Care for patients suffering from major trauma, such those who have been in a car crash, has not significantly improved in the last 20 years according to a new report.

The report from the National Audit Office (NAO) also suggests that major trauma care varies greatly from hospital to hospital and that nationwide up to 600 lives could be saved were trauma care managed more efficiently.

According to the report the variable quality of care depending on hospitals can be seen in the survival rates of those suffering major trauma which varies from five unexpected survivors to eight unexpected deaths per 100 trauma patients.

It also found that only one hospital had 24 hour consultant care seven days a week, and that most consultants were not normally in the emergency department at night and weekends when major traumas are most likely to occur.

Major trauma describes serious and often multiple injuries where there is a strong possibility of death and disability. In England, the most common cause is a road accident.

Mr Amyas Morse, head of the NAO, said: "Current services for people who suffer major trauma are not good enough. There is unacceptable variation, which means that if you are unlucky enough to have an accident at night or at the weekend, in many areas you are likely to receive worse quality of care and are more likely to die.

"The Department of Health and the NHS must get a grip on coordinating services through trauma networks, on costs and on information on major trauma care, if they are to prevent unnecessary deaths."

The report has been welcomed by the Royal College of Surgeons (RCS) which says it supports its own proposal for the establishment of regional major trauma centres.

Richard Collins, vice-president and RCS lead on trauma care said: "The NAO report recognises that there are dramatic variations in care between hospitals and that it is neither cost effective nor in the best interest of patients for all hospitals to treat victims of major trauma.

"There is indisputable evidence that the introduction of regional trauma centres would save thousands of lives every year, however, very little progress has been made."