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

Objectives-The Royal College of Surgeons (RCS) Report on the management of patients with head injuries under the chairmanship of Professor Galasko, pu blished in June 1999, made important recommendations that will have a profo und effect on the organisation of management of head injuries and major imp lications for resources. The Eastern Region carried out an audit study to d etermine the provision of current services available, to assess the shortfa ll and likely resource implications for the implementation of the report an d hence lay the foundations for a strategic plan for change across the regi on. Methodology-A series of interviews with all 20 accident and emergency (A&E) departments across the Eastern Region and the two regional neuroscience un its (RNU) was undertaken. The results of the survey and the implications of the implementation were fed back to and discussed at a multidisciplinary r egional seminar. Results-There is considerable variation and major deficiencies in the servi ce provision currently available for the management of head injuries in the Eastern Region. There are major deficiencies in A&E resources, care of mod erate head injuries and rehabilitation and follow up of patients. There is a significant shortfall in resources for the implementation of the recommen dations. Conclusion-There are major deficiencies in the overall management of head i njuries. Although the RCS Galasko Report recommendations were agreed to be very desirable, they cannot be implemented without a large increase in reso urces in terms of funding, staffing and training.