BSUH has been approved as the prospective major trauma centre for the Sussex network using acute facilities at the Royal Sussex County Hospital in Brighton.
BSUH underwent a designation visit in February 2012 with clinical representatives from the London Trauma system and the South of England SHA.
The area of greatest concern was the projection that neurosurgical services for neurotrauma would only be in place in Brighton after June 2012 and still depended on successful surgeon recruitment. For this reason full designation could not be approved.
However, it was noted that good progress has been made in other areas, and that BSUH is already delivering a much-enhanced service with high volumes of activity. Around 250 patients with ISS greater than 15 were treated in BSUH during 2011 with very good performance in areas such as consultant led trauma teams in A&E (87%) and time to CT scan (consistent performance under 60 minutes with median times around 40 mins).
Some major trauma services are established including trauma and orthopaedics (pelvic injury service, limb reconstruction and orthoplastics), vascular and rehabilitation. Good capacity plans for additional polytrauma theatre, ITU beds, polytrauma ward, and rehabilitation are in place for April 2012.
Capital development schemes in the emergency department and theatres are underway with completion expected during the summer of 2012.
BSUH will have access to best practice tariff income from 2 April 2012 to help fund the enhanced services on offer and while plans to deliver neurosurgery on the Royal Sussex County Hospital site are implemented. In the interim, the existing head injury pathways to Hurstwood Park neurosciences centre and, when needed, to St George’s will continue.
Trauma network and pre-hospital care
Pre-hospital pathways for children will follow adults. Brighton is to maintain links with King’s as paediatric neurosurgical centre, but London does not have a designated paediatric major trauma centre. Therefore pathways, transfer and retrieval protocols with Southampton are being developed. Southampton has been designated as a paediatric major trauma centre with a full range of clinical services available.
An onward care policy has been approved by the network to maintain flow through the major trauma centre and provide appropriate care closer to home for injured patients.
Trauma onward care and rehabilitation
BSUH has well developed plans for rehabilitation and Sussex has a Rehabilitation and Re-ablement Network which encompasses Trauma.
A rehabilitation consultant has been recruited for the major trauma centre to compliment the existing two consultants at the Sussex Rehabilitation Centre.
The rehabilitation pathway will commence in ITU, with high levels of therapy, social and psychological support available on the polytrauma ward. Trauma practitioners will case manage patients and assist with discharge planning and filling community rehabilitation prescriptions. In addition, six beds for major trauma rehabilitation are being put in place in the Sussex Rehabilitation Centre at the Princess Royal Hospital.