Longitudinal neurosurgical activity in the NHS: a retrospective study

Area of Science:

• Neurosurgery
• Health Services Research

Background:

• Neurosurgical care in the UK's National Health Service (NHS) has seen changes since 2000.
• Despite increased consultant and training numbers, waiting lists remain high.

Purpose of the Study:

• To examine trends in neurosurgical activity, including caseloads, procedures, staffing, and infrastructure, at a single NHS institution from 2000 to 2023.
• To assess the impact of the COVID-19 pandemic on neurosurgical services.

Main Methods:

• Retrospective analysis of inpatient and outpatient neurosurgical cases from January 2000 to December 2023.
• Statistical analysis using Shapiro-Wilk Test, Mann-Whitney U Test, and repeated-measures ANOVA.
• Data processed using Microsoft Excel and GraphPad Prism.

Main Results:

• Annual inpatient procedures showed no significant change, while outpatient cases and elective surgeries significantly increased.
• A rise in consultant numbers correlated with decreased inpatient and outpatient activity per consultant.
• The COVID-19 pandemic temporarily reduced inpatient activity, followed by a rebound exceeding pre-pandemic levels. No significant change in bed or theatre numbers was observed.

Conclusions:

• Neurosurgical inpatient activity has stagnated despite increased outpatient volumes and consultant staffing.
• Lack of infrastructural expansion, such as beds and theatres, is a potential limiting factor.
• Addressing infrastructure is crucial for enhancing NHS neurosurgical capacity and managing patient demand.