Conceptualising the Post-Acute Trauma Continuity Gap After Serious Road Traffic Accidents: The Iceberg Effect, Golden Quarter Protocol and PATS Model

To define the Post-Acute Trauma Continuity Gap (PATCG) as a conceptual construct describing potential post-acute discontinuity after serious road traffic accident (RTA) trauma, and to outline the linked conceptual architecture, governance and evaluation requirements for future use. Conceptual framework paper originating in lived experience and practice-based development, supported and refined through a recorded revision-stage narrative review. No primary data were collected. Post-acute recovery following serious RTA trauma in the UK, spanning transition from acute care into community rehabilitation, primary care, case management, self-management and longer-term recovery. No formal research participants were recruited. Developmental use and feedback from individuals with RTA trauma-informed early Trauma Pain Support (TPS) programme refinement. No primary or secondary outcome measures were assessed; developmental feedback is not presented as outcome data. PATCG describes a potential structural continuity risk when acute visibility reduces while pain, trauma responses, fatigue, functional limitation, confidence loss, occupational disruption and community reintegration needs continue. The paper introduces the Iceberg Effect, Golden Quarter Protocol and Post-Acute Trauma Support (PATS) Model as linked framework components, positions them against established continuity and transitional-care models, and specifies a staged pathway of co-design, content validation, acceptability, safety and feasibility evaluation. PATCG offers a conceptual lens for serious RTA post-acute recovery. The PATS Model is not an outcome-validated intervention; existing TPS materials provide a practice-derived basis for co-design, refinement and feasibility evaluation before wider implementation.