Trauma system set for major reform

Two major trauma centres recommended
  • Deborah Condon

The Government has insisted that if implemented, a new trauma system for Ireland will lead to better outcomes for patients.

Around 1,600 people suffer a major trauma here every year. Major trauma involves complex injuries that have the potential to lead to prolonged disability or death.

A Trauma Steering Group was established by the Government with the aim of reducing death and disability among these patients. The group also set out to ensure that high-quality trauma services are available to everyone nationwide.

The report of this group has now been published, following Government approval. It recommends the establishment of ‘an inclusive trauma system', which will include two regional trauma networks - one central and one in the south.

"There will be one designated major trauma centre in each of these networks, which should treat a minimum number of major trauma patients in order to maintain a critical mass of specialist expertise.

"The networks will also include a number of other trauma units and, in addition, a trauma unit with specialist services, which will also deal with trauma cases. This approach of an inclusive trauma system with two networks recognises both the geographical spread of our population and current hospital configuration," the Department of Health said.

It noted that currently, there is no trauma system in Ireland. Instead, there are Emergency Departments (EDs) that are equipped to deal with trauma, but to varying degrees and with no clear protocols. In other words, a person could present to an ED that has relatively little experience or expertise in trauma. They may then have to be moved to a second hospital, which can lead to delays in treatment and poorer overall outcomes.

International evidence shows that the introduction of a trauma system is linked with a reduction in death and disability.

"The overall aim of this report is to address the needs of all injured patients wherever they are injured, and wherever they receive care. There is a relatively low incidence of major trauma in Ireland, but the cost to individuals and their families can be very high. A trauma system will enhance the chance of survival and lead to better patient outcomes," commented the Minister for Health, Simon Harris.

It is understood that the two major trauma centres would be located in Dublin and Cork and these reforms would take around seven years to implement, at a cost of €30 million.

The report was welcomed by the Irish Association for Emergency Medicine (IAEM), which has been calling for reforms in this area for many years.
"It is vital for patients that the report is implemented in its entirety and as soon as possible. The international experience from England, Wales and Australia tells us that we will see 30% more survivors as a result...Good early care saves both lives and ultimately saves money," the IAEM added.

The report was also welcomed by the Royal College of Surgeons in Ireland (RCSI), which emphasised that the best outcomes are achieved by patients ‘receiving the right treatment in the right place by experienced trauma teams as rapidly as possible'.

"The trauma system in Ireland is fragmented and under-invested. This is impacting on outcomes. The recommendations of this important report must be urgently implemented," commented RCSI president, Prof John Hyland.

The report, A Trauma System for Ireland, can be viewed here


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