More patients in the south are surviving life-threatening injuries thanks to the development of a regional trauma network and major trauma centre at Southampton General Hospital.
It is part of a national system which went live across the country in April 2012 and consists of 27 regional networks made up of one designated centre supported by surrounding hospitals known as trauma units.
An independent report produced by the Trauma Audit and Research Network (TARN), published in The Lancet’s EClinicalMedicine journal, found 1,656 additional lives have been saved in England since the launch – 61 in the south central region alone.
It showed an increase of nearly a fifth in the odds of survival from severe injury nationwide in the five years from 2012.
It also highlighted changes including pre-hospital intubation, improved treatment for major bleeding and advances in emergency surgery techniques had led to a reduction in the number of patients needing critical care from 31% to 24%, while patients now spend a day less on critical care wards.
More than half of all major trauma – the term used to describe life-threatening injuries commonly sustained through road traffic accidents, falls, violence or sporting injuries – happens on the road and it is twice as common in urban areas than rural parts of the country.
There are around 20,000 instances in England every year and it is the most common cause of death in children and adults under the age of 40, as well as the fifth most common cause of death in the elderly.
Southampton General Hospital is one of only 11 centres across the country to offer the full range of specialist surgical, intensive care and supporting services for both adults and children who suffer major trauma.
Latest TARN data for University Hospital Southampton NHS Foundation Trust, shows 4,009 patients were treated for life-threatening injuries between 2014 and 2017, with 3,668 survivors compared to an expected number of 3,641 based on the severity of their conditions.
Patients across the region with major injuries bypass their local hospitals to go directly to Southampton if their injury occurs within a 60-minute drive, while those injured further afield are taken to their nearest trauma unit and assessed and resuscitated before being rapidly transferred if they require specialist intervention.
The city's trauma centre is supported by six trauma units – based at Portsmouth, Basingstoke, Poole, Dorchester, Salisbury and St Mary’s Hospital on the Isle of Wight – as well as two ambulance services and the Hampshire and Isle of Wight Air Ambulance. These combine to make the Wessex Trauma Network.
“The launch of major trauma networks across England in 2012 was one of the most significant developments in the NHS in a generation,” said Professor Robert Crouch, deputy director of major trauma at UHS.
“It is estimated to take up to 10 years for a trauma system to 'mature' and reach its full potential, so to be at this milestone in terms of additional lives saved at the halfway point is an amazing achievement.”
Prof Crouch said education among clinicians on how different teams work, including projects on team psychology and behaviour led by consultant major trauma anaesthetist Dr Suzanne Kellett, were “integral” to the success of the network.
“Within the Wessex Trauma Network we have focused on education among our clinical teams and understanding how teams, including pre-hospital and hospital-based, work best together which has helped to create a strong patient focus,” he said.
Professor Chris Moran, NHS England’s national clinical director for trauma care, said: “This study shows that changes to trauma care, designed by clinicians, are saving hundreds of lives every year. Patients suffering severe injury need to get to the right specialist centre staffed by experts, not simply the nearest hospital.
“Thanks to the skills of NHS staff, we are confident that we will continue to see further increases in survival rates for this group of patients.”
Prof Crouch added: “We have made really important steps in improving survival from injury both nationally and locally, but a key area for future work should be education and injury prevention.
“Many of the injuries and ‘accidents’ that we deal with are preventable – we simply have to do more to prevent some of these unnecessary tragedies.”
Posted on Monday 20 August 2018