23 The Role of Telemedicine in the Management of Acute Trauma Referrals to a Regional Plastic and Hand Surgery Unit in the South East of England

1.1 The Queen Victoria Hospital The Queen Victoria Hospital (QVH) provides Burns and Plastic Surgery services, on a hub and spoke model, to the South East of England (4.5 million population), with a catchment area extending into the Southern aspect of greater London. Geographically the region is 50 by 70 miles; the transport links are primarily organised towards London, rather than East Grinstead where the QVH is situated, halfway between London and the coast. For some patients, travelling to the QVH can be time consuming and expensive. The QVH receives about 400 acute trauma and burns referrals per month; our own audits demonstrate an increasing demand for trauma services each year. Hand injuries account for the majority of referrals to our service and the London and South East geographical region is under considerable capacity strain with 17% of hand surgery units being closed to referrals at any one time (Skillman et al. 2003).