Trauma care should be moved to specialist centres, say nurses in the wake of a highly critical review.
The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) said that the current treatment of severely injured patients is patchy and disorganised and more than half of trauma patients do not receive a good quality of care.
The review, published last week, was based on 795 trauma patients who presented at hospitals in England, Wales and Northern Ireland between 1 February and 30 April 2006.
Findings showed 20% of hospitals had no dedicated trauma team and a quarter of patients in need of a CT scan did not receive it in a timely fashion.
Use of ambulance pre-alerts was also patchy, with only 51% of patients arriving at hospital with a pre-alert.
However, the study showed that specialist units seeing more than 20 trauma cases per week were more likely to show good organisational practice.
‘The number of patients seen has a direct bearing on the experience and ability of clinicians to manage challenging cases,’ said NCEPOD clinical coordinator Dr George Findlay.
Mike Hayward, RCN professional adviser for emergency care, said: ‘It is shocking that nearly 60% of patients did not receive adequate care.’
He added: ‘The traditional model of district general hospitals providing standard level-one care in emergency departments will have to change and be replaced by regional super-centres. But there must be necessary investment in walk-in centres and emergency care centres.’
Trauma nurse Simon Davies, a member of NCEPOD’s severely injured patients expert group, backed a move towards more specialist centres seeing more serious conditions.
‘It seems to be a bit of a lottery at the moment – who is treating you, what time of the day you are treated and where you are taken to,’ he said.