• Wounds
• treatment

In February this year the National Audit Office (NAO) published a 37 page report called Major Trauma Care in England.1 The NAO, if you are not already aware, aims to spend the nation's money wisely, promote the highest standards in financial management and reporting, in the conduct of public business and also make beneficial changes in providing public services.

Its methodology included evaluation of statistical data, a review of key policy documents, standards of care and academic literature, an estimate of the incidence of major trauma, economic analysis/modelling of its costs, telephone interviews and visits with strategic health authorities (SHAs), visits to 10 ambulance trusts and nine acute trusts, a census of non-trauma audit and research network (TARN) trusts, a survey of TARN trusts, semi-structured interviews with the Department of Health and key stakeholders and, finally, telephone discussions with patient representative groups.

Key points from the report are:

• Annually England has at least 20 000 major trauma cases, 5400 deaths, many others with permanent …