A runner with a below-knee running prosthetic gets ready to go to the gym illustrating the need for rehabilitation treatment for people who have been discharged from a major trauma centre

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Falling off a cliff…. Rehabilitation treatment failure following discharge from a Major Trauma Centre

The introduction of Major Trauma Centres throughout the UK has had many benefits but after patients are discharged from a Major Trauma Centre, they are at risk of falling off a cliff and losing the positive effects. Brian Coghlan explains how people in need of rehabilitation treatment are being let down.

In 2012 the NHS implemented a radical overhaul to the way that patients suffering from major trauma were treated.  This was a great success, and in 2018 research[i] showed the survival rates for severe injuries increased by nearly a fifth in the five years from 2012 onwards.

Major Trauma is defined by NHS Choice as ‘multiple, serious injuries that could result in disability or death’[ii], and prior to this overhaul any patient who sustained an injury requiring hospital treatment would simply be taken to the nearest A&E department.

Major Trauma Centres throughout the UK

In April 2012 the NHS appointed a number of large hospitals Major Trauma Centre status which meant they would be the destination hospital for any patient assessed to be suffering from major trauma by attending paramedics.  In practice, this meant an ambulance could drive (or fly) past one or more accident & emergency hospital departments on their way to the nearest Major Trauma Centre, but when they got there they would have access to specialist experts and rehabilitation care.

We now have 28 hospitals with Major Trauma Centre status across England and Wales, plus a further 4 across Scotland and one in Belfast.

This is all very positive, but it is also clear that we now have more patients surviving major trauma injuries, and it’s inevitable that many of those patients will have the most complex ongoing rehabilitation and support needs.

A runner with a below-knee running prosthetic gets ready to go to the gym illustrating the need for rehabilitation treatment for people who have been discharged from a major trauma centre
A runner with a below-knee running prosthetic gets ready to go to the gym illustrating the need for rehabilitation treatment for people who have been discharged from a Major Trauma Centre.

After being discharged, rehabilitation treatment ‘falls off a cliff’

This brings us to the problem that many major trauma patients experience when they are discharged from a Major Trauma Centre, into the care of their GP and other local NHS service providers.  The phrase used by some patients anecdotally is that their rehabilitation treatment ‘falls off a cliff’ at this point.  This is not a criticism of GP’s or local NHS services as such, but the reality is that they do not have the funding they need to provide timely and comprehensive treatment programmes for patients being discharged from Major Trauma hospitals.

Some patients are fortunate in that they have the option of private funding to fill any gaps in NHS provision, often through private medical insurance or via a compensation claim being handled by a specialist major trauma lawyer – but others will find that their patient experience and access to fluid and effective treatment drops considerably.

The benefits of Major Trauma Centres will be lost

Whilst the introduction and development of Major Trauma Centres should be applauded, the government must also take steps to ensure that patients who benefit from this specialist treatment are not then failed when they are discharged into the care of local NHS services.  Failure to properly fund rehabilitation services across the NHS generally will result in some of the positive effects of the major trauma overhaul unravelling.

How Major Trauma Group can help

If you or someone you know has been discharged from a Major Trauma Centre and found that rehabilitation provision has dropped, please contact the Major Trauma Group to see if one of our members can assist you.


References:

[i] https://www.england.nhs.uk/2018/08/more-than-1600-extra-trauma-victims-alive-today-says-major-new-study/

[ii] https://www.uhs.nhs.uk/Media/SUHTInternet/Services/Emergencymedicine/Regionalnetworksformajortrauma.pdf

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