The List - Transforming Trauma Management across NHS Wales
Betsi Cadwaladr University Health Board
Introduction:
Trauma and Orthopaedics across many Welsh hospitals faced fragmented, insecure handover processes reliant on Word/Excel or costly, non-integrated tools. These systems often breached GDPR/FOI regulations, caused missed patients, and contributed to inefficiencies, duplication, and clinical risk. Baseline audits showed 0% GMC handover compliance and 17 Datix incidents in two months. A new solution was urgently needed to ensure safe, efficient, and compliant trauma care.
Methods:
Orthopaedic trainee Mr Faisal Mohammed led the design of The LIST, a secure, auditable SharePoint-based trauma management tool using NHS Microsoft 365 infrastructure. It replaced unsafe paper systems with real-time, version-controlled digital handovers, developed using Prudent Healthcare principles and PDSA cycles. The multidisciplinary design team included clinicians, admin, IT, and governance experts, ensuring the system was legally compliant, clinically relevant, and easy to use. The LIST was piloted and refined through five PDSA cycles—each improving functionality, usability, and reach. Continuous stakeholder engagement and education ensured widespread adoption and ownership.
Outcomes:
- 100% digital handovers with zero missed patients
- 90% paper reduction
- 92% of trauma patients had clear, documented outcomes
- 70% of users saved at least 1 hour daily
- Improved compliance with GDPR, FOIA, and GMC guidelines
- £200,000+ cost savings per hospital per year
- Enhanced MDT collaboration and reduced junior doctor stress
- Replicated across three hospitals, now expanding to other specialties
Coroners and clinicians recognised its impact on handover safety and efficiency.
Learnings:
Success hinged on clinical leadership, strong governance, and early co-design. Key lessons included involving patients and IT security earlier, expanding user experience testing, and formalising satisfaction metrics. Prudent, scalable, and cost-neutral, The LIST proved local innovation can deliver national impact.
What next?
Planned expansion across NHS Wales and new specialties, with ongoing evaluation and ambitions to lead national trauma care transformation.
