As indicated above, a tertiary referral service is a specific unit or hospital dedicated to the management of a specific
type of injury (e.g. burns unit). Often these units are part of an advanced trauma service but sometimes they can be
free-standing. In certain circumstances patients are referred between advanced trauma services to take advantage of the specific mix of tertiary referral components in the respective facilities. New Zealand has one specialist spinal hospital and a cardiothoracic hospital but all other advanced capabilities are integral to the service component of general hospitals. No one hospital in NZ has all the facilities necessary to care for all the aspects of complex trauma care. In addition to the sites of care, there are some specialised requirements for an effective trauma care system and these are achieved in NZ to a greater or lesser degree.