
networks, on costs and on information on major trauma care, if they
are to prevent unnecessary deaths."
Notes for Editors
- Major trauma describes serious and often multiple injuries
where there is a strong possibility of death and disability. In
England, the most common cause is a road accident. The NAO
estimates that there are at least 20,000 cases of major trauma each
year in England resulting in 5,400 deaths and many others resulting
in permanent disabilities requiring long-term care. There are
currently 193 hospitals in England that provide trauma
services.
- Major trauma costs the NHS between £0.3 billion and £0.4
billion a year in immediate treatment costs. The cost of any
subsequent hospital treatments, rehabilitation, home care support
or informal carer costs are not known.
- Press notices and reports are available from the date of
publication on the NAO website, which is at http://www.nao.org.uk/.
Hard copies can be obtained from The Stationery Office on 0845 702
3474.
- The Comptroller and Auditor General, Amyas Morse, is the head
of the National Audit Office which employs some 900 staff. He and
the NAO are totally independent of Government. He certifies the
accounts of all Government departments and a wide range of other
public sector bodies; and he has statutory authority to report to
Parliament on the economy, efficiency and effectiveness with which
departments and other bodies have used their resources.
Press Notice 09/10
All enquiries to Sarah Farndale, NAO Press
Office:
Tel: 020 7798 5350
Mobile: 07985 274 421