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Thursday, 20 July, 2000, 11:29 GMT 12:29 UK
Accident care 'costing lives'
Accident and Emergency
Accident and emergency departments 'need more doctors'
People severely injured in accidents are dying unnecessarily or being left with preventable disability, say doctors.

The Royal College of Surgeons (RCS) says standards of emergency care in the UK are "unacceptable".

It says improvements could save thousands of lives every year, and has put forward radical plans for a major shake-up of services.

If these proposals are enacted, more lives will be saved and the quality of life of survivors will be improved

Hugh Phillips, President of the British Orthopaedic Association

The RCS puts the blame on a severe shortage of accident and emergency consultants, a lack of equipment and problems with rehabilitation services.

Doctors were "deeply concerned" by the death rate in the UK from severe injury, which is higher than in the US.

In 1988, research by the RCS concluded that a third of all deaths occurring after major injury were preventable.

Each year about 10,000 people in the UK suffer multiple injuries, and in 1996 there were 3,740 deaths in road accidents.

The college was particularly concerned by rates among children - 450 youngsters die every year as a result of accidents and 10,000 are permanently disabled.

The RCS report says there is a shortfall of about 400 accident and emergency consultants in the UK.

It calls for the establishment of a National Trauma Service to co-ordinate care.

Experts say that the fact that the average hospital may treat only one severely injured person a week might mean staff are not experienced enough to provide the best care.

Trauma system

The report recommends that there should be a trauma system to serve the population in blocks of 3m people in designated geographical areas.

Each area would have a "major acute hospital" with a 24-hour resuscitation trauma team, intensive care beds in the casualty department, and a helicopter pad next to the A&E site.

Severely injured patients in other hospitals in the area could be transferred to the major acute site to ensure the best standards of care.

Staff at the hospital would also give advice to ambulance staff treating patients at the scene of an accident.

Acute general hospitals would still take patients, but would act in partnership with the major acute hospitals.

The report said severely injured patients should be taken to the hospital most suited to their needs, rather than just to the closest one.

It was also important that senior clinicians were involved in their care from the outset - something that does always happen at present.

Treatment, death rates and other standards would also be audited to ensure nationwide improvements.

Hugh Phillips, President of the British Orthopaedic Association, said: "There can be no doubt that if these proposals are enacted by the Department of Health, more lives will be saved and the quality of life of survivors will be improved."

Professor Phillips told BBC News Online that the main problem was that standards were not uniformly high across the country.

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See also:

06 Jun 00 | Health
NHS 'must modernise'
19 May 00 | Health
Emergency care 'getting better'
01 Feb 00 | Health
Massive casualty waits revealed
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