BBC News
watch One-Minute World News
Last Updated: Wednesday, 21 November 2007, 04:35 GMT
Half of trauma care 'not good'
A&E staff
About 800 trauma patients end up transferring hospitals
More than half of trauma patients are not receiving good care, experts say.

The National Confidential Enquiry into Patient Outcome and Death looked at the care given to 795 patients, many with head injuries from falls and crashes.

It found medical staff in 200 hospitals in England, Wales and Northern Ireland often did not appreciate the severity and displayed little urgency.

It said care would improve if services were centred at fewer sites - something which is already government policy.

NCEPOD said many of the problems identified in nearly 60% of patients treated across 200 hospitals were associated with staff being too inexperienced.

Our mortality rates are among the worst in the developed world, and yet trauma care remains a low priority for the government
Royal College of Surgeons spokesman

In particular, they found patients were not always given essential tests such as CT scans or assessed by hospital consultants, especially during the night.

Researchers said most hospitals would only deal with one trauma patient a week and this meant staff did not get the necessary experience to keep skills up to date.

They also said about 800 trauma patients each year needed to be transferred to other hospitals - often in an "ad hoc" manner - because of a lack of specialist facilities such as neurological services.

Ambulance crews were also criticised for failing to always unblock airways and alert hospitals of incoming cases.

But the researchers said in hospitals which dealt with more than 20 cases a week the care was classed as good.

The report said this in itself was a good argument for centralising services in regional centres.

Services

This is already a government policy, but it is proving controversial because of the aim of a whole host of other services such as maternity and A&E being centralised as well.

Campaigners say such a move would lead to many local hospitals being stripped of key services.

Report author Dr George Findlay said: "The number of patients seen has a direct bearing on the experience and ability of clinicians to manage challenging cases.

HAVE YOUR SAY
There's no point having a fantastic "regional site" if most of the people who really need A&E would expire in the ambulance while travelling for 30 minutes or more to get to it
Mary, Midlands

"It is not possible for all hospitals to have a trauma team on call with the necessary experience, organisation and support structures.

"We need to look at how we can organise trauma care on a regional basis."

The Royal College of Surgeons said care urgently needed to improve.

A spokesman said: "Our mortality rates are among the worst in the developed world, and yet trauma care remains a low priority for the government.

"This a national health service and what we need is a national trauma system."

Health Minister Ben Bradshaw said: "We have argued for some time that it is not the proximity of the nearest A&E that matters to most trauma victims but the care they receive from ambulance and paramedic staff and the quality of care they receive once they arrive at hospital.

"Concentrating trauma treatment in specialist centres can arouse opposition from some people concerned about 'downgrading' of their local A&E facilities, but what the opponents often fail to recognise is that lives will be saved and the quality of care improved, as this report makes clear."

VIDEO AND AUDIO NEWS
The family of a trauma victim speak out



SEE ALSO
Fears over trauma patient care
07 Sep 06 |  Health
MP speaks out over hospital plans
05 Jul 06 |  Lancashire
NHS trust cuts more than 600 jobs
27 Jun 06 |  Lincolnshire
A&E expert visits troubled town
01 Aug 05 |  Southern Counties
A&E change causes ambulance waits
15 Sep 04 |  Southern Counties

RELATED INTERNET LINKS
The BBC is not responsible for the content of external internet sites



FEATURES, VIEWS, ANALYSIS
Has China's housing bubble burst?
How the world's oldest clove tree defied an empire
Why Royal Ballet principal Sergei Polunin quit

PRODUCTS & SERVICES

Americas Africa Europe Middle East South Asia Asia Pacific