title: The effect of introducing a Trauma Network on patient flow, hospital finances and trainee operating.
abstract: In April 2012 the National Health Service in England introduced the Trauma Network system with the aim of improving the quality of trauma care. In this study we wished to determine how the introduction of the Trauma network has affected patient flow, hospital finances and orthopaedic trauma training across our region. The overall pattern of trauma distribution was not greatly affected, reflecting the relative rarity of major trauma in the UK. A small decrease in the total number of operations performed by trainees was noted in our region. Trainees at units designated as Major Trauma Centres gained slightly more operative experience in trauma procedures overall, and specifically in those associated with high energy, such as long bone nail insertion and external fixation procedures. However, there have been no significant changes in this pattern since the introduction of the Trauma Networks. Falling operative numbers presents a challenge for delivering high quality training within a surgical training programme, and each case should be seen as a vital educational opportunity. Best practice tariff targets for trauma were delivered for 99% of cases at our MTCs. Future audit and review to analyse the evolving role of the MTCs is desirable.
authors.affiliation: Health Education North East, Newcastle Upon Tyne, UK.
authors.forename: Daniel
authors.initials: D
authors.lastname: Hipps
authors.affiliation: Royal Devon & Exeter NHS Foundation Trust, Exeter, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Jameson
authors.affiliation: Northumbria Healthcare NHS Foundation Trust, Ashington, UK.
authors.forename: An
authors.initials: A
authors.lastname: Murty
authors.affiliation: County Durham and Darlington NHS Foundation Trust, Durham, UK.
authors.forename: Rob
authors.initials: R
authors.lastname: Gregory
authors.affiliation: University Hospital Ayr, Ayr, UK.
authors.forename: David
authors.initials: D
authors.lastname: Large
authors.affiliation: Northumbria Healthcare NHS Foundation Trust, Ashington, UK.
authors.forename: Jackie
authors.initials: J
authors.lastname: Gregson
authors.affiliation: Health Education North East, Newcastle Upon Tyne, UK.
authors.forename: Ramsay
authors.initials: R
authors.lastname: Refaie
authors.affiliation: Northumbria Healthcare NHS Foundation Trust, Ashington, UK. Electronic address: mike.reed@nhs.net.
authors.forename: Mike
authors.initials: M
authors.lastname: Reed
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D016208:Databases, Factual; D004503:Education, Medical, Graduate / Q000379:methods / Q000458:organization & administration*; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration; D016347:Medical Records Systems, Computerized; D009104:Multiple Trauma / Q000453:epidemiology / Q000601:surgery; D009985:Orthopedics / Q000193:education* / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D018794:Problem-Based Learning / Q000706:statistics & numerical data; D013514:Surgical Procedures, Operative / Q000193:education* / Q000706:statistics & numerical data; D014193:Trauma Centers / Q000458:organization & administration; D006113:United Kingdom / Q000453:epidemiology
keywords: Major Trauma Centre; Polytrauma; Training; Trauma Network