Our Head of Services, Naomi Fitzgibbon, was present at the announcement in her role as Patient and Public Representative on NOCA’s Major Trauma Audit, and welcomes this important development.
The government today approved the designation of the Mater Hospital as the Major Trauma Centre for the Central Trauma Network and St Vincent’s University Hospital and Tallaght University Hospital as the Trauma Units for Dublin.
The decision, announced by Minister for Health Stephen Donnelly TD, is a crucial step in the development of a national trauma system for Ireland. The Major Trauma Centre will provide all major specialist services relevant to the care of major trauma, leading to better outcomes for severely injured patients. The Trauma Units will deliver trauma care for less complex cases or patients with injuries that are considered time critical and where direct transfer to the Major Trauma Centre is not possible within the necessary timeframe.
Minister Donnelly said:
“Major trauma involves complex injuries that have the potential to be life changing or life ending – on average, around 1,600 patients in Ireland suffer major trauma injuries each year. Studies have consistently shown that severely injured patients are 15-20% less likely to die if admitted to a Major Trauma Centre than if admitted to other hospitals. Concentrating major trauma cases in high volume centres provides the necessary critical mass, clinical throughput, specialised infrastructure and specialist skills under one roof, leading to better outcomes for patients with major trauma.”
The National Trauma Strategy recommends the introduction of an inclusive trauma system for Ireland with one Major Trauma Centre based in Dublin servicing the Central Trauma Network and another based in Cork University Hospital servicing the South Trauma Network. It further recommends that each of these Major Trauma Centres will be linked to several Trauma Units throughout the country and that Dublin should have a maximum of two Trauma Units, in addition to the Major Trauma Centre.
The government accepted the recommendation of the HSE Board on the locations following the report of an Independent Assessment Panel comprised of local and international experts. The Minister said:
“Seriously injured trauma patients will now be treated by the right clinicians, in the right hospitals, as quickly as possible, and will receive much more rapid care from specialist trauma teams who can identify life-threatening injuries much quicker and perform life-saving operations earlier. In treating trauma of a lesser severity, the two Trauma Units in Dublin will be essential to ensuring that the Major Trauma Centre is capable of dealing with major trauma when it arrives.”
Mr Ciarán Devane, Chair of the HSE Board said:
“The decision announced by Government today progresses the National Trauma Strategy, an important strategic reform under Sláintecare. Commencing the phased development of the Major Trauma Centre in Dublin was also a defined target in our National Service Plan and will lead to improvements in outcomes for trauma patients going forward. The investment for trauma services included in that plan, coupled with today’s decision, gives the HSE the means to strengthen the services provided to trauma patients in Ireland.”
1. The Report of the Trauma Steering Group; A Trauma System for Ireland (the National Trauma Strategy) was approved by Government in February 2018. The National Trauma Strategy recommends the introduction of an inclusive trauma system for Ireland.
2. The National Trauma Strategy sets out how adult trauma services will be delivered by two regional networks (Central and Southern Trauma Networks), each with a Major Trauma Centre, with one based in Dublin and another based in Cork University Hospital, that will provide the highest level of specialist trauma care to the most severely injured patients on a single hospital site.
3. Within each network, a number of Trauma Units will deliver more general trauma care to the majority of patients who do not need the specialist expertise of a Major Trauma Centre.
The process to designate the Major Trauma Centre for the Central Trauma Network and the Dublin Trauma Units
4. To ensure a robust designation process, the HSE established a Trauma Review Implementation Group (TRIG) comprising senior clinical and managerial representation. The TRIG prepared a designation framework providing detailed, specific and evidence-based guidance against which hospitals could be assessed. This framework was subject to an eight-week formal public consultation.
5. An Independent Assessment Panel, comprised of national and international experts, was appointed to provide advice on the preferred location of the Major Trauma Centre for the Central Trauma Network and the number and location of Dublin Trauma Unit(s), using the agreed designation framework.
6. The Panel advised that the Mater Hospital be designated as the Major Trauma Centre for the Central Trauma Network and that both St. Vincent’s University Hospital and Tallaght University Hospital be designated as Trauma Units for Dublin. The HSE Board subsequently made this recommendation to the Minister for Health.
7. The National Clinical Lead, working with sponsors from across the healthcare system, the Central Trauma Network Clinical Lead and the management teams of the hospitals, will oversee the establishment of the Mater Misericordiae University Hospital as the Major Trauma Centre for the Central Trauma Network and St. Vincent’s University Hospital and Tallaght University Hospital as Trauma Units for Dublin .
8. The implementation of the trauma system will occur over three phases. Phase One will see the fundamentals of a trauma system in place for Ireland. This will see the most injured patients from the Central Trauma Network accessing the Mater Misericordiae University Hospital either directly or via secondary transfer.
9. Phase Two will see the development of other components of the trauma networks, including the development of major trauma services at Cork University Hospital, the Major Trauma Centre for the South Trauma Network and at the Trauma Unit with Specialist Services (TUSS) at University Hospital Galway, and the establishment of trauma services at the first of several Trauma Units nationwide.
10. Funding of €5.7 million has been provided in Budget 2021 to allow for the commencement of Phase 1 of the development of the Major Trauma Centre for the Central Trauma Network. This funding will enable the establishment of a number of vital services at the Major Trauma Centre. Once established, it is planned that the Centre will formally commence services early in 2022.
11. Phase Three will see the maturation of the trauma system towards its final state with the continued development of all services established in Phases One and Two.