Cranial neurosurgery report

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The cranial neurosurgery report from the ‘Getting It Right First Time’ (GIRFT) programme sets out 15 recommendations to improve the way adult cranial neurosurgery — surgery to the brain and the nervous system, is delivered in the NHS.

This report seeks to identify how cranial neurosurgery providers, national bodies and programmes could work together to deliver a better service to patients, treating them more promptly and to higher standards. 

What the report found

There are substantial opportunities to improve patient experience and outcomes, and deliver cost efficiencies of up to £16.4m through smarter procurement, avoiding unnecessary admissions and using critical care only when clinically required.

These opportunities include:
  • a streamlined admissions-to-surgery process (admitting more elective patients on the same-day as surgery rather than in advance). This could save up to 3,625 bed days a year, equivalent to a saving of £1.4m
  • increasing the number of minimally invasive day-surgery procedures such as stereotactic radio surgery, endovascular surgery and trigeminal thermocoagulation, thereby reducing the requirement for overnight admissions and reducing pressure on beds, which could save up to 245 bed days and around £95,000
  • reducing the average length of stay in critical care for cranial trauma patients who undergo surgery to five nights or fewer could save 2,030 critical care days at a cost of £1.9m and free up critical care beds for other patients
  • reserving at least one operating theatre per unit for emergency (non-elective) cases to reduce postponement and cancellation rates for elective procedures could save up to 1,095 spells in hospital per year equivalent to £1m – and deliver a major improvement in patient experience
  • increasing elective admissions for glioma tumour surgery could save up to £1.18m based on bed day reductions

The recommendations are made following visits to 24 NHS trusts in England that conduct cranial neurosurgery. This report should serve as the catalyst for further discussion and action at national, trust and individual surgeon level.

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