By our Head of Research Dr Mark Bacon
Trauma care in London is set to change, hopefully for the good. There is compelling clinical evidence that a regional trauma care system (as adopted in the US where mortality rates for the most severely injured patient are 40% lower than in the UK) improves patient outcomes. It is based on the principle that getting access to the most appropriate care rather than on getting to the nearest hospital as quickly as possible is the major factor influencing outcomes in major trauma.
With this in mind, London’s primary care trusts (PCTs) have agreed to develop a similar model for the capital - a move that is likely to herald change across the country. But will it benefit spinal cord injury (SCI) patients? Those responsible for developing the proposal, Healthcare for London, have so far recognised that stroke or burns patients need particular consideration within any trauma network and plans have been developed for these. It is disappointing to see no such attention has been given to those who have suffered spinal cord injuries. With such major changes being proposed there may never be a better time to establish the best care model for SCI and Spinal Research has responded to the consultation by outlining the strong case for regionalising SCI trauma care.
We are calling for an immediate review of the care path for those entering the new trauma networks with SCI; we recommend that ideally only 1 of the 4 proposed new trauma networks should receive SCI patients, making that centre automatically responsibility for their care. Spinal cord injuries are relatively rare and also very complicated injuries, leading to clinical mismanagement amongst general trauma units and A&E departments who see so few. Thus, reducing the number of centres responsible for their care will ensure high patient volumes and concentration of appropriate level of specialist care and expertise not otherwise possible or justified when spread too thinly.
Further information can be found on www.healthcareforlondon.nhs.uk.
