Scotland failing on trauma care, say surgeons

The Royal College of Surgeons says hospitals must be better equipped. Picture: Getty
The Royal College of Surgeons says hospitals must be better equipped. Picture: Getty
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SCOTLAND is lagging behind other developed countries in its provision of care for victims of major trauma and needs to radically overhaul its approach, medical experts have warned.

A report by the Royal College of Surgeons of Edinburgh said death rates for severely injured patients who are alive when reaching hospital is 40 per cent higher in the UK than in North America.

But while England has reformed its healthcare policy to improve survival rates, the situation in Scotland has not yet been addressed, the medical body said.

Major trauma, the commonest killer of children and adults under 45, accounts for 1,300 deaths every year in Scotland.

The college will today publish its report, which calls for major trauma treatment to be carried out at a small number of dedicated major trauma centres serving a wide geographic area.

They want the centres to have access to all the necessary medical specialities on a single site and be fully resourced with adequate equipment and medical staff to deal with major trauma patients.

The report will also recommend the development of a trauma system across Scotland that focuses on reducing a patient’s chances of long-term disability as well as their death.

Major trauma often involves patients arriving at hospital with multiple, complex injuries which could result in death or permanent disability, usually sustained in an accident such as a car crash or gas explosion, or from a violent situation such as a shooting or stabbing.

More than half of all trauma patients have major head injuries.

Ian Ritchie, vice president of the Royal College of Surgeons of Edinburgh, said Scotland had to wake up the fact its major trauma care was not as effective as it should be.

He said: “The model recommended by our report is equivalent to that in North America and the one being adopted in England.

“Major trauma treatment requires a precise set of skills and knowledge, it also needs to pull expertise from a wide range of specialities and resources.

“Under the current system in Scotland, major trauma patients are sent for treatment at the nearest local hospitals which may not have access to all the resources and specialisms needed.”

He said that previously the system now recommended by his organisation was one which experts did not think would suit Scotland, given the geographical layout of the country.

Research now shows that as long as a patient is stable, the length of the journey to final treatment is not as crucial as previously believed.

Mr Ritchie, consultant orthopaedic surgeon at the Forth Valley Royal Hospital in Larbert, said: “It is more important that the patient is delivered as soon as possible to a hospital, and a team, which is fully equipped to deal with the unique requirements of major trauma patients.

“If necessary, under the new system, major trauma patients could be taken to a local trauma unit to be stabilised but it would be crucial they were then transferred to a major trauma centre as soon as possible.

“Experience suggests that major trauma patients and their families would accept a longer journey in the knowledge that they are in the best place and receiving the best care available.”

He added: “The authors of the report believe that the model being used elsewhere in the world could indeed work in Scotland, and would ensure patients here have the best level of care possible.

“The next step should be to examine the situation in even greater detail, to determine exactly what a trauma system for Scotland could look like.”

Margaret Watt, chair of the Scotland Patients’ Association, said: “This is nothing short of scandalous. We have known for some time the health service in Scotland is lacking in specialist care.

“Trauma patients should have access to the best qualified, best doctors for the job.

“The report comes from specialists who work in the frontline and know what they are talking about. They can not be ignored.

“It will be no good politicians coming back and saying they will look into it. These recommendations are already long overdue.”

“They should already be in place. They need to act now to ensure Scotland’s patients get the life-saving care they expect and deserve.

“Scotland used to be the world leader in health care – to lag behind the rest of the world is just not an option.”

Health Secretary Nicola Sturgeon said the Scottish Government would work with the college to explore possible improvements.

She said: “The report recommends that further research is required and we will explore further with the College possible ways of enhancing the current service as part of our commitment to continuously improve the quality of services for the people of Scotland.”

Part of the college’s report reads: “Mortality for severely injured patients who are alive when reaching hospital is 40 per cent higher in the UK than in North America.

“Recognition of this in England has led to a shift in healthcare policy. However, the situation in Scotland has not yet been addressed.

“In general, trauma care in Scotland is of a very high standard. However, we can do better for those people who are very seriously injured.

“This report represents the beginning of a process.”