First year success after major change to children’s services in Bristol

The major trauma centre accepts patients from across the South West of England, from Cornwall to Gloucester, covering a paediatric population of around 810,000. In its first year, the centre has seen 202 paediatric major trauma patients.The day marked the first anniversary of the hospital becoming the paediatric major trauma centre for the South West of England, as well as the centralisation of specialist paediatric services in Bristol.

Dr Giles Haythornthwaite, paediatric emergency medicine consultant and clinical lead for the new children's major trauma centre at the BRHC, said: "Becoming a paediatric major trauma centre has added a lot of value for paediatric patients in the region who are very seriously injured.

"In terms of numbers through the doors, we have been busier than predicted, but the emergency department and the hospital as whole has coped remarkably well. The centre has been peer-reviewed nationally, and our outcome measures place BRHC very well compared to other paediatric major trauma centres in the UK.

"However, we know there is still work to do, and we are far from complacent."

An important component for the major trauma centre is the helideck on the roof of the Bristol Royal Infirmary, which allows seriously injured and ill patients to be transferred by air ambulance. Giles said: "The helideck has worked very well, everything has been very smooth. Dale Robson, the supervisor, and his team deserve a lot of credit."

In the last year, many young patients have also benefitted from having all the services they needed in one location, following the centralisation of specialist paediatric services.  As well as major trauma and additional emergency activity, BRHC also welcomed paediatric burns, neurosurgery, plastic and orthopaedic services from Frenchay.

Consultant paediatric anaesthetist and paediatric burns specialist Dr Amber Young, whose service transferred from Frenchay last year, and who was instrumental in the project's planning, said: "The service at Frenchay for these specialist services for children was high quality. The services at the Bristol Royal Hospital for Children are world class. Now that we have all paediatric services on one site, the care pathways for children with burns, neurosurgical problems or major trauma have improved, importantly along with outcomes. Team working is fantastic and all the staff have worked hugely hard to make this major change a success, which it has been. This is something to be proud of."

The family of two-year old Noah Hardman, from Gloucestershire, understand the value of having all children's services in one place better than most. Noah, his two brothers Ethan and Finley, and their father Alex were all brought to UH Bristol's emergency departments following a serious car collision.

All three children suffered serious injuries, but most seriously injured was Noah, who suffered a broken neck, broken ribs and a fractured clavicle. His mother, Kirsti, said: "We'd never used the hospital before, so it was all brand new to us. Only when we came here did we realise how big it was, and the fact it was a major trauma centre. They have been, from day one, amazing.

"It's definitely been important that all the medical specialities all the boys needed were here on the same place. From day one, after the prognosis we were given for Noah, to now is phenomenal. Having the rehab centre separate was great as Noah could relax more, sleep better, and get the rehabilitation he needed, but still have all the necessary teams around if they were needed.  "When they were all brought in, Noah was in resus, the two other boys were in children's ED and Alex was in the BRI's ED. I couldn't be in three places at once, so two of the staff in ED, a nurse called Lucy and a trainee doctor called Rachel, stayed with them the whole time while the trauma co-ordinator, Trish, was a go-between letting me know how Alex was. That meant I could stay with Noah in resus. I don't think we could have done it if we hadn't had all their support.

"The physiotherapists have been fantastic. The first day they worked with him, he screamed, he didn't understand - he's only two. Now, they come in and he tries to give them a hug and gets really excited, and he knows that they're going to help him walk. They've been so patient with him. Everyone has made an effort to get to know him, and worked so hard to earn his trust, he loves them all. It worked completely for Noah, it was everything he needed to aid his recovery. We can't praise it enough."