Welsh Major Trauma Unit: consultation on location
Welsh Local Health Boards and Community Health Councils will be leading public debate soon on where a new hospital service dealing with major trauma from the whole of South Wales will be sited.
The Socialist Health Association Cymru Wales is asking the people of South Wales to get involved in this decision about where any new Major Trauma Unit should be located to serve people badly injured in South Wales. An expert advisory group has recommend that the Major Trauma Unit should be located at UHW in Cardiff and Morriston Hospital should co-ordinate the Major Trauma network.
We have five concerns given what we know of the process so far.
- The terms of reference given to the expert group by the Chairs and Chief Executives of Health Boards and Trusts in Wales seem to give great weight to the current clinical capabilities of two major hospitals (Morriston Hospital Swansea and UHW Cardiff) and to assessing which is better equipped clinically to handle the new role. Whilst existing clinical skills are important, SHA Cymru Wales would expect a new Welsh service to complement the UK –wide Major Trauma service to give optimal coverage for populations within the UK as a whole. A Unit located in South Wales would complement those in the West Midlands, South West of England, Merseyside, and Devon and Cornwall. On this basis, given extant trauma units in Bristol, Birmingham and Plymouth and the increased involvement of air cover for serious trauma, the merits of a Swansea site would seem to offer enhanced resilience when compared with a Cardiff option.
- The ability of the wider hospital infrastructure around both localities to absorb the inevitable knock on effect that adding a major trauma load to existing theatre, ITU and after care provision brings must also be overtly considered. It is not clear from the work done so far that adding this extra service to those already in Cardiff can be done without degrading existing services in South West Wales.
- The proposed two roles of Morriston Hospital – retaining a high level (undefined) of trauma work and of leading the trauma network – are not fully described in terms lay people would understand. The consultation process should make these roles clear and explore what would happen if Morriston were the site of the major Trauma Unit and the leadership of the network was located elsewhere.
- The justification for choosing Cardiff seems to be based on the population density of South East Wales including the capital city and a desire to avoid sending Welsh patients living in South East Wales to Bristol. We would have expected to see more detailed epidemiological data about the incidence and volume of major trauma rather than mere population numbers – as was done when the decision to base the Burns service in Swansea was being taken in recognition of the then location of likely causes of burns injuries.
- The travel time data to the competing sites needs to be in the public domain. The Expert Group’s report suggests that travel time data and “accessibility” to both sites is not fully agreed. Road and air travel times are very different. Given the impact that travel times have on outcomes for those needing access to major trauma units, this crucial data needs to be available to the public. Air cover for parts of North and Mid Devon would come into play if the District Hospital currently in Barnstaple is downgraded as has been proposed in some quarters.
SHA Cymru Wales believe this is a major national investment decision that needs to be carefully considered so that the right decision is made for Wales and the UK as a whole. A correct decision is preferred to a quick one.
We urge and encourage the public to take part in the consultation process.”