Cardiff recommended as major trauma centre location
University Hospital of Wales in Cardiff has been recommended to become Wales' first major trauma centre (MTC), BBC Wales understands.
There is a network of 27 MTCs in England, providing specialist care for the most life-threatening injuries.
A panel of independent experts has been assessing Cardiff's bid, along with one from Morriston in Swansea.
Cardiff is the only Welsh specialist neurosurgery hospital and many major trauma cases involve head injuries.
The panel of experts from outside Wales was tasked by NHS Wales to assess both bids.
BBC Wales understands they concluded that Cardiff should be the preferred option - partly because of the range of specialist services currently located there.
As well as its neurosurgery specialism, it is also home to Noah's Ark Children's Hospital of Wales and it was argued Cardiff was also better placed to provide care for seriously injured children.
However experts from Morriston in Swansea had argued it was better located to become a MTC - with a greater proportion of the south Wales population living within an hour's travelling time.
Morriston also has a well-established burns and plastics surgery unit - which serves Wales and the south west of England.
The Welsh Government said: "We are pleased with the progress that the NHS has made in developing plans for a major trauma network for south Wales, but no decision on the location of the MTC has been made as yet."
Cardiff, if it becomes the MTC for south Wales - would work with the support of other hospitals - designated major trauma units (MTU).
It understood the expert panel has recommended Morriston should be designated a MTU as part of that wider network.
But a final decision could still be many months away.
Discussions are continuing between the Welsh NHS, individual health boards and local community health councils - which represent patients views,
But if they cannot come to an agreement, a final decision may have to made by Health Secretary Vaughan Gething.
What is a major trauma centre?
- It is a specialist hospital responsible for the care of the most severely injured patients.
- It has a concentration of expertise in dealing with a wide range injuries meaning expert care is available 24/7.
- If it is safe to do so patients with serious injuries are usually transferred directly to the major trauma centre instead of the nearest A&E.
- Major trauma cases are relatively rare but getting to right care quickly can make a "huge" difference to their chances of survival and subsequent quality of life.
- MTCs were first established in the UK in London in 2010 and a network has opened up across England.
- There are plans for four MTCs in Scotland.
- Examples of MTCs in action includes St Mary's Hospital in Paddington after the Westminster Bridge terrorism incident in March.
Key elements include a large emergency department (A&E), neurosurgery, plastic surgery and burns, specialist orthopaedics and general surgery.
Neither the University Hospital of Wales or Morriston currently offer the full complement of these services.
Bob Hudson, director of NHS Wales Health Collaborative, said: "It is anticipated that whatever the final decision both hospitals will play an enhanced role within the trauma network.
"We anticipate that proposals for the development of the trauma network and the preferred location of the MTC will be developed for presentation to Health Boards by September 2017."
What about north Wales?
It is already arguably better served than south Wales as badly injured patients are taken to the MTC in Stoke. The same formal arrangement applies for parts of mid Wales.
But given the expertise required - and the fact major trauma cases are rare - it is unlikely north Wales would be able to sustain its own MTC.
The absence of a major trauma set-up in Wales has been called "embarrassing" with claims that NHS Wales has been falling behind other developed countries in its care of seriously injured patients.
Survival rates in England have improved significantly since a major trauma care network was established over the past seven years.