Major Trauma Rehabilitation Workshop

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Major Trauma Rehabilitation Workshop

• 22nd June 2009

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Agenda - Morning

• 9.30 Welcome objectives for the day
• 9.40 London Trauma System Context and progress
  to date
• 10.00 Current evidence on outcomes
• 10.15 Major Trauma Rehabilitation Workstream
• summarising the key themes
• 10.45 QA
• 11.00 Refreshments
• 11.30 Explanation of break out groups
• 11.45 Break out groups
• 12.45 Lunch

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Agenda - afternoon

• 13.30 Break out groups (second session)
• 14.40 Refreshments
• 15.10 Feedback from facilitators
• 15.40 Voting on priorities
• 16.00 Next Steps
• 16.30 Close

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Objectives for the day

• By the end of today you will have-
• A common understanding of Rehabilitation
  Workstream and your contribution to it
• Had an opportunity to imprint your expertise,
  knowledge and experience into the this work

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London Trauma System context and progress to
date

• Tracy Parr Jane Barnacle
• Network Development Manager Rehab Workstream
  Lead
• Major Trauma Project Major Trauma Project

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What is major trauma?

• Major trauma a limb amputation, severe gunshot
  or knife wounds, a spinal injury, open skull
  fracture, paralysis or multiple injuries e.g. a
  road traffic accident. Injury severity score
  greater than 15
• Trauma fractured neck of femur, broken ankle,
  minor head injury

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The scale of the problem

• Around 1,660 major trauma cases per year
• About one case a week for most AEs
• Most major trauma cases occur in central London

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The case for change

• Current death rates are 40 higher in the UK than
  in parts of the US where there are effective
  trauma systems
• Two thirds of major trauma patients taken to a
  local hospital end up being transferred
• Royal London has 28 less deaths from major
  trauma compared with national average

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What a good major trauma service looks like

• New specialist centres of care which have
• sufficient volumes of patients for clinicians to
  become skilled
• are open 24/7, and
• provide a complete range of specialist major
  trauma care to a defined high standard

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Staff involved in Major Trauma
Renal physicians
Speech Language Therapists
ENT surgeons
Urologists
Maxillofacial Surgeons
Porters
Haematologists
Trained ambulance personnel
Ophthalmologists
Resident Major Trauma team
Pharmacists
Cardiothoracic Surgeons
A E Team
Endocrinologists
Physiotherapists
General Surgeons
Occupational Therapists
Vascular Surgeons
Intensive Care Team
Cardiologists
Transplant Co-ordinators
Specialist Nurses
Radiologists
Dieticians
Anaesthetists
Laboratory Staff
Orthopaedic Surgeons
Psychiatrists
Cleaners
Neurosurgeons
Rehabilitation Physicians
Geriatricians
Data Collectors
Theatre Staff
Social Workers
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Establishing a Trauma System
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Pre-Hospital Triage Protocol
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What a good trauma network looks like

• Three or four networks with a major trauma centre
  leading and co-ordinating the service and clear
  transfer agreements
• Local trauma centres in all AEs would improve,
  so thousands of patients would have better care
• Ability to cope with a major disaster

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HfL Major Trauma Project Structure
The governance arrangements for the Major Trauma
project within the overall HfL Programme is
illustrated below
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Currently

• JCPCT has run a Public Consultation on various
  options
• Public responses
• Organisational responses (e.g. Royal Colleges,
  Charities)
• Equality Impact Assessment
• Joint Health Overview and Scrutiny Committee

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Four networks JCPCT preferred option
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Four network - alternative option
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Three network option
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Next steps

• Decision potentially 20 July
• Commissioning
• London Trauma Office
• London Trauma Director appointed

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CPD Project

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Possible structure
Project Lead 8b
Senior Clinical Advisor 8a
Senior Clinical Advisor 8a
Clinical Advisor 7
Clinical Advisor/ Project officer 7

• Needs assessment
• Leadership programme
• Development of core syllabus
• Commissioning
• Standardised competency framework

• Indicators/outcomes/standards
• Development of a core syllabus
• Standardised competency framework
• Learning culture
• AHP role development