The Managed Service Network for Neurosurgery was awarded national service designation in 2014. The National Specialist Services Committee (NSSC) recommended that funding for the MSN should continue and the Cabinet Secretary approved this recommendation on May 21st 2014. The MSN continues to report to the Cabinet Secretary on an annual basis.
The Annual MSN Report: Paediatric Neurosurgery in Scotland 2015
We are pleased to announce the publication of this year’s national report: Paediatric Neurosurgery in Scotland 2015 . This report represents the culmination of two years work developing national standards for paediatric neurosurgery and auditing the service in each of the four centres. The MSN is grateful to Dr Catherine Calderwood, Chief Medical Officer for contributing to the report and we would also like to extend our thanks to members of the clinical teams throughout the country, third sector partners and our parent representatives for their participation in the Audit Review Panels that visited each hospital. We welcome your comments in relation to the report, these should be sent to: firstname.lastname@example.org.
In 2016 the national report on the paediatric service will focus on two quality performance indicators: traumatic brain injury and neuro-oncology and the results of a patient and parent patients experience survey.
We have started working on the development of four national pathways in the adult service for the following four conditions: subarachnoid haemorrhage, traumatic brain injury, brain tumour and cauda equina. We have taken an integrated approach to the development of the pathways with our various reference groups each designing their own discipline-specific component of the pathways. Our patient groups Neurosurgical Voices will be working with the MSN Hubs on the development of the patient information leaflets for the four conditions.
New National Clinical Director
Miss Jennifer Brown took up post as National Clinical Director of the MSN in October 2015. Although a new National Lead for Paediatric Neurosurgery will be appointed in early 2016, Jennifer will complete the series of national reports arising from the national audit programme of paediatric neurosurgery over the course of 2016.
The MSN is grateful to Mr Ballantyne for his six years of service to the network and is reassured that we can still draw upon his encyclopaedic knowledge of the history and development of the MSN since its inception in 2009. He continues to be the MSN Lead Consultant in NHS Tayside.
The MSN Hubs
Each of the four adult neurosurgical centres now has a MSN Lead Consultant who is responsible for the running of the local multidisciplinary MSN Hub in their centre. The remit of the MSN Hubs is to provide a link from the MSN central office to each of the units and to encourage the staff in the centres to engage with the MSN in improving the care for patients and their families. The membership of the Hubs is drawn from the local multidisciplinary teams and national MSN reference groups – everyone is encouraged to attend if they have an idea or an issue they would like to discuss.
The MSN Audit Facilitators support the Hub meetings and are happy to liaise with staff who would like to join in. The MSN Lead consultants sit on the MSN Board and report on activities in their centres at each meeting so each unit has a direct link to the Board.
Could you help us make our services better for children and young people?
A Patient Experience Survey is being introduced across all four Scottish Paediatric Neurosurgery Centres which is part of the National Audit of Paediatric Neurosurgery. To find out more or to download a copy please visit our Paediatric page at http://www.msn-neuro.scot.nhs.uk/Paediatrics/
The National Service
Aberdeen Royal Infirmary
The Department of Neurosurgery in Aberdeen based in Aberdeen Royal Infirmary (ARI), Foresterhill provides a full service in the field of Neurosurgery for both adults and children. This is the only regional centre in the northeast of Scotland. The Neurosurgical Unit has the largest geographic catchment area in the UK, serving a population of 800,000 from across Grampian , Highland , Orkney and Shetland.
Aberdeen Royal Infirmary has a complement of 975 beds on the teaching hospital site with the Medical School of the University of Aberdeen. Aberdeen Royal Infirmary is the principal adult acute hospital of the Grampian area.
Neurosurgical and Neurological services share a thirty-nine bedded ward (ward 40) including a high dependency area. The Neurosurgical Unit has 29 dedicated neurosurgery beds. Four of these beds are in a specialist neurosurgical High Dependency Unit (HDU) inside the ward 40. The ward is staffed by a multidisciplinary team with specialised experience and training in neurosurgical/neurological care. A full neuro-radiological service is provided, including CT, MRI, angiography and PET scanning.
The Neurosurgical Unit has access to a 12 bedded Intensive Care Unit (ICU), where patients are managed under the joint care of Neurosurgeons and Intensivists.
Clinical Neurophysiology and Neuropsychology services and the Acute Stroke unit are located adjacent to the Neurosurgical Unit thus creating a comprehensive neurosciences unit. Close links exist with Rehabilitation service at Woodend hospital.
There are four Consultant Neurosurgeons in the Neurosurgical Unit. All four Consultant Neurosurgeons are deal with both adult and paediatric emergencies.
Paediatric Neurosurgery is carried out in appropriately equipped facilities in the Royal Aberdeen Children Hospital (RACH) that joined to the adult ARI Hospital, Foresterhill. The RACH operating theatres are equipped for neurosurgery and are served by a team of specialist paediatric anaesthesia and theatre staff.
Information about services and advice on travel to hospital can be found on the NHS Grampian website
Ninewells Hospital, Dundee
The neurosurgery unit in Ninewells Hospital, Dundee serves a population of about 700,000 people from Tayside and North East Fife.
Ward 23B is on the 6th floor of the South Block. This is the dedicated neurosurgery ward in the hospital and has 20 neurosurgery beds. Four of these beds are in a specialist neurosurgical High Dependency Unit inside the ward. Another two neurosurgery beds are also available in Ward 23A, the neurology ward. This is joined to Ward 23B and run by the same Senior Charge Nurse.
Neurosurgery patients needing intensive care go to the 7 bed general Intensive Care Unit in the hospital. Care is managed jointly managed by a Consultant Neurosurgeon and a Consultant Intensivist.
Four Consultant Neurosurgeons work in the Unit.
Neurosurgery out-patient clinics are held in the Ninewells Hospital Polyclinic, Area 3a on Level 7. Consultant led clinics run between Monday and Thursday every week.
Information about services and advice on travel to hospital can be found on the NHS Tayside website .
Edinburgh Western General Hospital
The Department of Clinical Neuroscience (DCN) in Western General Hospital, Edinburgh serves a population of 800,000 from Lothian, Fife, Borders, Dumfries & Galloway and Forth Valley.
DCN has a total of 48 beds in the Unit. There are three wards in DCN: Ward 31 is on the first floor of DCN and has 18 beds. This ward looks after neurology patients, as well as neurosurgical patients; Ward 32 is on the second floor of DCN and has 15 beds; Ward 33 is on the third floor of DCN and has 16 neurosurgical beds and 7 High Dependency Unit beds.
DCN has access to a 10 bedded Critical Care Unit.
There are currently seven Consultant Neurosurgeons working in the DCN Unit, with two consultants about to be appointed.
Neurosurgery outpatient clinics are held in the Western General Hospital, Department of Clinical Neuroscience (DCN) Outpatient Department on the lower Ground Floor in DCN.
Click here for further information about the neuroscience service provided in Lothian .
Information about service and advice on travel to hospital can be found on the NHS Lothian website .
Royal Hospital for Sick Children, Edinburgh
The Royal Hospital for Sick Children (RHSC) is currently based in Sciennes Road in Edinburgh, EH9 1LF. A new hospital for children and young people and Department of Clinical Neuroscience (DCN) is to be built at the Royal Infirmary of Edinburgh (RIE) and the hospital is due to become operational in the summer of 2017. See plans for new hospital here .
The RHSC, provides a comprehensive range of dedicated children's services, including neurosurgery, caring for youngsters from across Lothian and beyond. The Emergency Department at RHSC typically manages children until they are 13 years of age. However, the inpatient facility manages young people into their teenage years.
NHS Lothian is responsible for meeting the health needs of more than 800,000 people living in Edinburgh, the Lothians and beyond.
The neurosciences ward is Ward 7. This is the only ward which looks after paediatric patients with neuro-medical and neurosurgical conditions. This is a 12 bedded mixed gender ward.
There are currently two Paediatric Consultant Neurosurgeons who work between the adult and paediatric neurosurgical units in NHS Lothian.
Queen Elizabeth University Hospital
The adult Neurosurgery Unit for Glasgow is based at the Institute of Neurological Sciences at the new Queen Elizabeth University Hospital in south Glasgow. The Institute of Neurological Sciences provides Neurosurgical, Neurological, Clinical Neurophysiology, Neuroradiology, Neuro-oncology and Neuropathology facilities for the West of Scotland. It serves a population of 2.7million.
The neurosurgical department comprises three wards (Wards 63, 64 and 65), with 66 beds and an ITU and HDU facility providing a critical care service for a further 12 patients. There are three dedicated neurosurgical theatres.
There is an outpatient clinic within the unit where consultant-led neurosurgery clinics are held on a daily basis. There are also clinics run by Extended Scope Physiotherapy Practitioners.
The Institute is equipped with two Magnetic Resonance Imaging Suites, SPECT Scanner, two Computerised Axial Tomography Scanners, and angiography facilities.
There are currently 14 neurosurgeons based in the unit and approximately 60% of the unit's workload is emergency care. The adult unit has close links with the new Royal Hospital for Children which opened in June 2015. The children's Neuroscience Units is once more co-located with the adult neuroscience service.
Information about services and advice on travel to hospital can be found on the Queen Elizabeth University Hospital Website .
Royal Hospital for Children, Glasgow
In June of 2015 the new Royal Hospital for Children opened as part of the Queen Elizabeth University Hospital on the site of the Southern General Hospital. This new purpose-built children's hospital replaces the hospital at Yorkhill. The paediatric Neuroscience Unit is now located on the same campus as the adult neurosurgical facility and benefits from shared facilities with the adult hospital.
The new children's hospital has 256 beds in including 24 paediatric critical care beds and looks after children and young people until their 16th birthday. It provides a comprehensive range of local, regional and national children's services. The paediatric Neuroscience Unit is within Ward 3, a 24 bedded ward comprising 20 single rooms and a four bedded bay. Children and their families have access to a range of facilities including family rooms, quiet rooms and a garden area.
Further information on the New Children's hospital can be viewed by accessing the following link: New Children's Hospital
Further information on the MSN's national audit of paediatric neurosurgery is available here
The Managed Service Network for Neurosurgery aims to work with the four neurosurgical centres to create a single service working collaboratively for the people of Scotland.
Neurosurgery is described as a 'low volume specialty' - this means that there are fewer operations than those performed by orthopaedic surgeons for example. There are 32 consultant neurosurgeons in Scotland working closely with colleagues who deliver the neuroscience service; they are based in Aberdeen, Dundee, Edinburgh and Glasgow and each has specialist areas of interest. All four units look after patients who present as emergencies as well as those who are referred by their GP.
The units in Aberdeen and Dundee manage adults and children in adjacent hospitals whereas both Edinburgh and Glasgow have looked after children in neuroscience units within dedicated children's hospitals that are situated in other parts of the cities from their adult counterparts. In June 2015, the children's hospital at Yorkhill in Glasgow moved to the new Royal Hospital for Children as part of the Queen Elizabeth University Hospital in south Glasgow In 2017, the children's hospital in Edinburgh will move to the Royal Infirmary of Edinburgh site at Little France in the south of Edinburgh.
In 2017 all four neuroscience centres in Scotland will achieve co-location of the adult and paediatric neurosurgery services on a single site in each city. The opportunity to share resources will yield significant benefits to the national neurosurgical service and provide a modern, fit for purpose environment in which to care for our patients and their families.
Contact us on:
Tel: 0131 537 2069
Managed Service Network for Neurosurgery
Department of Clinical Neurosciences
Western General Hospital
Crewe Road, Edinburgh, EH4 2XU
The MSN is pleased to announce the publication of the Annual Report for 2013: Standards of Care in Adult Neurosurgical Units in Scotland. The report contains the results of a comprehensive audit of services in the four adult centres and a series of recommendations on potential improvements agreed jointly with service providers. We are about to undertake the design of a national audit of paediatric neurosurgical services with a view to beginning the audit process in October of 2013.
Download the full report
Download PDF Report [3.9mb]