Trauma care changes in Northern Ireland
The way in which major trauma care is provided across Northern Ireland is changing.
From today (Monday, 26 Oct), seriously injured patients may be taken directly to the Major Trauma Centre (MTC) at the Royal Victoria Hospital in Belfast. New protocols to enhance collaboration between all acute hospitals, and a new dedicated trauma ward at the MTC, ensure that Northern Ireland patients have access to the best model of care for major trauma.
Health Minister Robin Swann welcomed the latest developments by the Major Trauma Network. He said:
“This marks the culmination of several years of co-operation, planning and investment, and demonstrates what we can achieve when the component parts of our health service work together as one system.”
“I want to place on record my thanks to the network team for their continued commitment to improving the life-saving care they provide to the people of Northern Ireland.”
Major trauma, such as head injuries, serious burns, road traffic collisions or agricultural accidents, is one of the leading causes of death and disability globally. In the United Kingdom it is the main cause of death for people under the age of 45.
Evidence has shown that when hospitals work together as a network, with a MTC at the hub, patient survival rates may improve by as much as 20%.
The Belfast MTC offers a range of specialist trauma care services, including a new consultant-led major trauma ward and a rooftop helicopter landing pad which enables NI’s Helicopter Emergency Medical Service (HEMS) to take severely injured patients directly to the Centre. It will operate 24 hours a day, seven days a week and is staffed by a specialist trauma team with access to the best diagnostic and treatment facilities.
The aim of any major trauma network is to minimise the time between a patient acquiring a severe injury and accessing specialist care at the MTC, and thus the adverse impact that any delay can have on their treatment, and ultimately their clinical outcomes.
Today’s activation of new trauma protocols enables ambulance responders, who are within a 45 minute drive time, are able to take seriously injured patients directly to the MTC. Here they will be immediately assessed and treated by the full specialist trauma team. Likewise children under 16 years will be taken to the Royal Belfast Hospital for Sick Children where they will be assessed and treated by a specialist paediatric trauma team.
Dr Duncan Redmill, Lead Clinician, NI Major Trauma Network and Consultant in Emergency Medicine, RVH explained: “It’s really important that seriously injured patients are assessed and treated quickly after an accident. Thanks to advances in medicine and technology, patients are now able to survive horrific injuries that previously may have resulted in death”.
He continued; “Having a joined-up system ensures timely, high quality trauma care throughout Northern Ireland and results in improved survival rates and reduced disability. Our new major trauma ward is a state-of-the-art facility, staffed by a dedicated multidisciplinary team whose purpose is to care for our most seriously injured.”
Patients who have suffered a severe injury often need immediate care from many professionals so the major trauma team includes specialists from emergency medicine, intensive care, surgery, nursing, allied health professionals and support staff who all work together to assess and manage the patient.
Many trauma patients will require rehabilitation and a long recovery period to help them return to an active life. Their journey moves through the major trauma ward and continues to ongoing care in local hospitals and community based facilities.
Dr Redmill continued; “Local hospitals will play a key role in the recovery of trauma patients. They will provide individual rehabilitation programmes for each patient including physiotherapy and occupational health services. Of course, having this extended period in a local hospital will mean patients’ relatives and friends will find it easier to visit, as and when appropriate”.
Michael Bloomfield, Chair of the Northern Ireland Major Trauma Network and Chief Executive of the Northern Ireland Ambulance Service said; “This is a very positive development. People who suffer major trauma will now be given the best chance of survival and recovery wherever they live. Lives will be saved by having all the expertise, experience and equipment in one place.”
“The activation of the new major trauma system is the culmination of five years’ work and I wish to commend my HSC colleagues for their significant efforts in improving major trauma care”.
The NI Major Trauma Network is led by the Health and Social Care Board and works to co-ordinate the provision of adult and child trauma care across Northern Ireland. The Network promotes a whole system approach that covers pre-hospital, in-hospital and rehabilitation to ensure the delivery of care to the right patient, in the right place, at the right time.
Major trauma describes serious and often multiple injuries where there is a strong possibility of death or disability. These might include serious head, chest, abdominal and skeletal injuries sustained as a result of accidents, sport or violence. Major trauma is the main cause of death for people under the age of 45 years and is a major cause of debilitating long term injuries. More than half of major trauma is caused by road traffic collisions.
There are approximately 1,500 major trauma patients (children and adults) across Northern Ireland each year. Whilst this is a relatively small number from a population of 1.8 million, major trauma patients have complex injuries and need expert care to have the best chance of surviving and recovering. International experience of implementing major trauma networks has seen a 15-25% decrease in mortality over a period of five years.
The NI Major Trauma Network was established in December 2016 following a commitment by Health Ministers to establish an integrated trauma service alongside a Helicopter Emergency Medical Service (which launched in July 2017). The Network comprises commissioners from the Health and Social Care Board and Public Health Agency, as well as clinical and service leaders from Health and Social Care Trusts including the NI Ambulance Service. It provides the infrastructure that allows healthcare professionals, commissioners and other stakeholders to collaborate across the Health and Social Care system to plan, coordinate and manage the treatment of people injured as a result of major trauma, including injury prevention, pre-hospital care, acute specialty services at the Major Trauma Centre and local Emergency Departments, and rehabilitation services.
Ambulance and hospital staff have been involved in on-going trauma team training.
The Major Trauma Network is the culmination of a series of developments to improve trauma care, including HEMS, the new Major Trauma Ward, and the Call & Send protocol (which enables local hospitals to redirect patients to the MTC).