London Major Trauma System: a review of an organised trauma system and the challenges it faces

London Major Trauma System (LMTS) was the first organised trauma system in the United Kingdom. It was created in 2010 in response to multiple reviews that suggested a large number of deaths from trauma may have been preventable. LMTS has all the features of a modern organised trauma system, including regionalisation, integration of care, transfer services, trauma teams, and a world leading research service. Since its introduction the benefits on mortality, morbidity, and other key metrics have been widely demonstrated. Despite its success, LMTS still faces a number of challenges; most notably from the ageing population, but also in ensuring equity of improvements across the entirety of the trauma network and throughout the whole patient journey. The very nature of LMTS being an inclusive and organised trauma system will help it in facing these challenges.