About Us

The Pre-hospital Research and Audit Network (PRANA) programme, based within the University of Southampton, is a national clinical audit of pre-hospital critical care which serves as a national collaborative asset. PRANA provides a secure and confidential, high quality clinical registry of pre-hospital critical care activity in the UK.

Background

Each day across the UK, people become suddenly unwell or get injured. In 2022-2023, ambulance services nationally attended to a total of 8 million patients, delivering immediate care and transporting patients to hospital. A small proportion (estimated 0.5%) of these patients were so severely ill or injured that their lives were immediately threatened (40,000 patients). These patients received high level pre-hospital critical care from a range of specialist NHS and independent sector CQC registered pre-hospital critical care services. Although these patients are proportionally a small subset of the medical and trauma patients cared for by ambulance services, the potential benefits in terms of reducing morbidity and mortality are disproportionately significant. Data on trauma patients in recent military campaigns and international published meta-analyses of civilian data demonstrate a 2-3 fold reduction in death in patients receiving pre-hospital critical care versus patients of equal severity not receiving such care; demonstrating the huge potential of critical care delivery in the pre-hospital setting for these patients.

Patient data is crucial to the safe and effective provision and development of clinical services. The central importance of data to saving lives was recognised by the national findings of the Goldacre Review in April 2022 and the subsequent NHS Data Strategy in June 2022 (references 17-18). At present there is no nationally coordinated data collection regarding provision of pre-hospital critical care in the UK. Whilst patient specific data is collected by the ambulance services across their pre-hospital care pathway, data regarding pre-hospital critical care treatment is not currently collated beyond provider organisations nor linked to outcome. Therefore, the potential systematic improvements created through national data collection, analysis, review and publication are currently absent within UK pre-hospital critical care.

To answer this national deficit, a team of researchers from across the country have collaborated to create a digital, cloud-based, pre-hospital critical care registry under the governance of the University of Southampton. The registry is called the Pre-hospital Research and Audit Network (PRANA).

Our Purpose

To enable data from critically ill and injured patients’ whole care pathways (from moment of recognition of illness or injury onwards) to be utilised to improve direct care for individuals, reduce risk for patients and clinicians, improve population health, evaluate the impact of new professional roles on the UK health economy, enable service planning and improvement and to support future research and innovation.