Quality requirement 3: Emergency and acute management

The Eastern Head Injury Group Study (EHIS) was set up in 2000 to assess the current provision of HI services in the Eastern Region, and to facilitate strategic planning and development of high quality acute and rehabilitation services in line with national guidance. They have developed a number of useful resources including Head Injury Standards for Acute Hospitals, a set of rehabilitation codes which map patient pathways through the rehabilitation stages, and a template for HI coordination.

The A&E department at North Tyneside and Northumbria NHS Trust has implemented the NICE Head Injury Guidelines and as result has virtually eliminated the use of skull x-rays in patients presenting with head injuries. The use of CT scans has greatly increased. For people admitted with head injuries at Newcastle General Hospital A&E department, they have introduced a multidisciplinary assessment process, which involves rehabilitation physicians and acute neurosurgeons.

See pages 30-31 and 50 of the Action on Neurology report for information on this example of a care pathway for people admitted to A&E with acquired brain injury.

The unit has developed an accredited course to educate key workers about spinal cord injury (SCI). The key workers support the care of people with SCI within a local district general hospital environment prior to transfer to a specialist spinal injuries unit (SIU). The benefits of having a key worker in post include earlier transfer of patients to an SIU, a reduction in secondary complications and improved compliance with evidence-based protocols of care.

The NHS Modernisation Agency has produced The Neuroscience Critical Care Report, which includes examples of good practice in the field of emergency care.