The Scottish Audit Trauma Group (STAG) is an integral part of our ability to manage traumatic injuries in Scotland. Year on year the STAG produces this high quality, validated and insightful annual report. However, their remit and output goes far beyond a singular report. Through the local audit coordinators (LACs), highly accurate data are input in near time into an interrogatable database for use at local, regional and national level. Careful analysis, on both a clinical and statistical level, allows trends and patterns in the epidemiology and management of severe traumatic injuries to be seen.

The Scottish Trauma Network (STN) began a phased implementation in 2018 following significant investment from the Scottish Government. The North and East regional trauma networks (TN), centred around the major trauma centres (MTCs) of Aberdeen and Dundee respectively, went live in 2018 followed in 2021 by the South East and West (centred around the MTCs in Edinburgh and Glasgow). As such, this is the second annual STAG publication reporting on the STN as a whole and, as discussed in the introduction, is the most complete picture to date of the epidemiology, service performance and patient outcome in those who suffer severe traumatic injury. The STN remains incredibly grateful for the work that the STAG does.

Its output helps to validate our current structure and strategies for managing traumatic injury in Scotland. It also provides valuable insight into the strengths and weaknesses of the STN service that help drive quality improvement. The collaboration between the STN and the STAG remains strong and is synergistic. The key performance indicators (KPIs) detailed in this report continue to evolve as the STN develops and our trauma population changes. Longitudinal analysis of patient outcome data in terms of mortality, functional status, experiences and ability to work following traumatic injury remains important to assess how the STN is performing and developing. However, these data must be contextualised appropriately for meaningful conclusions to be drawn.

Saving lives, giving life back remains the STN mission and provides the optics for viewing these data. Quality of life and functional outcome following traumatic injury are perhaps the more important markers of ‘success’ rather than crude numbers of patients treated or mortality. Whilst the latter obviously remain important, patient centred care focussed on achieving the best outcome for that individual is paramount. With an aging trauma population, as seen in this latest report, this focus on realistic medicine is even more pertinent. This report, as with previous years, shows that the vast majority of severe trauma in Scotland is caused by falls and moving vehicles. Falls account for 76% of traumatic injuries across all ages, rising to 90% in those over 65 years old. Prevention strategies remain essential in reducing this largely avoidable burden with much work
still needing to be done. This report’s conclusions and recommendations are acknowledged and endorsed by the STN. They represent a considered view of the data and their analysis, identifying both where service development is needed and where additional work should be focussed in order to better understand the meaning of the data. The STN thanks the STAG for its continued hard work and dedication in the pursuit of improving the outcomes of patients who have sadly suffered traumatic injury.