Sometime ago I had agreed to open up a session at the North West Major Trauma Symposium. This was being run by the University and the organiser had persuaded me that I should attend as I could showcase the University’s work around translational medicine, collaboration and partnership opportunities. The conference focus was on major physical trauma caused by disease and accident. Whilst such trauma can result in mental health issues (anxiety and long term depression being the most prevalent) it wasn’t the kind of trauma I was familiar with.
It also seemed to be aimed at medical folk, and 'skill thrill' surgeons in particular. The thought of spending a long morning in this company did not fill me with joy. How wrong could I have been! It was brilliant. Humour, science, innovation, humanity, challenge and commitment were the narrative elements that shaped the presentations and discussions. Surprisingly, I knew 3 of the speakers from my previous roles in the NHS and within Universities.
Two former colleagues were also mentioned by speakers. One was Professor Ged Byrne, a surgeon and Director of Quality at Health Education England. His name came up in a session about trauma services in Ethiopia. Ged has long been involved in developing clinical learning placements for UK health professionals in resource scarce countries, particularly those in Africa. I was privileged to spend a very interesting and humbling 10 days with him in Uganda, and it was an experience I will never forget.
The other name mentioned was Professor Dame Sue Bailey, who as well as being a child and adolescent consultant psychiatrist, is also the current Chair of the Academy of Medical Royal Colleges. 35 years ago we worked together in establishing the only NHS Forensic Child and Adolescent service in the UK. It was a service aimed at making a difference to the lives of troubled and troubling children, and I have very fond memories of those pioneering times. However at last Thursdays conference it was older people that provided the greatest focus.
Professor Leela Biant, Academic Head of the Department of Trauma and Orthopaedic Surgery at University of Manchester, and a practicing consultant orthopaedic surgeon presented a paper that looked at trauma services in 2020. Surprisingly, trauma is a growing and serious public health problem. In the UK over 17,000 deaths a year are the direct result of trauma injuries; there are 720,000 admissions to hospital and over 6 million visits to A&E departments annually. Equally surprisingly was the fact that it’s not 19 year old boys driving cars at high speed and then crashing them that accounted for these figures, but older people tripping over a rug or something similar (a low energy, low height fall) and sustaining major trauma injuries as a result.
It is the case that today trauma still remains the largest cause death for people aged under 25, and worldwide, young men aged up to 25 are 3 times more likely to die as a consequence of a road traffic accident than young women. However, it is those over 60 and particular 75 years of age that have the highest incidence of trauma. Its projected there will be 101,000 hip fractures a year by 2020. It is the most common trauma injury associated with this group. It is also likely that most will be female, with nearly 50% of the falls occurring to people living in community based residential settings like nursing homes. Older people are nearly twice as likely to die from their trauma as younger people with equivalent injuries, and some 20% will die within 4 months after the trauma occurred.
Now you may be wondering why I am sharing this information with you. Well in my mind there are a couple of connections that can be made – one was to the story published last week that in the UK, nearly half the population are giving up drinking alcohol. The good news was this group were in the main those aged under 45 so reducing long term harmful alcohol related health problems. The bad news is that alcohol related hospital admissions have risen by 64% over the last decade. There were some 1.1 million alcohol related admissions last year, predominately for liver and heart disease and cancers. Trauma related admissions are not included in these figures. It’s the Baby Boomers (those aged between 53-71 in 2017) who are largely responsible for these challenging statistics. Just because they are in their 60s it appears they are not slowing down when it comes to alcohol consumption. Its easy to picture the scenario - too many glasses of red wine, a loose mat, a low fall = major trauma head injury or other severe fracture = and possible death.
The second reason is that the health promotion has to be more effectively communicated to folk of my age if the health care of this growing group in our population is to be contained and better health well being outcomes achieved. Interestingly, they are a generation that take health issues seriously, they will seek advice and help for a wider range of mental and physical health problems, and will invest in self-improvement – but excessive alcohol consumption remains stubbornly unchanged for many in this group. As someone who is an educator of health care professionals, and responsible for health care service provision, this fact worries me a lot. Something needs to be done if we are going to avoid the growing tsunami of trauma related problems. Suggestions please, on a post card to the usual place…