A THIRD of major trauma patients wait more than an hour to be seen by an emergency consultant in hospital in Scotland.

Delays are worse in some A&E departments than others, according to an audit of the way the most seriously injured patients are looked after.

The report also reveals well under half of those who have lost consciousness or suffered a head injury are given a CT scan within an hour of reaching hospital.

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The lack of consultants and radiographers in Scottish hospitals late at night and during weekends is said to be one reason for the delays. During these hours patients, rushed to hospital by ambulance, can have to wait until these senior professionals dash in from home to assist in their care.

The creation of a network of major trauma centres in Scotland, as recommended by the Royal College of Surgeons of Edinburgh in 2012, is being cited as the way to address this problem.

Responding to the findings of the latest trauma management report, Health Secretary Shona Robison said "preparatory work" for the new centres to be based in Glasgow, Edinburgh, Aberdeen and Dundee was due to be completed by the end of this year.

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The Audit of Trauma Management in Scotland, which looked at the experiences of 3289 patients treated in 2015, found hospitals were performing better against most standards for good care. Their last report raised concern about mortality rates at Inverclyde Royal, in Greenock, but this year no hospitals were flagged-up for having more deaths than expected.

The new analysis found 67 per cent of major trauma patients were seen by a consultant in emergency medicine within an hour, up from 62 per cent the year before. But there is wide variation between hospitals, from more than 90 per cent at Edinburgh Royal Infirmary to less than 40 per cent at Inverclyde Royal and Perth Royal Infirmary.

Chairman of the Scottish Trauma Audit Group Mr Malcolm Gordon, who is also clinical director for emergency medicine at the Queen Elizabeth University Hospital in Glasgow, said: "None of the emergency departments in Scotland have an emergency medicine consultant in the department 24/7.

"We again have the problem that a patient who comes in and while injured, seems stable, and might not warrant an initial call to a consultant who is on call at home - then becomes unwell."

An increase in the number of A&E consultants is helping address the situation, he said and added: "One of the intentions with the trauma centres is to have consultants 24/ 7."

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Mr Gordon said the presence of more experienced, senior staff is associated with better outcomes for trauma patients. He continued: "You have got someone who is experienced in managing these patients. It is a complex clinical problem you are faced with. You have multiple things that need to be carried out simultaneously. You have a team of people who need to be controlled and you need a plan for the patient as to where they go next."

He noted that it would never be possible for all head trauma cases to receive CT scans within an hour, as the patients may need other life-saving interventions first. But he added: "In some sites we still do not have 24 hour resident radiographers to take the images."

Creating the four major trauma centres is hoped to ensure more consistent access to specialists around the clock and particularly during weekends. It is also hoped rehabilitation services, to ensure the best possible recovery, will become less patchy.

Mr Gordon said: "Without the development of a more effective trauma system we are not going to see much change in these things because of the resource implications of the current sites, rather than the potential resource implications for a smaller number of sites."

Ms Robison said: “This report is a vital tool in helping us to support and drive improvement in our trauma services – ensuring the best outcomes for our most seriously ill patients. Through this auditing we can identify where trauma services can be further improved and focus our efforts in these areas."