Following publication of the National Burn Care Review (NBCR) in 2001, the need to implement its recommendations were recognised by the creation of the UK National Burn Care Group (NBCG) in 2003.
The 143 recommendations of the National Burn Care Review (NBCR) were subsequently translated into the international Burn Care Standards (iBCS) in 2003 and have been applied to the UK burn services subsequently.
The international Burn Care Standards (iBCS) are now available in a web-based form. This allows registered burn services to longitudinally record their service development. It also provides a comparison tool to allow a given service to compare itself with a peer group of currently contributing burn services.
The international Burn Care Standards (iBCS) were originally created in 13 sections, with each Standard categorised according to the type of burn service they apply to and to their overall priority in terms of contributing to high quality burn care.
There are over 230 separate items within the international Burn Care Standards (iBCS), each one is intended to be applied to Burn Facilities, Burn Units or Burn Centres as described and defined in the National Burn Care Review (NBCR, 2001). Each one is scored by the host burn service against defined compliance criteria in a range from 0 to 4 (highest). There web based arrangements for these scores to be confirmed and verified by an external visiting team, but the host burn service can simply re-appriase itself periodically after a period of time without external review if it wishes.
The intention of this work has been to allow the creation of international Burn Care Standards (iBCS) that are aspirational gold standards. This recognises that the majority of burn services globally will not fulfill all international Burn Care Standards (iBCS) to the highest level. However this process provides a series of defined and measurable goals for burn services to aspire to and against which the burn service might monitor their progress over time. It also allows them to identify when levels of burn care provision have lapsed in some way, for whatever reason. It is suggested the iBCS can thus be usefully employed in middle and low income countries (M&LIC) as well as high income countries (HIC) as at present.
Taken into consideration with reports from the international Burn Injury Database (iBID) a complete picture of burn service achievement is gained. In the England and Wales, the Burn Care Quality Dashboard results produced from iBID each quarter add further detail to the picture.
In the UK the international Burn Care Standards (iBCS) have been successfully used to identify areas of burn care provision requiring investment and then used to monitor the improvement in provision as a consequence of that investment.
It is anticipated that as the baseline data grows with a greater numbers of contributing burn services, then the volume of peer group data for any given type of burn service (paediatric, adult, mixed age or indeed burn services in MICs or LICs) will be sufficient to allow meaningful comparisions for all types of burn services globally.
It must be appreciated that in the matter of burn service designation, the international Burn Care Standards (iBCS) will never provide the complete answer. What they can do is provide part of the evidence for such decisions. They effectively benchmark a burn service against others and detail what degree of development would be necessary for that burn service to attain the level of development felt necessary to care for a specified level of burn injury complexity.
The burn care demands of a given population will dictate the capacity of the services necessary and the geographical distribution of burn injury cases may indicate that a lower scoring burn service is the better one in which to invest and thus to ultimately designate so the population be best served. The international Burn Care Standards (iBCS) give an indication of the degree of development and thus investment necessary following designation for a given burn service to achieve the desired level.