Why the Acci had to close

  • Closed July 1993 after 62 years
  • Pioneering work in the severely traumatised patients with respect to:
    • Reception
    • Resuscitation 
    • Treatment
  • Insolvent parent health authority
  • Practicality of maintaining a single specialty hospital 
  • Increasing recognition for the need of multi-specialist involvement
  • Service reconfiguration across South Birmingham
  • Future service provision across two sites – Selly Oak and Queen Elizabeth Hospitals which will work as a single coordinated unit
  • For reasons of economy the Birmingham General Hospital closed in March 1993, its medical and surgical wards were transferred to Selly Oak Hospital and the Queen Elizabeth Hospital.  The orthopaedic workload from the General Hospital transferred to the Royal Orthopaedic Hospital.  Four trauma & orthopaedic surgeons from the General Hospital transferred to the Accident Hospital.
  • Preserving the principles
    • Time honoured system with three receiving teams
    • Well known major injuries unit at the front of the hospital enabling direct delivery by ambulance to an intensive care unit
    • Need to look after MSK, head, chest and abdominal injuries
    • Need to reintegrate Accident Hospital with other surgical specialties
  • Note the foundation stone of a new Accident Hospital was laid at the Queen Elizabeth Hospital in the 1960s before the foundations were complete the project was abandoned due to the first major post-war credit squeeze.  Had the hospital been built the first present modern Major Trauma Centre in England could have been in Birmingham.
  • Between March and July 1993 parts of the vacant General Hospital were upgraded and the Accident Hospital moved into new premises on 1 August 1993 – the hospital was rechristened the “South Birmingham Trauma Unit”
  • Adoption of four team structure permitting one in four rota and junior doctors hours to be respected
  • The front door was run by A&E staff from Selly Oak, the Major Injuries Unit still received direct transfers and were received by the trauma team
  • Additional capabilities at South Birmingham Trauma Unit:
    • Each team comprised of two T&O consultants equivalent of one whole time person
    • Two registrars per team, one SHO per team, one house officer per team
    • One consultant anaesthetist per team supported by two junior anaesthetists 
    • Good specialty back up (as before) particularly in relation to cardiac, abdominal and vascular trauma
    • Direct link for CT scan transmission to Neurosurgeons
  • Attendant figures
    • Admitted twelve trauma patients per day
    • 4.500 per annum
    • Outpatients 32,000 per annum
    • Daily fracture clinics 120 patients per day
    • Admissions to MIU were 300 per annum
    • In relation to the MIU 25% of the bed days were on average taken up by burns patients
  • Residual problems
    • SBTU – geographical isolation 
    • The Department of Health desired to abandon team work and move to shift system 
    • Changes to nursing skill mix with loss of higher and experienced grades (driven by efficiency targets)
    • Plans to transfer care of injured children to Birmingham Children’s Hospital
  • Beyond 1993
    • Transfer SBTU A&E, Burns Units and Plastics Units to Selly Oak Hospital 
    • Bespoke new build A&E and MIU 
    • Direct admission to MIU by ambulance staff maintained

The relocation of the Acci to the Queen Elizabeth Hospital

  • The first phase of the building involves the re-location and re-building of the Pharmacy and the Radiotherapy Department. These are admittedly not actual parts of the new Accident Hospital, but their relocation is an essential preliminary to our new building, and I think this stage of the development is of great interest and importance to us in two ways.
    • This phase of the development in itself makes very little sense except in relation to what is to follow it, and therefore, I think it can fairly be said that the financial commitment by the Department of Health to this phase renders very much less probable any further delaying action on their part with regard to the remainder of the development. 
    • Although 1977 may seem, still quite a long way off, the actual building programme is now physically underway, which, it is intended, will go on as one continuous process until we finally have out new hospital as an end result.