Professor Stephen Smith Principal, 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 Committee 5 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 3 rd in Europe and 11 th 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 Centre St 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 Quality 2)Critical Mass 3)Time Time/Coverage 4)Major Incident Compatibility 5)Reconfiguration Alignment 6)Ease of Deliverability 7)MTC Capacity 8)Deliverability and Sustainability of Networks 9)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