Professor Stephen SmithPrincipal, Faculty of Medicine, Imperial College London

and CEO of Imperial College Healthcare NHS Trust

London’s 4th Major Trauma Network:

The case for St Mary’s

Presentation to the Joint Health Overview and Scrutiny Committee5 March 2009

Imperial College Healthcare NHS Trust at a glance

AHSC

• A national centre for research, education and patient care, serving a local population of two million in West London

• Lowest Hospital Standardised Mortality Ratio in UK (Dr Foster, 2009)

• Largest NHS Trust in England with over a million patient contacts a year and annual turnover of over c.£850 million

• Ranked 3rd in Europe and 11th internationally for Life Sciences and Bio-medicine (Times Higher 2008)

• Highest research spend of any UK Medical School at £145 million. 73% of all College research judged as world leading, highest in UK

Major Trauma Centre

• 24-Hours, 7 Days per Week provision for most severe trauma injuries

• Often from major car accidents and violent crime

• Can increase survival rates by over 28% (Mortality rates at Royal London).

• 0.1% of A&E admissions, approximately 1,600 admissions across London per year

• Establishment of MTCs should save approximately 500 lives per year

Patient Pathway – Point of Injury

Major Trauma CentreSt Mary’s Hospital

Network Trauma Centre

Patient Pathway – Immediate Transfer

Site Selection - Core Criteria

• Criteria used for comparing St Mary’s and The Royal Free

1) Clinical Quality2) Critical Mass3) Time Time/Coverage4) Major Incident Compatibility5) Reconfiguration Alignment6) Ease of Deliverability7) MTC Capacity8) Deliverability and Sustainability of Networks9) Speed of Implementation

• St Mary’s has been judged by an independent panel to be ahead on five criteria

Accessibility

• Strategically ideal for the North West sector which is poorly covered by the 3 centre model • Close to major transport arteries and

facilities 0.5 miles from Westway 0.5 miles from A5 1 mile from A41 4.5 miles from M4 5.5 miles from M1 Nearest proposed unit to

Heathrow Airport

Sited in Central London and can provide on-the-doorstep support for major incidents in the centre of the city

Academia & Training

• Academic Unit of Trauma Surgery• Academic Unit of Neurosurgery. Strong

traumatic brain injuries/stroke team with research ranging from population studies, healing/rehabilitation and trauma management

• Kennedy Institute expertise in inflammation with research into fracture healing development of osteoarthritis post injury to joints, system inflammatory response following major trauma/surgery and neuro-inflammation new appointee

• Defence Medical Service & collaborative work at Porton Down

• Providing first class specialist trauma training for civilian organisations, the Armed Forces and NGO’s

Experience and Expertise

• Pivotal in London major incident response (Paddington rail crash, terror attacks 7/7)

• National leader in Resuscitation practice

• Part of the UK’s first functional Academic Health Science Centre; transforming leading research into life-saving treatment

The case for the Major Trauma Centre at St Mary’s

• Best coverage for North, North-West and West London sectors, including Heathrow airport

• Pivotal role in handling major emergencies

• Larger MTC capacity

• Highly regarded specialist academic units

• Lowest Hospital Standardised Mortality Ratio in UK

Hyper-Acute Stroke at Imperial College NHS Trust

• Stroke mortality significantly lower than UK average

• Highest UK score in 2008 RCP Organisation Audit

• Investment in place to deliver world-class Stroke services

• Critical mass of specialist expertise