Profound cut ultimately derailing a small hospital (4)

I believe the answer is:

gash

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'profound cut' is the definition.
'gash' can be an answer for 'cut' (a gash is a wound or cut). I'm unsure of the 'profound' bit.

'ultimately derailing a small hospital' is the wordplay.
'ultimately' indicates one should take the final letters.
'small' becomes 's' (abbreviation - e.g. clothes size).
'hospital' becomes 'h' (abbreviation for hospital on maps).
The final letter of 'derailing' is 'g'.
'g'+'a'+'s'+'h'='GASH'

Can you help me to learn more?

(Other definitions for gash that I've seen before include "Unnecessary" , "Jagged cut" , "Gaping wound" , "extra" , "Open wound" .)

I've seen this clue in The Independent.

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