UK Researchers Find Deficiencies in Head-Injury Care

Two recent studies of more than 200 UK accident and emergency (A&E) departments have revealed poor rehabilitation and follow-up of patients with head injuries. The studies also pinpointed major deficiencies in the funding, staff, and services of the departments. The studies, published in the September 2001 issue of the Emergency Medical Journal, were conducted by the Royal College of Surgeons and the Society of British Neurologic Surgeons.

While all the hospitals surveyed had computed tomography (CT) scanning facilities, more than one-third complained of access problems because of lack of resources or radiologists. The report included 20 acute hospitals but only one offered specialist neurosurgical care to patients requiring treatment for more than 48 hours. More than half of all head-injury care was provided by general or orthopedic surgeons, not neurosurgeons. Access to specialist beds was difficult for almost one-third of respondents. Immediate and long-term rehabilitation was poor, and hospitals had no formal system of follow-up for patients with minor head injuries. Only one-third of A&E departments were involved to some degree in the care of head injuries as recommended.

The studies also found that few hospitals had adequate numbers of consultants. To achieve recommended levels, consultants would have to be increased by more than 70%. The authors conclude that UK levels of care for head-injured patients are far from optimal.




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