‘Major trauma’ can be defined as multiple and serious injuries that could result in disability or death. These may include serious head injuries, multiple injuries caused by road traffic accidents, industrial accidents, falls, mass casualty events, knife and gunshot wounds. Major trauma is the leading cause of death in people under the age of 45 and is a significant cause of short- and long-term illness or poor health.
A major trauma network is a group of hospitals, emergency services and rehabilitation services that work together to make sure a patient receives the best care for life-threatening or life-changing injuries. Within the network there is a major trauma centre, trauma units, local emergency hospitals and rural trauma facilities, supported by other hospitals within the region. There is strong evidence that a major trauma network saves lives and provides better outcomes for patients, including rehabilitation as close to home as possible.
The Major Trauma Centre for adults and children is located at the University Hospital of Wales (UHW), Cardiff. As major trauma is uncommon and complex to manage, the services provided in the major trauma centre are highly specialised and it collaborates with and supports other hospitals in the network.
The major trauma centre is supported by a number of trauma units. Trauma units are important in providing immediate life-saving services to patients who, because of their injuries, are not stable enough to travel to the major trauma centre and, following which, will transfer them quickly to the major trauma centre.
A trauma unit, with specialist services, at Morriston Hospital, Swansea, provides specialist support to the major trauma centre and provides specialist surgery for patients who do not have multiple injuries, but need burns, plastic, spinal and cardiothoracic surgery.
In addition to the trauma unit at Morriston Hospital, there are five trauma units at the following locations:
There is a Local Emergency Hospital at the Royal Glamorgan Hospital, Llantrisant. A Local Emergency Hospital does not routinely receive major trauma patients. However, it has processes in place to ensure that if this does occur, patients are appropriately managed and transferred to the Major Trauma Centre or nearest Trauma Unit. However, this hospital will continue to receive both moderate trauma and isolated orthopaedic trauma. Royal Glamorgan Hospital will maintain a 24/7 Emergency Department with associated acute services.
There are rural trauma facilities at Bronglais General Hospital, Aberystwyth, and Withybush General Hospital, Haverfordwest. Hywel Dda University Health Board is committed to ensuring these hospitals maintain the ability to assess and treat major trauma patients, given their relatively unique geographical locations. These two hospitals currently receive and manage major trauma and are now better supported in doing so and face fewer issues with referral and onward transfer.
When we say that the major trauma network will cover ‘South Wales’, we are talking about the broad geography of Wales split into two regions – north and south. The South Wales Trauma Network will cover the whole of the South Wales region, which includes the counties of: Blaenau Gwent, Bridgend, Caerphilly, Cardiff, Carmarthenshire, Ceredigion, Merthyr Tydfil, Monmouthshire, Neath Port Talbot, Newport, Pembrokeshire, Rhondda Cynon Taf, Swansea, Torfaen and the Vale of Glamorgan. It will also cover the South of Powys, which is the part of the county largely south of Newtown.