Up to 600 victims of stabbing, shooting and road accidents die each year due to “unacceptable” variations in how NHS hospitals manage trauma cases, according to an official report.

Trauma care has not “significantly improved” for more than two decades, despite ongoing criticisms of the treatment given to assault, blast, burn and fall victims, said the National Audit Office.

There is indisputable evidence that the introduction of regional trauma centres would save thousands of lives every year

Between 450 and 600 more lives could be saved every year if hospitals were better organised, it said.

NAO comptroller and auditor general Amyas Morse said: “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.”

A total of 193 hospitals currently use their accident and emergency departments to treat trauma cases.

But it amounts to just 0.2 per cent of their total activity, meaning there is insufficient experience among some medics.

Gathering experts at regional centres would lead to improvements in the speed and quality of treatment given, despite increasing the distance travelled to receive care in some cases, the NAO said.

Guidelines from the National Institute for Health and Clinical Excellence say head injury casualties should have a CT scan within a hour of arriving at hospital.

But based on the figures collated, the current average waiting time is one and a half hours - and more than two hours for 25 per cent of patients.

The NAO highlighted a network being set up in London, based on the principle that ambulances should be able to reach a trauma centre within 45 minutes, as an example of how the system could be improved.

Richard Collins, of the Royal College of Surgeons of England, said: “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.”