Board to Ward – February 2025
We are a Major Trauma Centre for the region and provide excellent, high-quality care for our patients. This is shown in our patient story this month, which comes from Sheila who shares her experience of a tertiary trauma survey, a thorough examination which 9 out of 10 major trauma patients receive. We also detail the great progress we’re making in the quality of care we offer patients – we are the most improved hospital trust in the country for emergency care. For the second month running, our Board members welcomed the Chair of our Patient Council to sit alongside them, strengthening the voice of patients at this leadership meeting.
In February’s Board to Ward we share three highlights to demonstrate progress, decisions made and share in a transparent way some key developments and learning:
Sheila’s story
Sheila is an 80 year-old, well-travelled lady who was visiting friends for lunch when she was involved in a road traffic collision. Sheila experienced multiple injuries including several fractures requiring trauma support on our new Major Trauma Ward at Derriford Hospital. In this story, Shelia shares her experience of a tertiary trauma survey and her experience of care.
Sheila shared her story as a result of the Tertiary Trauma Survey. Catie Crisp and Chris Knight (pictured), Major Trauma Advanced Clinical Practitioners, explained to the Board what this is. It is not a questionnaire, it is a thorough head-to-toe and front-to-back examination and review of investigations within 24 hours once the patient has been stabilised. It is the 3rd survey that a trauma patient has. The patient will already have had a rapid A-E assessment in the emergency department to identify and treat life and limb threatening injuries and an in-depth head-to-toe examination to identify any significant injuries once the primary survey +/- trauma CT scan has been completed. The Tertiary Trauma Survey can take an hour to complete and it helps to
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Prevent missed injuries happening – up to 40% in literature internationally
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Missed injuries can cause pain, infection, immobility, prolonged stay in hospital, delays to rehabilitation and death
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Even CT scans can miss injuries….
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Provide a chance to catch up and coordinate management plans
Around 90% of our patients at Derriford Hospital receive a Tertiary Trauma Survey and 11% of these find a missed injury – often on hands and feet, as in Sheila’s case. This is part of our continued development of the Major Trauma Service and Major Trauma Ward to holistically meet the complex physical and psychosocial needs of our patients. The Board thanked Sheila for sharing her experience, noting she really had had a tough time and, Chris and Catie for their work and sharing their expertise.
Growing need for our services
We forecast what the need will be for healthcare services, using Office of National Statistics data to forecast population growth in conjunction with Disability Adjusted Life Years (DALYs) data to understand overall disease burden and the need for emergency and planned healthcare. This year we have seen a sustained increase in demand for healthcare which is higher than last year and above what was planned.
| Service | Demand % |
|---|---|
| Emergency attendances at Derriford Hospital | Demand up 6.1% - an additional 4,646 attendances |
| All emergency attendances (including at Cumberland Urgent Treatment Centre and the Minor Injuries Units) | Demand up 9.6% - an additional 12,208 attendances |
| Emergency patient spells over 1 day | Demand up 8.5% - an additional 2,748 admissions |
| Emergency Same Day Emergency Care spells | Demand up 20.7% - an additional 3585 patients |
| Referrals for planned operations and procedures | Demand up 9.4% - an additional 11,700 referrals |
Most improved in the country for emergency care
Even though we face growing demand for our services, we have improved the quality of care offered to patients. Our Deputy Chief Executive, Sarah Brampton said that, in terms of improvements for patients who attend as emergencies, we are the most improved hospital trust in the country. We have seen a nearly 10% increase in the number of patients who are seen and treated within 4 hours, from 55% in 2023/24 to 65% in January 2025.
We know we have more work to do though as we are still 109/122 hospital trusts nationally. In 2024/25 we have achieved the following:
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Increased the number of beds for emergency patients by 35 beds
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Created a frailty same day emergency care unit
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Created a surgical Same Day Emergency Care area
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Opened 24 protected orthopaedic beds for patients needing planned orthopaedic operations
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Cared for an additional 3,585 patients through our Same Day Emergency Care /Hot Clinic pathways – avoiding admission for these patients
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Implemented a community x-ray car which to date has significantly improved patient experience by reducing the number of patients who need to be conveyed by providing assessment and wrap around care in the community. This has resulted in 9 beds saved.
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Implemented an End of Life Care service at the front door of the Emergency Department, with patients who are able being moved to a more comfortable end of life unit at Mount Gould Hospital. The Mount Gould site provides better community access for family/carers, and a quieter environment, more time to care, and now with Marie Curie specialist support available across Mount Gould and Derriford’s site and Emergency Department
