Agenda item

Nicola Brooks (Head of Medical Services, South East Coast Ambulance Service NHS Foundation Trust), Matthew England (Clinical Quality Manager, South East Coast Ambulance Service NHS Foundation Trust), Dr Marie Beckett (A&E Consultant, East Kent Hospitals NHS University Foundation Trust),Dr Patricia Davies (Dartford, Gravesham and Swanley Clinical Commissioning Group) andHelen Medlock (Associate Director of Urgent Care and Trauma, NHS Kent and Medway) were in attendance for this item.

(1)       The Chairman welcomed the Members of Medway Council’s Health and Adult Social Care Committee who were present as guests of the Committee. Both Committees had previously examined the proposals but the Kent HOSC wished to follow up on a number of key issues.

(2)       There was a broad consensus around some of the main reasons why the trauma network in Kent and Medway needed developing. Nationally there was variation between the survival rates for trauma between hospitals and there was often a lack of appropriate coverage at the weekend. This had led to the development of a national plan and the appointment of a national tsar. However, the staffing requirements to give full coverage and the number of trauma patients in Kent and Medway annually meant it was not possible for every Accident and Emergency Department to contain a Trauma Unit. In the event of an incident, the aim is that patients whose injury was over 15 on the Injury Severity Score (ISS) be taken to a Trauma Unit for stabilisation. Of the 488,189 emergency cases across Kent and Medway in 2010/11, 202 of them, or 0.04% had an ISS of over 15. Of these, over 50% had been able to be taken to a Major Trauma Centre, mainly King’s in London, within 45 minutes. In sum, less than 100 patients a year require stabilisation.

(3)       Members asked a number of specific questions. In answer to one it was confirmed that all the designated Accident and Emergency Departments have a Majors area for seriously ill patients and a Resuscitation area for life threatening conditions. Another one confirmed that a patient from Broadstairs would be taken to Medway in the first instance and this was possible within the 45 minute target. Thirdly, it was not regarded as feasible to reverse the services available at Maidstone and Pembury respectively because of all the equipment necessary for a Trauma Unit which would also need to be moved.

(4)       Representatives from the South East Coast Ambulance Service explained the process of hot secondary transfer. Trauma was a priority for the service and Critical Care Paramedics would be despatched to an incident. Where there was a procedure which could not be carried out by a paramedic, perhaps involving the airways or a chest drain, then the process would be to take the patient to the nearest Trauma Unit, where the patient would stay on the ambulance trolley, for stabilisation before transfer to a Major Trauma Centre. There were also doctors who volunteered to attend the scenes of incidents and these clinicians were able to provide a range of treatments paramedics could not.

(5)       In terms of data and performance monitoring, it was explained that there were robust information technology and monitoring systems in place. Data was shared across the care pathway and assessed against national bench markers.

(6)       A number of Members expressed concerns about emergency resilience planning, particularly in the context of the Olympic Games taking place in 2012. The Chairman explained that there was a window of opportunity at the January meeting and NHS colleagues explained that they were more than happy to return with detailed information on this topic at that time.

(7)       AGREED that the Committee note the report.