TARN System Updates & Best Practice Tariff Changes 2019-20

Data entry system updateThe Trauma Audit & ResearchNetwork (TARN) 822200002281

Recent system changes As agreed by TARN Audit Committee

Major Trauma Centre: Best Practice Tariff • NHS England have updated the BPT criteria for 2019-20 • BPT is an additional payment made to Major Trauma Centres only • Based on Injury Severity • Level 1: Moderate Trauma (ISS>8): £1,500 • Level 2: Major Trauma (ISS>15): £3,000 • Conditional on ‘Best Practice’ targets being met & data correctly entered onto TARN database

Recent system changes- From April 2019: Best Practice Tariff Criteria 2019-20 Developed by NHS England

Rehabilitation prescription 2019 • Launched April 2019- mandatory from this point. • All patients admitted from April 2019 must have this section completed in order to be eligible for BPT. • Existing BPT rehabilitation questions will remain, and continue to determine BPT payment for all patients admitted before April 2019. Must be answered to ensure BPT payment for these patients. • Prescription matches TARN system exactly • Guidance document in Resources section of TARN website. • BPT flowchart document from NHS E & Professor Chris Moran available on website

BPT Eligible • Rehabilitation needs assessed- no needs identified • Rehabilitation needs assessed- needs identified: • rehabilitation prescription completed • Prescription contains core items • Prescription developed with patient/ family/ carer • Prescription discussed with patient where possible • Prescription given to patient, GP & next care provider • Rehabilitation needs checklist completed • 2019 Rehabilitation Prescription payment flow diagram available in 2019 BPT support document in resources section of website

BPT 19-20 Consideration of Intubation • Patients with a GCS of <9 must have documented evidence of intubation being considered within 30 minutes of arrival at the MTC. • This includes patients transferred in to the MTC. • This question appears in ED and CC if a GCS of less then 9 is recorded. • If a patient arrives intubated and ventilated in the MTC no GCS should be recorded, this does not affect BPT eligibility.

Recent system changes- From April 2019: Best Practice Tariff Criteria 2019-20 Developed by NHS England * * Arrival of ambulance crew at scene

BPT 19-20 Clinical Frailty Scale • All patients age 65 or older must have a Clinical Frailty Scale completed within 72 hours of admission by a geriatrician (defined as a Consultant, Non-Consultant Career Grade (NCCG) or Specialist Trainee ST3+). • This is completed in the ‘At Discharge’ section of a TARN submission • The Clinical Frailty Scale can be completed for all patients regardless of age, but this is only a BPT requirement for those 65 and older.

Rehabilitation prescription 2019 questions: Added October 2018 Agreed by NHS-E Task & Finish group

Rehabilitation prescription 2019 questions: Added October 2018

Recent system changes-CORE dataset: From April 2019 • As agreed by TARN Audit Committee • Data Accreditationhas been amended in the following ways: • Time of Intubation: added due to inclusion in new NICE Quality standards. • People with major trauma who cannot maintain their airway and/or ventilation have drug-assisted rapid sequence induction (RSI) of anaesthesia and intubation within 45 minutes of the initial call to the emergency services (NICE Quality Statement) • Incident date/time will be reviewed separately to 999 call date/time: Due to importance of ambulance call times in new NICE Quality standards regarding intubation. • Time of provisional and final CT report: added due to inclusion in new NICE Quality standards. (Written or verbal provisional report). • People who have had urgent 3D imaging for major trauma have a provisional written radiology report within 60 minutes of the scan (NICE Quality Statement) • Time of TXA: added as time administered determines effectiveness of this treatment • Name of Previous/next hospital patient is transferred to/from: removed.

Recent system changes-CORE dataset: As agreed by TARN Audit Committee • Incident location added: Segregated Cycle Route • Used for pedal cyclists injured on a fully segregated cycle route, this does not include cycle lanes • Was the patient involved in a Major Incident: added to Incident location. • Help text guidance updated >>>

Recent system changes & guidance-CORE dataset As agreed by TARN Audit Committee • Injury Intent • Suspected domestic (intimate partner) violence added. Protection in vehicle Forward facing and Rear facing child seats (for under two years old) have been added. Help text guidance has been updated to advise the use of the generic ‘Child seat’ option if the type of child seat is not known &/or the child is 2+years old.

Recent system changes & guidance-CORE dataset As agreed by TARN Audit Committee • Anticoagulant reversal added to interventions, Pre Hospital, ED & CC • Pre-injury Anticoagulant added to At Discharge screen See Help Text for advice The options for anticoagulants are the same as for antiplatelets. If you are unsure of the reason these products were administered please record them as anticoagulants.

Recent system changes- From February 2019 • As agreed by TARN Audit Committee • Chest Wall Trauma Screen report added: • To accompany the Chest Wall Trauma specialist screen. This report pulls information both from the specialist screen & the CORE dataset and focuses on patients with 3+ rib fractures. • It will be available for users to produce anytime – from the Audit tab (as with the BOAST4 report

TARN System Updates & Best Practice Tariff Changes 2019-20