It seems to be the case that while there has been considerable upgrading of hospital services generally since the end of the last war, and more particularly in the last few years, casualty services have lagged behind. There seem to have been deficiencies in organisation and medical staffing as well as in the provision of proper facilities for treatment.
This report is the result of a reconnaissance of the casualty departments of a number of hospitals in England, made with the object of discovering whether the criticisms of casualty services are justified. The study was neither planned nor executed to be definitive, but its results suggest that there is a need for leadership and urgent executive action on the part of hospital authorities to review, reorganize and improve the services for casualties. Part of the failure to recognize the nature of the real problem of casualties stems from the imprecision of the term.
A casualty is officially defined as a casual patient attending hospital for diagnosis or treatment outside of a normal consulting session. Thus the kind of organization hospital authorities consider necessary depends on the kind of casual patient they feel they should provide for, and this may only accidentally coincide with the real need which is to improve the services for those 'casualties' requiring immediate attention and treatment; that is, urgent emergency and accident cases.
The report gives an account of the technique developed by the team for studying hospital services and suggests how the procedure might be applied by Regional Hospital Boards. Included as appendices are suitably edited extracts from the private reports of the surveying team on medical staffing, accommodation, organisation of work and function, etc., which sketch vivid, if occasionally disturbing, pictures of the current state of affairs in the places studied.
Nuffield Trust (1960) Casualty services and their setting: A study in medical care.