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Expansion in psychological support at London’s major trauma centres 3 Apr 2025

The NHS in London has been expanding mental health support for patients at London's major trauma centres and the staff who care for them, including at Mary's Hospital. This is improving the NHS’ day-to-day resilience and its ability to step-up support in the event of a major incident in the capital – and has already benefited over 5,000 patients (December 2024).

The two-year pilot, which is now in its second year and includes a £4 million investment in London's major trauma centres, is funded by the NHS England London Violence Reduction Programme and led in partnership with NHS England’s specialised commissioning and emergency planning and resilience teams. As reported by BBC London, it involves introducing psychology teams at each of London’s four major trauma centres: King's College Hospital, Royal London Hospital, St George's Hospital, and St Mary’s Hospital. The pilot is a collaboration between NHS organisations across London, coordinated by Imperial College Healthcare NHS Trust and West London NHS Trust.

Each centre now has a full team of psychologists in place, covering both child and adults, who are providing direct mental health care to patients, alongside training and support for the wider staff team. This is helping to ensure NHS staff can identify major trauma patients who have psychological support needs early - and provide ongoing specialist support both inside and outside hospital, alongside existing community services.

Prior to launching the pilot, the NHS estimated that it would help around 2,000 patients every year and support the wellbeing of staff working in major trauma. In its first full-year of operation, the pilot supported over 5,000 patients.

Members of the Major Trauma Psychology Network in 2024

Between 30 - 40 per cent of people who undergo major traumatic injury report serious, long-term psychological disorders. This can have a devastating, sometimes lifelong, impact on patients’ lives who may need significant ongoing support from the NHS and local authorities.* Studies have shown that up to 35 per cent of trauma patients are not returning or making an incomplete return to work.** The pilot aims to change this through early identification and prevention, ensuring major trauma patients get the psychological support they need at the right time.

The teams will also allow psychological support to be quickly stepped up in the event of a major incident, such as a natural disaster, significant accident or terrorist attack – and will support patients, their families and staff in major trauma teams, as well as start the coordination of psychological support for the wider community.

The new model of care is based on evidence, including learning from previous major incidents, particularly around the need to proactively screen and treat for symptoms of psychological trauma.

The four major trauma centres are part of a unique network of hospitals, air ambulances and paramedics that provides a safety net for 10 million people in London. It’s known as London's major trauma system and treats over 12,000 people with the most serious injuries each year.

Dr Idit Albert, consultant clinical psychologist and clinical lead for the Pan London Major Trauma Psychology Network, NHS London Violence Reduction Programme, NHS England and West London NHS Trust, said: “I’m really delighted that we now have full psychological support teams in place at all four of London’s major trauma centres. This is a real step forward in ensuring equity in high quality physical and psychological trauma care – and is good news for patients and staff alike.

“Recent major incidents in London, highlighted the critical importance of emergency and community services being able to provide an early and integrated response, as well as the need for proactive investment to support infrastructure, capacity and capability. Our pilot builds on this - it allows us to be more proactive in offering psychological support and helps improve our preparedness to immediately step up in the event of another major incident.

“This is very much a collaborative effort between organisations across London, including the NHS, charities, local authorities, the Greater London Authority, Met Police, and of course experts by experience and local communities. Thank you to the many people and organisations who have made this possible.”

Dr Helen Devonshire, clinical psychologist at West London NHS Trust, who leads the major trauma psychology team at St Mary's Hospital, said: “There is growing recognition that trauma healthcare is not just about fixing the body but also healing the mind.

"We are proud that psychological support following traumatic injury is now a routine part of clinical care at St Mary’s Hospital's major trauma centre. This care goes beyond hospital stay. We also provide follow-up psychological care to patients once they have been discharged home, which can be a lifeline when patients are not sure who to turn to.

"As well as improving patient care directly, we are also investing in the psychological wellbeing of our major trauma centre colleagues, ensuring the team are supported, resilient and capable of doing their best under the most difficult conditions”.

Professor Shehan Hettiaratchy, major trauma director and consultant plastic and reconstructive surgeon at Imperial College Healthcare NHS Trust, said: "We have an outstanding major trauma centre, which is now even stronger with our psychology team fully integrated.

"We've always been clear that our role isn't only to save lives. We also help our patients come to terms what what's happened and rebuild their lives. Our psychology team play a vital role in this journey, alongside our wider team, helping patients one step at a time.

"The pilot also recognises the mental strain that working in major trauma can place on our staff team, who treat and care for people with the most severe injuries in often highly pressurised situations. Having a dedicated psychological service embedded within the centre providing training and day-to-day support has been transformative and I know will continue to improve staff wellbeing.”

Professor Karim Brohi, clinical director of the London major trauma system and trauma and vascular surgeon at Barts Health NHS Trust, said: “The introduction of the major trauma psychology teams across London has been transformative for our patients and for our staff. Major trauma staff have to deal with some of the most harrowing scenes imaginable, day after day. London delivers world class injury care, and we have the best survival rates anywhere.

“The psychology service allows trauma survivors to understand what has happened to them and to rebuild their lives. For our staff, psychological support and training allows them to look after themselves and thereby continue to provide the best care for their patients. I am excited to see how the service develops in the future."

Martin Griffiths, the London clinical director for violence reduction at NHS England and consultant trauma and vascular surgeon at Barts Health NHS Trust said: "This is a significant investment in the capital's major trauma centres, which improves the NHS's ability to support major trauma patients and staff through some of the most difficult moments in their lives.

"A major traumatic injury can have a huge impact on many different parts of a patient's life, both physically and emotionally. By working in partnership with the NHS and charity partners like Redthread and St Giles Trust, we want to ensure that teams can intervene at critical moments to help patients rebuild their lives."

Shelah's story

NHS England has further information about the London Major Trauma Psychology Network.

* Prevalence of depression and posttraumatic stress disorder after acute orthopaedic trauma: a systematic review and meta-analysis.

** A study of outcomes of patients treated at a UK major trauma centre for moderate or severe injuries one to three years after injury.