Major trauma care in England is not good enough, according to the National Audit Office which is calling on the NHS and the Department of Health to get a grip on services to prevent unnecessary deaths. It estimates that between 450 and 600 lives could be saved if care was managed more effectively.

In a report today it says care for major trauma patients, such as those who have been injured in road accidents or falls, has not significantly improved in the last 20 years despite numerous reports that have identified poor practice with services not being delivered efficiently. Survival rates vary significantly from hospital to hospital from five unexpected survivors to eight unexpected deaths per 100 trauma patients.

The report says care should be led by experienced consultants but major trauma is most likely to occur at night and at weekends when they are not normally in hospital emergency departments. Only one hospital has round-the-clock consultant care seven days a week. The NAO says, too, that care is not coordinated, formal arrangements for patients going directly for specialist treatment or moving between hospitals do not exist and a significant number of patients that need a CT scan do not get one.

The head of the NAO, Amyas Morse, said services were not good enough.”If you are unlucky enough to have an accident at night or at the weekend, in many areas you are likely to receive worse quality of care and are more likely to die,” he said and added: “The Department of Health and the NHS must get a grip on coordinating services through trauma networks, on costs and on information on major trauma care, if they are to prevent unnecessary deaths.”