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Standards for head injury management in acute hospitals: evidence from the six million population of the Eastern region
  1. H M Seeley1,
  2. C Maimaris2,
  3. P J Hutchinson1,
  4. G Carroll5,
  5. B White6,
  6. S Kirker3,
  7. R C Tasker4,
  8. C Steward5,
  9. K Haynes1,
  10. D Hardy1,
  11. J D Pickard1
  1. 1Neurosciences Department, Addenbrooke’s Hospital, Cambridge, UK
  2. 2Emergency Department, Addenbrooke’s Hospital, Cambridge, UK
  3. 3Lewin Stroke and Rehabilitation Unit, Addenbrooke’s Hospital
  4. 4Department of Paediatrics
  5. 5Eastern Specialised Commissioning Group, Fulbourn, Cambridge, UK
  6. 6Queen’s Medical Centre, Nottingham, UK
  1. Correspondence to:
 C Maimaris
 Emergency Department, Box 87, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 2QQ, UK; chris.maimaris{at}


Objectives: To develop standards of care for head injury and thereby identify and prioritise areas of the service needing development; to report the findings from a survey of compliance with such standards in the Eastern region of UK.

Methods: The standards were collaboratively developed through an inclusive and iterative process of regional surveys, multidisciplinary conferences, and working groups, following a method similar to that used by the Society of British Neurological Surgeons. The standards cover seven topics relating to all aspects of service delivery, with standards within each objective. Each standard has been designated a priority level (A, B, or C). The standards were piloted using a self-assessment questionnaire, completed by all 20 hospitals of the Eastern region.

Results: Full compliance was 36% and a further 30% of standards were partially met across the region, with some areas of service delivery better than others. Seventy eight per cent of level A standards were either fully or partially met. Results were better in the north of the region compared with the south.

Conclusion: A survey of compliance with the head injury standards indicate that, with their whole systems approach and subject to further refinement, they are a useful method for identifying deficiencies in service provision and monitoring for quality of care both within organisations and regionally.

  • A&E, accident and emergency
  • EHIG, Eastern Head Injury Working Group
  • RNU, regional neurosurgery unit
  • SBNS, Society of British Neurological Surgeons
  • head injury
  • standards
  • health service research
  • NSF
  • long term conditions

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  • HMS has been partly funded by the Eastern Region Head Injury Working Group. JDP and RCT are supported by an MRC Programme Grant No. G9439390-ID56883. PJH is supported by an Academy of Medical Sciences/Health Foundation Senior Surgical Scientist Fellowship.

  • Competing interests: none declared

  • The following hospitals in the Eastern region participated in the regional study:

    North of region: Addenbrooke’s Hospital, Cambridge, Cambridgeshire; Hinchingbrooke Hospital, Huntingdon, Cambridgeshire; Peterborough District Hospital, Peterborough, Cambridgeshire; James Paget Hospital, Gorleston, Great Yarmouth, Norfolk; Queen Elizabeth Hospital, King’s Lynn, Norfolk; Norfolk and Norwich University Hospital, Norwich, Norfolk; Ipswich District Hospital, Ipswich, Suffolk; West Suffolk Hospital, Bury St Edmunds, Suffolk; Bedford General Hospital, Bedford, Bedfordshire.

    South of region: Luton and Dunstable Hospital, Dunstable, Bedfordshire; Hemel Hempstead Hospital, Hemel Hempstead, Hertfordshire; Lister Hospital, Stevenage, Hertfordshire; Queen Elizabeth II Hospital, Welwyn Garden City, Hertfordshire; Watford General Hospital, Watford, Hertfordshire; 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.