The number of major trauma cases being dealt with by medics has increased during the Covid-19 crisis – while at the same time the pandemic has “slightly scuppered” plans to open two specialist centres, MSPs have heard.
Dr Martin McKechnie, the national clinical lead from the Scottish Trauma Network, said lockdown had resulted in more cases linked to domestic abuse and mental health problems.
But while Scotland was meant to have four specialist major trauma centres to treat complex cases where patients may need a range of care, so far only those in Aberdeen and Dundee have opened.
That took place in 2018, and while similar centres in Glasgow and Edinburgh were originally due to open in 2019, these were delayed, with a further hold-up as a result of the pandemic.
Dr McKechnie told MSPs on Holyrood’s Health Committee that while “we are ready to be activated as a national trauma network, there are still one or two pieces of that jigsaw still to be completed”.
He said that work on this had been “slightly scuppered over the last year, by additional pressures that we all know about caused by the difficulties and staff deployment and recruitment and demands made upon health services”.
An area that was meant to be a major trauma centre ward at the Queen Elizabeth University Hospital in Glasgow is currently being used as as high dependency area for medical patients, Holyrood’s Health Committee heard.
Dr Iain Wallace, the interim lead clinician for the West of Scotland Trauma Network, said it was “disappointing we haven’t been able to open as planned”.
Similarly Edward Dunstan, the lead clinician, South East of Scotland Trauma Network, said they were “very disappointed we are unable to open”.
Despite this he said that “significant progress” had been made in recent years “when it comes to dealing with major trauma cases”.
And while the opening of the centre in Edinburgh had been delayed, he said there was “no question in my mind we will open this year”, adding that the “team is ready to go”.
The delays in opening the centres for the West and South East of Scotland comes as Dr McKechnie told MSPs that data showed that “very major trauma has increased” during the last year.
He said: “There has been a status quo or a slight reduction in … less severe trauma, and the reasons for that are behaviourally interesting because clearly we have been in lockdown, or various degrees of lockdown, over recent months.
“But there is evidence that shows that severe trauma in terms of road traffic accidents and leisure-related activities have increased.
“One of the other areas that has increased is, sadly, domestic violence and mental health-related self-inflicted violence, but also violence against others.”
James Anderson, the lead clinician for the North of Scotland Trauma Network, said in his area “numbers have continued in absolute terms largely unchanged in terms of major trauma admissions”.
However, he said the type of injuries people were suffering from had changed, adding: “Because people are spending more time at home during the first lockdown we saw more injuries in domestic settings – that would be falls from heights, falls from domestic tasks.
“Unfortunately the clinical impression is also of an increase in injuries related to alcohol and to a degree self-harm as well, which I suspect is an indication of the levels of distress that some people are experiencing.”
And Mr Dunston said: “People might think because of the Covid pandemic, people not driving cars, that there is not as much major trauma around. It is not the case at all.
“We have hardly seen a fall off, people are injuring themselves in different ways – recently, tobogganing.”