According to the National Audit Office's 2010 report Major trauma care in England, 'There is unacceptable variation in major trauma care in England depending upon where and when people are treated. Care for patients who have suffered major trauma, for example following a road accident or a fall, has not significantly improved in the past 20 years despite numerous reports identifying poor practice, and services are not being delivered efficiently or effectively.'

Since then regional trauma networks have been developed across England. Within these networks major trauma centres provide specialised care for patients with multiple, complex and serious major trauma injuries, working closely with local trauma units. This guideline, together with the NICE guidelines on non-complex fractures, complex fractures, major trauma and spinal injury, aims to address areas of uncertainty in the delivery of trauma services.

This guideline includes recommendations on:

  • pre‑hospital triage

  • the destination of patients with major trauma

  • the organisation of a hospital major trauma service

  • documentation

  • national audit systems to improve performance

  • provision of information and support for patients with major trauma, their family members and carers.