Up to 600 victims of stabbing, shooting and road accidents die each year due to “unacceptable” variations in how NHS hospitals manage trauma cases, according to an official report.
Trauma care has not “significantly improved” for more than two decades, despite ongoing criticisms of the treatment given to assault, blast, burn and fall victims, said the National Audit Office (NAO).
Between 450 and 600 more lives could be saved every year if hospitals were better organised, it said.
NAO Comptroller and Auditor General Amyas Morse said: “The Department of Health and the NHS must get a grip on co-ordinating services through trauma networks, on costs and on information on major trauma care if they are to prevent unnecessary deaths.”
A total of 193 hospitals currently use their accident and emergency departments to treat trauma cases.
But it amounts to just 0.2% of their total activity, meaning there is insufficient experience among some medics.
Gathering experts at regional centres would lead to improvements in the speed and quality of treatment given, despite increasing the distance travelled to receive care in some cases, the NAO said.
NICE guidelines state head injury casualties should have a CT scan within a hour of arriving at hospital.
But based on the figures collated, the current average waiting time is one-and-a-half hours - and more than two hours for 25% of patients.
The NAO highlighted a network being set up in London, based on the principle that ambulances should be able to reach a trauma centre within 45 minutes, as an example of how the system could be improved.
Despite major trauma being most likely to happen at nights and weekends, only one hospital in England has 24-hour consultant care, the report found.
Richard Collins, of the Royal College of Surgeons of England, said: “It is neither cost effective nor in the best interest of patients for all hospitals to treat victims of major trauma.
“There is indisputable evidence that the introduction of regional trauma centres would save thousands of lives every year, however, very little progress has been made.”