NNAP Neurosurgical National Audit Programme

Hospital: SALFORD ROYAL HOSPITAL

SALFORD ROYAL NHS FOUNDATION TRUST
Neurosurgical Unit
Trust Name SALFORD ROYAL NHS FOUNDATION TRUST
Hospital Name SALFORD ROYAL HOSPITAL
Address SALFORD ROYAL HOSPITAL
  STOTT LANE
  SALFORD
Post Code M6 8HD
Telephone 0161 789 7373
Website URL https://www.srft.nhs.uk/
Head Of Unit Mr John Leach
Hospital
Trust Name SALFORD ROYAL NHS FOUNDATION TRUST
Hospital Name SALFORD ROYAL HOSPITAL
Address
 
Town/City
Post Code
Telephone
Website URL
Head Of Unit
Hospital
Consultants at this Unit
Unit Overview
SRFT aims to provide safe, clean & personal care to every patient, every time. We are an integrated provider of care, including the University Teaching Trust. We are extremely proud to hold the top satisfaction scores for both patients and staff. We were the top Acute Trust nationally in the In-Patient Survey 2013 & celebrated the best results in the country for the NHS Staff Survey 2013. The Department of Adult Neurosurgery is part of The Greater Manchester Neurosciences Centre.
Clinical Services
Neurosurgery in Salford offers some of the largest subspecialty services in the UK, with World class outcomes. All our services offer multidisciplinary care for patients. We provide specialist training fellowships attracting UK & International applicants in oncology, skull base, spinal & vascular. We have strong links with the University, research & clinical trials. We have dedicated subspecialty surgeons offering the following services: Functional ò Spinal cord stimulation. MDT: Pain team / Psychology / Specialist Nurse ò Intrathecal baclofen pump. MDT: Specialist Neurorehab / physiotherapy ò Deep brain stimulation. ParkinsonÆs disease / Dystonia / Essential tremor. Experience of Tourette syndrome. MDT: Neurologist / Neurosurgeon / Neuropsychiatrist / Psychologist / Specialist Nurse ò Special interests: GA surgery, Dopamine Agonist Withdrawal Syndrome, Image verified surgery ò Offer surgery under General Anaesthetic via image verified approach - maximising patient comfort without compromising clinical effectiveness. Hosted 2014 British Society of Stereotactic & Functional Neurosurgery meeting. Won best poster presentation at 2014 European Society of Stereotactic and Functional Neurosurgery Neurooncology ò Weekly MDT. Median time from referral to MDT discussion 6 days, time to surgery 10 days ò Keyworker at all neurosurgical consultations, supporting patients throughout their journey ò Holistic approach ò Establishment of Cancer Network MDT ò Awake craniotomy service with brain mapping ò Fluorescein guided resection for high grade glioma ò Stereotactic radiosurgery service ò Consistently positive feedback at internal, external peer review assessments & from patient satisfaction surveys ò Leading center in UK in CNS clinical trials Clinical Lead for Neurooncology: Miss K Karabatsou, Tel 0161 2068338 MDT co-ordinator: D Jones https://neurooncology.srft.nhs.uk 0161 2061378 Fax 0161 2061303 CNS: S Cundliffe 0161 2060613. A Gilston-Hope 0161 2062073 Spinal ò With Deformity orthopaedic spinal surgeons, cardiothoracic & vascular surgeons provide fully comprehensive spinal service ò Provide day case surgery, minimally invasive surgery & use neuronavigation to ensure safe as well as accelerated recovery after surgery ò Provide support for the CHRISTIE, the largest cancer centre in Europe, treating + of all cancer cases in the UK ò Non operative spine services include specialist pain centre with access to neuromodulation, cognitive therapy, physical rehabilitation ò Spinal injury rehabilitation services in Southport. with neurorehab at SRFT ò Support the Neurofibromatosis type 1 service in Manchester and has the largest series of patients in the world. ò Submit outcome data to European spine database, Tango Skull base ò Treat all aspects of skull base pathology, including vestibular schwannomas, meningiomas, epidermoids, dermoids, arachnoid cysts, cholesterol granulomas, glomus jugulare, fibrous dysplasia, chordomas, chondrosarcomas and hemifacial spasm. ò Weekly MDT, refertoskull.srft@nhs.net, 0161 2069691 ò Skull base stereotactic radiosurgery at SRFT service with Joint oncology / surgery clinic to discuss treatment options. ò Weekly MDT & clinic in National Neurofibromatosis type 2 service ò Combined facial pain service with pain team for management of trigeminal neuralgia & atypical facial pain ò Combined service with orbital & head & neck MDTs ò Outcomes recorded in National vestibular schwannoma database ò http://www.srft.nhs.uk/about-us/depts/neuro-skull-base/ ò Lead Neurosurgeon: Mr S Rutherford, 0161 2060119 ò CNS, A Wadeson: 0161 2062303 Hydrocephalus ò Combined spina bifida clinic with Nephrologist ò Complex hydrocephalus with surgical expertise in colloid cysts, Chiari malformations, Normal Pressure Hydrocephalus, Idiopathic Intracranial Hypertension Endoscopic ò Allows neurosurgeon to operate on selected brain abnormalities, through key hole approach, benefits to patient - faster recovery, less post-operative pain ò Externally audited outcomes in pituitary surgery revealed outcomes comparable to best in the world ò Also used to tackle other complex pathology around the skull base ò Patients discussed at Pituitary, Skull base & Neurooncology MDTs ò Accept & treat patients from outside of the Manchester region, including overseas ò http://www.srft.nhs.uk/about-us/depts/neuro-surgery/services-provided/pituitary/ Neurovascular ò Work with interventional neuro-radiology & stroke team to provide an integrated cerebrovascular service ò Centralised approach to stroke care in Greater Manchester ò Provision of the largest unit in the UK for haemorrhagic stroke ò Interventional services: endovascular aneurysm & AVM management, thrombectomy in ischaemic stroke, aneurysm surgery, AVM & Dural AVF surgery, EC-IC bypass surgery ò Clinical links with University Medical Centre, Utrecht ò Submit outcome data to UK & Ireland SAH registries
Clinical Practice and Mortality
12 Month Practice (1 Year)


What does the Hospital Unit activity pie chart show?

The Hospital Unit activity pie charts represent the total procedures performed within elective (planned) Finished Consultant Episodes (FCEs) and non-elective (emergency) FCEs. An FCE is the time spent by a patient in the care of one consultant in one healthcare provider and there may be up to 24 procedures recorded for each FCE. The unit level pie charts are segmented to represent the proportion of cranial, spinal, and other procedures performed and, in addition, FCEs containing no procedures.


Please note that for Trusts which provide both adult services for patients aged 18 and older and paediatric services for patients aged 17 and younger, there will be two further pie charts showing elective and non-elective FCEs for their paediatric practice.


Activity Breakdown
Adult
Elective Non-Elective

Key

Cranial
No Procedure
Other
Spinal
Elective
Cranial No Procedure Other Spinal Total
856 672 1,073 1,668 4,269
Non Elective
Cranial No Procedure Other Spinal Total
631 1,191 1,039 121 2,982
Paediatric
Elective Non-Elective

Key

Cranial
No Procedure
Other
Spinal
Elective
Cranial No Procedure Other Spinal Total
7 <5 6 0 NA
Non Elective
Cranial No Procedure Other Spinal Total
8 17 9 <5 NA
36 Month Practice Profile (3 Years)


What does the Hospital Unit activity pie chart show?

The Hospital Unit activity pie charts represent the total procedures performed within elective (planned) Finished Consultant Episodes (FCEs) and non-elective (emergency) FCEs. An FCE is the time spent by a patient in the care of one consultant in one healthcare provider and there may be up to 24 procedures recorded for each FCE. The unit level pie charts are segmented to represent the proportion of cranial, spinal, and other procedures performed and, in addition, FCEs containing no procedures.


Please note that for Trusts which provide both adult services for patients aged 18 and older and paediatric services for patients aged 17 and younger, there will be two further pie charts showing elective and non-elective FCEs for their paediatric practice.


Activity Breakdown
Adult
Elective Non-Elective

Key

Cranial
No Procedure
Other
Spinal
Elective
Cranial No Procedure Other Spinal Total
2,590 1,706 3,834 5,075 13,205
Non Elective
Cranial No Procedure Other Spinal Total
1,826 3,660 3,095 316 8,897
Paediatric
Elective Non-Elective

Key

Cranial
No Procedure
Other
Spinal
Elective
Cranial No Procedure Other Spinal Total
15 <5 12 5 NA
Non Elective
Cranial No Procedure Other Spinal Total
23 72 29 <5 NA

Mortality – 30 Days

What does the Hospital Unit funnel plot chart show?

The mortality outcomes presented here are based on five years of data from April 2015 to March 2020. The analysis is based on adult elective surgery only which means that there will be no funnel plot displayed for any hospital that provides predominantly paediatric neurosurgical services, i.e. a children’s hospital.


Mortality
Adult
Paediatric

Mortality outcomes are based on adult elective surgery only and there are, therefore, no 30 day mortality outcomes available for this hospital. This may change in the future when a risk-adjusted methodology for paediatric outcomes has been developed.

Understanding the risk-adjusted mortality ratio

Risk adjustment (or case-mix adjustment) takes into account patient risk factors to calculate a predicted mortality ratio. This means that hospitals or consultants who see higher risk patients have their mortality rate adjusted to account for the factors that put these patients at greater risk.

Understanding the 'funnel plot'

The funnel plot displays the risk-adjusted elective procedural mortality ratio for each hospital, plotted against the expected number of mortalities for that hospital. The expected number of mortality events for each hospital will vary, dependent upon the number of procedures that have been performed and the risk profile of the patients they have been treated. The horizontal grey line represents the national average mortality ratio and the coloured lines the upper and lower 95% and 99.8% control limits. If a plot is above the upper 99.8% (blue) control line, the data is suggesting that the mortality ratio is higher than expected. Where plots are between that upper control limit and the lower control limit (yellow line), the mortality ratio is within the expected range. The hospital’s position is represented by the magenta-coloured plot.

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