According to the National Audit Office, six hundred lives a year could be saved if hospital services for those who suffer life-threatening injuries in accidents were better managed.

Emergency consultants are freqently not provided at night and weekends, when many accidents and injuries happen.  Without rapid diagnosis and treatment, people can suffer serious disabilities and lives can be lost.

Edward Leigh, chairman of the public accounts committee, blamed the government.

He said:

“For more than 20 years almost nothing has been done to remedy the lamentable provision of care for people suffering serious injuries, most commonly as a result of a road accident or fall,”

“The Department of Health and NHS trusts were warned by the Royal College of Surgeons in 1988 and similar warnings have been repeatedly published since then but progress has been slight.

“The shocking truth is that an estimated 450 to 600 lives are being unnecessarily lost each year because of poor care.”

“Only one hospital in the entire country, the John Radcliffe in Oxford, has the necessary specialist consultant cover 24 hours a day, seven days a week

“That means people who have an accident outside of office hours are unlikely to be seen immediately by somebody who can decide what action has to be taken.

“This means that your chances of avoiding death or disability can turn on when your accident happens and to which hospital the ambulance takes you.  Some hospitals have the appropriately trained surgeons for major trauma, many do not; and some areas have formal bypass arrangements for ambulances, but many do not.

“The situation could be worse than we think because two fifths of all hospitals with A&E departments do not provide statistics on how they deal with trauma patients. Major trauma services are currently provided in a disorganised and uncoordinated fashion. It cannot be beyond the capabilities of the Department and NHS trusts to establish a system, at little extra cost, enabling seriously injured patients to be delivered quickly to those parts of the health service best equipped to treat them.”

The report reveals that survival rates vary significantly between hospitals around the country, ranging from five unexpected survivors to eight unexpected deaths per 1,000 patients.

“There is unacceptable variation, which means that if you are unlucky enough to have an accident at night or at the weekend, in many areas you are likely to receive worse quality of care and are more likely to die,” said Amyas Morse, head of the NAO.

Dr John Heyworth, president of the College of Emergency Medicine, said the NAO report presented

“a picture which we would recognise completely and we share these concerns. There has been a 20 year hiatus in trauma management and frankly that is unacceptable.

“We have known what the answers are for about 20 years but there has not been the commitment from various administrations in government and at a regional level to take this forward.”

He said that major trauma centres need 16-18 consultants to provide 24/7 cover, while the average hospital currently has four, which is “self-evidently hopeless” and needs to be brought up to at least 10.

While the government has invested in extra scanners which can locate brain injury, they are often at a distance from the emergency department or not immediately available, he added.