Major reform of trauma services to be announced

The Government is expected to announce a major reorganisation of the trauma services in hospitals across the country as part of new reforms.

It is expected that the Mater hospital in Dublin and Cork University Hospital will be designated as major trauma centres under the new plan.

Overall, the plan is expected to see the country divided into two trauma networks for dealing with patients who, for example, have experienced car accidents, head injuries or broken limbs.

It is envisaged that one trauma network would cover the south and the other would be designated as a larger “central network”. A number of other hospitals in the proposed two national networks would still deal with less serious trauma cases.

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The new plan, to be considered by Ministers and launched either on Tuesday or later in the week, is based on a €57 million reform programme for trauma services originally put forward to the Government by then minister for health Simon Harris in 2018.

However, at that time the plan faced criticism from some ministers from the west of Ireland that the initiative was too Dublin-centric.

At that time it was envisaged there would be a trauma unit in Galway, “with specialised services” but not neurosurgical facilities.

Identifying locations

Over the intervening period the HSE and Department of Health have been involved in identifying locations for the proposed major trauma centres and the boundaries between the two proposed networks.

Medical experts have argued that trauma services should be rationalised into a smaller number of centres as high volumes of cases were needed to maintain expertise.

Mr Harris told the then cabinet in 2018 that up to 134 additional consultants could be required overall to operate the proposed new trauma system. He said at that point hospitals were dealing with about 1,600 major trauma patients annually. He said studies had consistently shown that severely injured patients were 15-25 per cent less likely to die if admitted to a major trauma centre than if admitted to other hospitals.

“The major trauma centre must treat a minimum volume of critically injured patients to maintain a critical mass of specialist expertise, which means that Dublin should have only two trauma units in addition to the major trauma centre to ensure necessary volumes,” Mr Harris told the cabinet in 2018.

Under Mr Harris’s plans, the appointment of up to 50 additional non-consultant hospital doctors as well as 226 nurses and more than 90 health and social care staff would be needed.

The recruitment of additional staff was forecast at the time to cost between €53 million and €57 million, while the capital costs for the system could be some €28 million.