The Society of British Neurological Surgeons

Neurosurgical National Audit Programme

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Surgeon

Mr Richard Kerr BSc MS FRCS
Professional Title Consultant Neurosurgeon
GMC Number 2523080
Personal Email richard.kerr@ouh.nhs.uk
Secretary Eleanor Young +441865234838 eleanor.young@ouh.nhs.uk
SBNS Member? Yes

Hospitals

Training


BSc. (Hons) 1976 University of London MB.BS (Hons) 1979 University of London FRCS England Part 1 1982 FRCS England Part 2 1984 Master of Surgery 1989 University of London MA (Status) 1990 University of Oxford
1990
The London Hospital Medical School 1973 -1979 University of London
General Surgery Training 1980 - 1984 The London Hospital, Luton and Dunstable Hospital, Northampton General Hospital. Neurosurgery Training 1985 - 1989 Dept of Neurosurgery The Radcliffe Infirmary Oxford Dept of Neurosurgery The Royal Melbourne Hospital, Melbourne, Australia Admitted onto the Specialist Register of the GMC 1989.

Professional Activity


Reader in Neurosurgery and Honorary Consultant Neurosurgeon University of Oxford 1990 - 1992 Consultant Neurosurgeon, The Radcliffe Infirmary, Oxford 1992 - 2007 Consultant Neurosurgeon, Oxford University Hospitals NHS Trust 2007 - onwards Honorary Senior Lecturer, University of Oxford 1992 - onwards Society of British Neurological Surgeons (SBNS) Elected Council Member 2004 - 2008 SBNS Honorary Treasurer 2010 - 2013 President Elect of the SBNS 2013 - 2014 President of the SBNS 2014 - 2016 Elected Council Member of the Royal College of Surgeons of England 2013 - 2019
Society of British Neurological Surgeons British Society of Skull Base Surgery British Neurovascular Group British Medical Association. Medical Defence Union
I do offer medico-legal opinions in the areas of expertise detailed above. This is for both prosecution and defence. Approx 10 reports per year for the last +20 years. I have given evidence in court on many occasions in the civil court and on one occasion in the central criminal court. I have taught regularly on courses run by Law South and presented lectures on subarachnoid haemorrhage, spinal disorders especially cauda equina syndrome, head injury and oncology.

Clinical Activity


General adult neurosurgery Skull base surgery including surgery for acoustic neuroma Vasacular neurosurgery Neuro-oncology Spinal degenerative disease Hydrocephalus. Trigeminal neuralgia / Hemi-facial spasm NFII management Attendance at the following MDT's : Neuro-oncology, Vascular, Skull base surgery, NFII
Chair, Skull Base MDT Lead Clinician in Neurosurgery 2007 - 2010 Training Programme Director for Neurosurgery 2011 - 2013 Liason SAC member for Scotland 2011 - 2013 Chairman of Finance committee SBNS 2010 - 2013

Research


INTERNATIONAL SUBARACHNOID ANEURYSM TRIAL (ISAT) 1994 - 2014 Principle Investigators and Grant Holders: - Dr A.J. Molyneux and Mr R.S.C Kerr RESEARCH GRANTS FOR ISAT Oxford Regional Health Authority Research and Development Grant for Pilot Phase of ISAT study 1993-1996 Co-applicant Medical Research Council (MRC) Grant: G 9401611 for International Subarachnoid Aneurysm Trial( ISAT) 1996 - 2000 Co-applicant.Awarded £1.3 million following pilot study for patients randomised from the UK Additional funds from French Ministry of Health AO 98150 and Canadian Institute of Health Medical research Council (MRC) Grant extension for ISAT study 2000 - 2007 Co-applicant.Awarded £1.9 million Medical Research Council (MRC) further grant extension for the ISAT study Co-applicant awarded for period 2008 - 2013 Other Research involvement:- BRC grant for 3 years for MRI biomarkers of cerebral vasospasm PI's Pattinson/Westbrook. Collaborators Jezzard/Kerr OxHEAD Prospective head injury database with now over 500 patients. Grant of £12000 in 2009 from Oxford Health Sciences Research Committee (OHSRC) Neurosurgical Research trust Fund 2011 £10,000 to continue. •Co-Founder of Neurovascular Research Unit, affiliated with University Dept of Surgery - developed and managed a series of clinical trials including the ISAT study •Local Co-ordinator MRC funded STICH and STICH II trials - study into intracerebral haemorrhage (Current) •Local Co-ordinator RescueICP trial - Study into Head Injury management (current) •Chairman of Cerocyte Coil Trial - 500 prospective randomised trial (2005 to date) •Data monitoring committee of MASH II trial - analysis of magnesium therapy after subarachnoid haemorrhage (current) •Invited Lectures: Over 20 invited lectures in UK, Europe and Worldwide. I have presented at all the major neurosurgical meetings including Society of British Neurosurgical Surgeons(SBNS), Royal Society of Medicine, European Association(EANS), Danish Neurosurgical Society, Scandinavian Neurosurgical Society, American Assoc of Neurosurgeons (AANS), Congress of Neurosurgeons, World Congress of Neurosurgeons & World Stroke Congress
A J MOLYNEUX, RSC KERR et al International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised comparison of effects on survival, dependancy, seizures, rebleeding, subgroups and aneurysm occlusion LANCET 2005; 366:809-817 CAMPI A, RAMZI N, MOLYNEUX AJ, SUMMERS PE, KERR RSC et al Retreatment of ruptured Intracranial Aneurysms: a randomised comparison of effects on survival, dependancy, seizures, rebelleding, subgroups and aneurysm occlusion. STROKE 2007; May 38(5):1538 – 1544 Epub 2007 Mar29 MITCHELL P., KERR RSC., MENDELOW AD., and MOLYNEUX AJ Could Late re-bleeds overturn the superiority of cranial aneurysm coiling over clipping seen in the ISAT trail J NEUROSURG 2008; 108(3): 437-442 HART Y., SNEADE M., BIRKS J., RISHMULLER J., KERR RSC., MOLYNEUX A., Epilepsy after subarachnoid haemorrhage: the frequency of seizures after clip occlusion or coil embolization of a ruptured cerebral aneurysm. J Neurosurg. DOI 10.3171/2011 SCOTT RB., ECCLES F., MOLYNEUX AJ., KERR RSC., ROTHWELL PM., CARPENTER KC., Improved cognitive outcomes with endovascular coiling of ruptured intracranial aneurysms:neuropsychological outcomes from the International Subarachnoid Aneurysm Trial (ISAT). Stroke 2010 Aug;41(8):1743-1747. Epub2010 Jul 8. MOLYNEUX AJ., KERR RS., BIRKS J., RAMZI N., YARNOLD J., SNEADE M., RISCHMILLER J., Risk of recurrent subarachnoid haemorrhage, death, or dependence and standardised mortlity ratios after clipping or coiling of an intracranial aneurysm in the International Subarachnoid Aneurysm Trial (ISAT): long-term follow-up. Lancet Neurol. 2009 May;8(5):427-33. Epub 2009 Mar 28 RIVERO-ARIAS O., WOLSTENHOLME J., GRAY A., MOLYNEUX AJ., KERR RS., YARNOLD JA., SNEADE M., The cost and prognostic characteristics of a ischaemic neurological deficit due to subarachnoid haemorrhage in the Unitied Kingdom. Evidence from the MRC International Subarachnoid Aneurysm Trial. J Neurol. 2009 Mar;256(3);364-73. Epub 2009 Feb 9 RYTTLEOFRS AT., ENBLAD P., KERR RS., MOLYNEUX AJ., International subarachnoid aneurysm trial of neurosurgical clipping versus endovascualr coiling: subgroup analysis of 278 elderly patients. Stroke. 2008 Oct;39(10):2720-6. Epub 2008 Jul 31

Outcome Report

SBNS
Understanding activity pie charts


What does the Consultant activity pie chart show?

The Consultant activity pie charts represent the total number of elective (planned) finished consultant episodes (FCEs) and non-elective (emergency) finished consultant episodes. A finished consultant episode usually represents the care of a single patient from admission to discharge.

Please note that for Consultants who provide both adult services for patients older than 17 years and paediatric services for patients 16 years old and younger there are two outcome reports.

Elective Procedural Case-mix and Case Volume
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SBNS
Understanding mortality funnel plot charts

What does the Consultant funnel plot chart show?

The Hospital Consultant mortality funnel plot represent the total number of elective (planned) finished consultant episodes (FCEs) and non-elective (emergency) finished consultant episodes. A finished consultant episode usually represents the care of a single patient from admission to discharge.

The mortality presented here is for three years: April 2014 – March 2017. Please note that for Consultant who provide both adult services for patients older than 17 years and paediatric services for patients 16 years old and younger there are two outcome reports.

The horizontal yellow line represents the national average mortality. The solid black lines above and below the yellow line are the control limits. The upper control limit represents the highest expected mortality rate. The Consultant's outcome is highlighted in magenta.

30 Day Risk Adjusted Elective Procedural Mortality
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The outcomes of this consultant are within the expected range

Understanding the risk-adjusted mortality rate

Risk adjustment (or case-mix adjustment) takes into account patient risk factors to calculate a predicted mortality rate. 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' diagram

The funnel plot displays the risk-adjusted elective procedural mortality ratio for each consultant plotted against the expected number of mortalities for that consultant. The expected number of mortalities for each consultant will vary depending on the number of procedures they have performed and the risk profile of the patients they have treated. The horizontal yellow line represents the expected ratio. The solid black line above the chart is known as a ‘control limit’. This control limit represents the highest expected mortality rate. Risk-adjusted rates appearing beneath this line are within the normal range.

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