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You are among the first to hear the most important news and updates happening across the East of England Trauma Network.

Newsletters will be issued quarterly.

(Volume 3 / Issue 2)

East of England Spinal Network

The East of England Spinal Network was formally established in 2022, the aim of the network is to improve the quality of spinal services and outcomes for patients across the region, each network is commissioned by NHS specialised commissioning and operates under a service specifications outlined by GIRFT (2019).

The network brings together all services in the region who provide treatment and care for spinal patients; this includes both primary and secondary care staff and local hospitals as well as the region’s spinal hubs.

The network is coordinated by a network manager and clinical lead, and meets as a board three times a year. In these meetings the clinical governance group reviews the network’s risk register and discusses any clinical concerns or developments. The Network brings together all of its members every three months for a clinical meeting to discuss best practice, learning and national developments and provides an opportunity for networking and discussions with pharmaceutical representatives.

The network also hosts sub group meetings and education days, such as the Spinal Cord Injury link worker forum and SCI education days, and later in 2023 will be launching the Spinal Advanced Practitioner forum.

There is a Spinal Surgery Network in every region across the country, with 14 in total nationally. All networks meet regularly with the national Clinical Reference Group (CRG) for Spinal and Neurosurgery. Each network has a network work plan and reports regularly to the local joint commissioning committee structure which is embedded within its ICB’s.

Over 2023/24 the East of England network is looking to support trusts with the implementation of the GIRFT Cauda Equina Syndrome (CES) pathway. It will also support trusts to implement wider spinal best practice pathways and national guidance in areas such as triage and spinal cord injury to reduce service variations.

Across the East of England there are three spinal surgery hubs, these are located at Addenbrookes Hospital, Norfolk and Norwich University Hospital and Ipswich Hospital. As a spinal hub, each hospital serves patients who are referred from a spoke hospital (local general hospital) and performs specialised spinal surgery 24/7.

Each of these hubs also care for spinal cord injury patients in the region. They have a specialised team of staff who support patients with post-operative care and support, as well as providing access to a regional psychologist. The spinal hubs work in partnership with the Spinal Cord Injury Specialist Treatment Centres such as Stoke Mandeville, Sheffield and Stanmore to ensure that patients start effective rehabilitation while awaiting transfer, and that staff are sufficiently trained in topics such as bladder and bowl care.

If you have any questions or queries please contact Rachael Scott (Senior Programme Manager: East of England Spinal Network)

New Document for Trauma Units

Guidance for Trauma Units:

Inpatient Management of Adult Traumatic Brain Injury 

Purpose

The East of England Trauma Network & East of England Head Injury service are jointly publishing standardised guidelines to aid regional Trauma Units in the management of patients with traumatic brain injury who do not require transfer to a neurosciences centre. 

These guidelines will detail assessment, ongoing monitoring, when to discuss and re-discuss with neurosurgery, and criteria for safe discharge.

As part of this process, a questionnaire is being cascaded to trauma units to gain an understanding of how these patients are currently managed, and the difficulties which regional units encounter during their care. 
A second questionnaire will follow a few months post-implementation to assess whether the new guidance has had a beneficial impact for both clinicians and patients.

Definitions and Scope
Traumatic Brain Injury (TBI) – Any damage to the brain resulting from trauma to the head. For the purposes of this guideline and questionnaire, TBI refers to any patients with abnormalities on brain imaging, neurological deterioration, or persistent post-traumatic amnesia requiring admission as a direct result of trauma/injury.

Locally managed – Patients who require admission to a regional Trauma Unit for a period of observation following TBI, but who do not require transfer to a Major Trauma Centre / Neurosciences Centre. 
Typically these patients will have abnormalities on brain imaging which have been discussed with a neurosciences centre, and where the recommendation has been to admit the patient locally for a period of neuro-observation.

Once complete you will be sent a link to download the new 
Trauma Unit Guidelines: Inpatient Management of Adult Traumatic Brain Injury

Please use this link or the QR code to access the survey

Research

There are always pieces of research being undertaken in our Network. Below are some of the current pieces which are relevant to Trauma patients:

Heads Together is a NIHR (National Institute for Heath and Care Research) funded research collaboration across Universities in the UK.

The lead for the work is Professor Andrew Bateman from the University of East Anglia. The Collaboration is exploring brain injury social work education with a view to developing a central resource point for practice and aims to improve outcomes for adults with brain injuries, and their families.

There are other brain injury related current research projects that are looking for participants – these can be found on www.headway.org.uk   

Another NIHR research project is being undertaken by Dr Jade Kettlewell who is currently based at Addenbrookes Hospital. This project is looking at the completion of the Rehabilitation Prescription.

Dr Kettlewell has involved three Major Trauma Centres in her project, which is looking at the processes involved in completing the Rehabilitation Prescription across different hospitals. The project will incorporate Case Studies that involve interviews with patients and professionals. The aim is ultimately to improve completion of the prescription.

The Spinal Injuries Association in partnership with the National Spinal Injuries Centre (Stoke Mandeville) has active research projects :

• The use of assistive technology for upper limb function in patients with Spinal Cord Injury (SCI)

• A feasibility study into the use of gentamycin for prevent of recurrent Urinary Tract Infections in SCI patients

• A study into the use of cingulotomy (a minimally invasive surgical procedure) to relieve neuropathic pain