Scotland is falling behind other parts of the world in its provision of care for victims of major trauma, according to a new report. The report found mortality for severely injured patients who are alive when they reach hospital is 40% higher in the UK than in North America. This has led to a shift in healthcare policy in England, the Royal College of Surgeons of Edinburgh study said. But the situation in Scotland has not yet been addressed, it added. Major trauma is classed as injuries which could potentially result in permanent disability or death. Trauma is the leading cause of death for people under the age of 45, and is responsible for about 1,300 deaths a year in Scotland.