National Major Trauma Registry (NMTR) NHS Wales

Traumatic injury is a global burden and contributes largely to death and disability across the UK. For every trauma death at least two people are left with severe and permanent disability and the effects of traumatic injury have considerable long-term implications upon the quality of life of its survivors. As a result of traumatic injury, there is also a significant impact upon the associated costs to the NHS.

The NMTR was formally known as the Trauma Audit and Research Network (TARN) data collection and is an established national clinical audit for trauma care across England, Wales and Northern Ireland.  In Wales, the data set supports the NHS Wales Health Boards who deliver direct care by providing each site with case mix adjusted outcome analysis, performance of key process measures and comparisons of trauma care.  Trauma is defined as serious injuries that could result in death or a life-changing disability.

NHS England will collect, analyse, link and disseminate information on trauma patients treated in Wales as requested under section 255 of the Health and Social Care Act 2012 (2012 Act) for the purposes of improving clinical safety, patient outcomes and reducing variation in clinical practice.

The NMTR for NHS Wales will be managed by NHS England’s Outcomes and Registries Programme which was established in 2022 to consolidate and standardise outcome registries in response to the Independent Medicines and Medical Devices Safety Review: First Do No Harm (Cumberlege Review) and Paterson Inquiry (Independent Reviews).  Recommendations from these reviews were accepted by the government in their update report on government implementation, which named the Outcomes and Registries Programme as the means to deliver ‘a central patient-identifiable database’ to enable a unified model of finance, governance, technical development, data linkage and access.

Under section 259(1)(b) of the Health and Social Care Act 2012, this Notice is served in accordance with the procedure published as part of the NHS England duty under section 259(8) on the following persons in Wales:

National Major Trauma Registry for NHS Wales data

South Wales Trauma Network:

• Hywel Dda University Health Board
• Swansea Bay University Health Board
• Cwm Taf Morgannwg University Health Board
• Cardiff and Vale University Health Board
• Aneurin Bevan University Health Board

North West Midlands and North Wales Trauma Network:

• Betsi Cadwaladr University Health Board

Note that there are no hospitals that treat major trauma cases in the Powys Teaching Health Board area. The hospital that treats the patient will submit this data to the registry.

Patient Episode Database for Wales (PEDW) data

• Digital Health and Care Wales

Under section 259(5) of the Health and Social Care Act 2012 the organisation types specified above must comply with the Form, Manner, and Period requirements within this Data Provision Notice.

NHS England has been requested by Digital Health and Care Wales under section 255 of the Health and Social Care Act 2012; to establish and operate a system for the collection and analysis of the information specified for this service. The request and accompanying requirements specification are published on the NHS England website: National Major Trauma Registry (NMTR) for NHS Wales Request 2024. 

This information is requested by NHS England under section 259(1)(b) of the Health and Social Care Act 2012.

Dissemination 

Under section 262(4)(b) of the 2012 Act, DHCW requests that NHS England exercises the power it has under section 261(5)(d) to disseminate the information that it obtains by complying with this Request back to the organisations which originally provided it, for their own patients, including all derived information such as injury severity score and probability of survival for the following purposes:

• Correcting data validation errors to ensure the completeness and quality of the submitted data and;
• Direct care, including enabling local monitoring of key care metrics for trauma patients such as measuring outcomes and to support local benchmarking for assurance of safe and high-quality care and treatment through local audit, the management of untoward or adverse incidents, person satisfaction including measurement of outcomes undertaken by one or more registered and regulated health or social care professionals and their team with whom the individual has a legitimate relationship for care

Under section 262(4)(b) DHCW also requests that NHS England exercises the power it has under section 261(5)(d) to disseminate the information it obtains by complying with this Request to DHCW to enable it to use this information in accordance with its statutory functions in supporting the Local Health Boards in Wales. This will include all collected, linked and derived data, including data relating to Welsh residents treated in England.                                                                                                     

NHS England will rely upon its discretionary powers under s261 of the 2012 Act to provide regular reporting. Recipients of aggregated anonymous, small number suppressed NMTR data are the DHSC, Regulatory bodies, NICE, Healthcare Quality Improvement Partnership (HQIP), National Advisory Group for Clinical Audit and Enquiries (NAGCAE), Royal College of Surgeons, British Orthopaedic Association, Society of British Neurological Surgeons (SBNS), Headway and the Care Quality Commission (CQC).

Data will be made available via the NHS England’s Data Access Request Service (DARS) including through the NHS England secure data environment where relevant and in line with national policy guidelines. NHS England will use its discretionary powers under section 261 of the 2012 Act and under any other statutory powers to disseminate data. Organisations will be able to apply to the DARS and on approval, with the appropriate legal basis, have access to data obtained under the Request.

Requesting organisation

Digital Health and Care Wales (DHCW) is a Special Health Authority established under section 22 of the National Health Service (Wales) Act 2006 (the 2006 Act) and by the Digital Health and Care Wales (Establishment and Membership) Order 2020 (Establishment Order). DHCW was created to take forward the digital transformation needed for better health and care in Wales, making services more accessible and sustainable while supporting personal health and well-being.

National Major Trauma Registry for NHS Wales data:

Submission to the NMTR for NHS Wales data collection is uploaded on a daily basis to the Outcome Registries Platform. Data can be entered throughout the 24-hour daily period, 365 days a year. Uploads are often submitted by people in clinical roles and not within the 9am to 5pm working day. The collection is ongoing with no end date.

Patient Episode Database for Wales (PEDW) data:

PEDW extracts will be submitted by DHCW to NHS England on a monthly basis, in order to identify NMTR eligibility and to link to NMTR data to create a longitudinal database.