To ask the Minister of Health to detail the specific support that exists for people who have experienced trauma.

SPPG can only comment on Major Trauma i.e. serious multi-system injury which requires multi-specialty input and has an Injury Severity Score (ISS) between 9 and 15+. All other trauma (ISS <9-15+, minor injury, or psychological trauma) is outside our ability to answer.

When a person sustains trauma and if they meet certain clinical criteria then NIAS will bring them to the Major Trauma Centre (MTC) at the RVH for multi-specialty care; this is true for patients if they are within 45 minutes' drive of the RVH. If a person sustains trauma but it does not meet the clinical criteria or if they are outside of a 45 minute drive time to the MTC, then they will be taken to their local Type 1 trauma-receiving unit. The clinical criteria is set out in the Northern Ireland Major Trauma Triage Tool (NIMTTT) and the governing SOP is called 'The Referral and Reverse Referral of Patients to the Major Trauma Centre...'. This type of major trauma system has been shown to improve survival rates by up to 20%.

There are seven sites that are classified as Type 1 hospitals in Northern Ireland: Altnagelvin (ALT), South West Acute Hospital (SWAH), Causeway (CAU), Antrim Area Hospital (AAH), Craigavon Area Hospital (CAH), The Ulster Hospital Dundonald (UHD), and Daisy Hill Hospital (DHH). However, the latter (DHH) has recently removed acute surgical provision and will be routinely bypassed by NIAS for cases of significantly injured patients.

At the Type 1 receiving unit the patient will avail of the full range of commissioned services associated with the management of physical trauma at that site. This will include emergency department input, imaging and diagnostics, acute surgical intervention and in-patient recovery. AAH and CAU will not provide orthopaedic surgical input as it is not available in the Northern Trust; in such cases they may directly refer orthopaedic patients to RVH if required. Additionally, if it is subsequently determined at a type 1 unit that a patient hits predetermined major trauma markers then they will be automatically sent to the MTC under the 'Call & Send' protocol.

At the Major Trauma Centre (MTC) in Belfast arriving patients will also avail of the full range of commissioned services for major trauma. These include emergency department input; imaging and diagnostics; interventional radiology; acute surgery (neuro, vascular, cardiothoracic, orthopaedic, general); plastics are located at UHD but a local agreement provides early access to services at the RVH site.

The MTC also provides a dedicated major trauma unit/ward which provides a consultant-led multidisciplinary team of trauma specialists. The major trauma unit provides direct input from non-medical consultants in rehabilitation medicine; a regional nerve block room; a major trauma review clinic; and a fracture clinic. Clinical psychology is currently not commissioned for major trauma at the MTC and any input from that specialty has been on a good will basis to date.

The Royal Belfast Hospital for Sick Children (RBHSC) serves as an unofficial paediatric major trauma centre. Similarly to the adult site if offers the full range of commissioned services which relate to trauma.

The Acquired Brain Injury Unit (RABUI), the spinal unit and the amputee unit are all based at Musgrave Park Hospital (MPH) and provide regional rehabilitation services for each category of recovering patient. The Whiteabbey Nightingale legacy model also provides a GP-led regional orthopaedic step-down in-patient unit for recovering patients with less complex needs.