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Emerg Med J 2001;18:358-365 doi:10.1136/emj.18.5.358
  • Original Article

Implementing the Galasko Report on the management of head injuries: the Eastern Region approach

  1. H M Seeley,
  2. C Maimaris,
  3. G Carroll,
  4. J Kellerman,
  5. J D Pickard
  1. Academic Neurosurgery Unit, Cambridge University, Addenbrooke's Hospital, Cambridge, UK
  2. Emergency Department, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK
  3. Eastern Region Specialist Services Commissioning Group, Great Abington, Cambridgeshire, UK
  4. Department of Neurosurgery, Oldchurch Hospital, Romford, Essex, UK
  1. Correspondence to: Mr Maimaris (chris.maimaris{at}msexc.addenbrookes.anglox.nhs.uk)
  • Accepted 17 June 2001

Abstract

Objectives—The Royal College of Surgeons (RCS) Report on the management of patients with head injuries under the chairmanship of Professor Galasko, published in June 1999, made important recommendations that will have a profound effect on the organisation of management of head injuries and major implications for resources. The Eastern Region carried out an audit study to determine the provision of current services available, to assess the shortfall and likely resource implications for the implementation of the report and hence lay the foundations for a strategic plan for change across the region.

Methodology—A series of interviews with all 20 accident and emergency (A&E) departments across the Eastern Region and the two regional neuroscience units (RNU) was undertaken. The results of the survey and the implications of the implementation were fed back to and discussed at a multidisciplinary regional seminar.

Results—There is considerable variation and major deficiencies in the service provision currently available for the management of head injuries in the Eastern Region. There are major deficiencies in A&E resources, care of moderate head injuries and rehabilitation and follow up of patients. There is a significant shortfall in resources for the implementation of the recommendations.

Conclusion—There are major deficiencies in the overall management of head injuries. Although the RCS Galasko Report recommendations were agreed to be very desirable, they cannot be implemented without a large increase in resources in terms of funding, staffing and training.

Footnotes

  • * Porter J, Swann I, et al. Implementing the Galasko Report on head injury care—implications for A&E departments. London: BAEM, June 2000.

  • * RCS. Report of the working party on the management of patients with head injuries. London: 1999:6.

  • Funding: H Seeley has been partly funded by the Eastern Region Specialised Commissioning Group.

  • Conflicts of interest: none.

  • The following hospitals participated in the regional study: north of region: Addenbrooke's Hospital, Cambridge, Cambs, Hinchingbrooke Hospital, Huntingdon, Cambs, Peterborough Dsitrict Hospital, Peterborough, Cambs, James Paget Hospital, Gorleston, Great Yarmouth, Norfolk, Queen Elizabeth Hospital, King's Lynn, Norfolk, Norfolk and Norwich Hospital, Norwich, Norfolk, Ipswich District Hospital, Ipswich, Suffolk, West Suffolk Hospital, Bury St Edmunds, Suffolk, Bedford General Hospital, Bedford, Beds, Luton and Dunstable Hospital, Dunstable, Beds. South of region: Hemel Hempstead Hospital, Hemel Hempstead, Herts, Lister Hospital, Stevenage, Herts, Queen Elizabeth II Hospital, Welwyn Garden City, Herts, Watford General Hospital, Watford, Herts, Basildon Hospital, Basildon, Essex, Broomfield Hospital, Chelmsford, Essex, Colchester General Hospital, Colchester, Essex Princess Alexandra Hospital, Harlow, Essex, Southend General Hospital, Westcliff on Sea, Essex, Oldchurch Hospital, Romford, Essex.

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