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Urgent and emergency care services in England

Major trauma services

Major trauma describes serious injuries that are life changing and could result in death or serious disability, including head injuries, severe wounds and multiple fractures.

Major trauma centres are set up to provide specialised trauma care and rehabilitation. They are hubs that work closely with local trauma units.

There are 27 major trauma centres in England. Of those:

  • 11 treat both adults and children
  • 11 only treat adults
  • 5 only treat children 

You can view the location of major trauma centres in England using the map provided on this site. Look up major trauma centres in England (PDF, 777kb).

Major trauma centres operate 24 hours a day, 7 days a week. They are staffed by consultant-led trauma teams that meet the patient on arrival at the hospital and have immediate access to the best diagnostic and treatment facilities, including blood transfusion, CT scans and emergency operating theatres.

Pre-hospital care

Ambulance crews will make an assessment at the scene using triage tools to ensure that those with major trauma are taken directly to a major trauma centre for urgent treatment.

This may involve bypassing their local hospital so patients can immediately receive specialist care with access to CT scans and innovative technology.

If the distances are long, patients may have to be taken to their local trauma unit first for stabilisation before they can transfer to the major trauma centre for definitive treatment.

Pre-hospital care is crucial – it means the ambulance service and the helicopter emergency medical service work closely with the major trauma network to ensure the most urgent patients are sent to the most appropriate place.

What happens at the trauma centre?

Once patients arrive at the trauma centre, they will immediately undergo a full assessment by a consultant-led trauma team trained to deal with these types of injuries.

Major trauma centres also treat children. The management of specific injuries and drug administration will differ for children, but the focused response from the children's trauma team will essentially be the same.

In life-threatening situations, the doctors and nurses from the trauma team will do what is required to save a person's life. If the patient is unable to give consent because they are incapacitated, treatment will still be carried out.

In these cases, the reasons why treatment was necessary will be fully explained once the patient has recovered. Read more about consent to treatment.

All relatives will be allowed to visit patients both at their bedside and in the ward. Find out more about visiting someone in hospital.


Patients who have suffered a severe injury often need complex reconstructive surgery and care from many professionals, such as physiotherapists, occupational therapists, and speech and language therapists. Psychological support for patients and their families is also very important.

Many patients need a personalised rehabilitation programme to help them return to an active life, which can take many months.

This care will start at the major trauma centre and then continue in the community or at a hospital closer to home. Some patients, such as those with paralysis, may need to go to a specialist rehabilitation unit. 

Many charities offer help and support to patients and families that have experienced trauma. For example, After Trauma and Day One provide access to support groups and resources. 

What does good trauma care look like?

Good trauma care involves getting the patient to the right place at the right time for the right care. This means:

Trauma care flow chart

  • Having the seriousness of the injury identified as early as possible, ideally at the scene of the incident.
  • Investigations such as CT scanning should take place immediately on arrival at the first hospital.
  • If the injury requires specialist care, the patient should be moved to a major trauma centre as quickly as possible.
  • Patients should have access to an appropriate programme of rehabilitation to assist their recovery.  


Page last reviewed: 07/09/2016

Next review due: 07/09/2019

Disorders of consciousness

Read more about impaired consciousness after brain injury, including comas, vegetative states and minimally conscious states

Intensive care

Find out about intensive care units (ICUs), specialist hospital wards for people who are seriously ill