The Society of British Neurological Surgeons

Neurosurgical National Audit Programme

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Surgeon

Mr Richard Edwards MD FRCS(Neuro.Surg)
Professional Title Consultant Paediatric & Adult Neurosurgeon
GMC Number 4102353
Personal Email richard.edwards@UHBristol.nhs.uk
Secretary Emma Stewart Emma.Stewart13@nhs.net
SBNS Member? Yes

Hospitals

Training


2010 MD Research Thesis (London University).

2004 FRCS(Neuro.Surg). Intercollegiate Examination Board (UK).

1998 FRCS (England). Royal College of Surgeons of England.

1994 MB BS, St. Mary’s Hospital Medical School, London University.

1991 BSc(Hons). London University.

2005

St Mary's Hospital Medical School, Imperial College, University of London.

2005-6. Fellowship in Paediatric Neurosurgery, University of Toronto, Canada.

1999-2005. Neurosurgical Training Program, Bristol

1998-9. Specialist Registrar (LAT). Atkinson Morley's Hospital, London.

Professional Activity


Senior Clinical Lecturer in Neurosurgery (Honorary), University of Bristol.

Intercollegiate Examination Board (Neurosurgery) Member (UK).

President, Hydrocephalus 2014 International Conference, Bristol, UK.

Pediatric Cranio-cervical Spine Society (USA)

Congress of Neurological Surgeons (USA)

International Society for Hydrocephalus and CSF Disorders

International Society of Pediatric Neurosurgeons

Society of British Neurological Surgeons

British Paediatric Neurosurgery Group

March 2007 Bond Solon Training Course: Excellence in Report Writing March 2007 Bond Solon Training Course: Courtroom Skills Training February 2008 Cross Examination Training February 2008 Law & Procedure Modules I &II Medico-legal expertise in non-accidental head injury in children ( Family and Criminal Courts); Personal injury (paediatric traumatic brain injury); medical negligence (paediatric and adult neurosurgery).

Clinical Activity


Neuro-oncology: with special interest in pineal, brainstem, spinal cord and cerebellar tumour surgery in both adults and children. Paediatric Neurosurgery: with special interest in surgery for spasticity in cerebral palsy; paediatric vascular surgery (Arteriovenous malformation & cavernoma). Spinal Surgery: with special interests in daycase surgery for adult degenerative spinal disorders; surgery for the correction of complex cranio-cervical deformity in children. Spinal dysraphism (tethered cord). CSF Disorders (hydrocephalus): with special interest in Normal Pressure hydrocephalus, Chiari malformation and idiopathic intracranial hypertension, paediatric hydrocephalus, neuroendoscopy including endoscopic colloid cyst excision.

Deputy Regional Training Program Director for Neurosurgery (Severn & Peninsular Deaneries).

Co-Chair Paediatric Spasticity MDT, Bristol Royal Hospital for Children.

Member of Paediatric and Adult Neuro-oncology MDT (BRCH & Southmead Hospital).

Executive Board Member, Circle Bath Hospital.

Research


BRAIN TUMOUR SURGERY: Supervising MD student undertaking research into intra-operative monitoring of cerebellar functioning during brainstem and cerebellar surgery. Member of research group evaluating Convection Enhanced Delivery of Chemotherapy for malignant Brainstem tumours (DIPG) in children.

HEAD INJURY: Health Quality Improvement Partnership (HQIP): National Study of Head Injury in Children (Advisory Board & Writing Committee). Approaches and Decisions for Acute Pediatric TBI (ADAPT) Trial (NIH funded), Local Principle Investigator.

HYDROCEPHALUS RESEARCH: CSF Dynamics, CSF Drainage & Volumetric CT Imaging in Predicting Shunt Responsiveness in Normal Pressure Hydrocephalus – Principle investigator. The British Antibiotic and Silver Impregnated Catheters for ventriculoperitoneal Shunts multicentre randomised controlled trial (ISRCTN49474281; NIHR –HTA Study)-Local Principle Investigator

Abhinav K, Whone A & Edwards RJ. Rapid Neurology & Neurosurgery. (Blackwell), 2012.[textbook]

Edwards RJ & Drake JM. CSF Devices. Youman’s Textbook of Neurological Surgery – 6th Edition (2011).

Aquilina K, Thoresen M, Chakkarapani E, Pople IK, Coakham HB, Edwards RJ. Preliminary evaluation of a novel intraparenchymal capacitive intracranial pressure monitor. Laboratory investigation. J Neurosurg. 2011 Sep;115(3):561-9

Brown EM, Edwards RJ, Pople IK. Conservative Management of Patients with CSF Shunt Infections. Neurosurgery, 2006;58(4):657-65.

Edwards RJ, Dombrowski SM, Luciano MG, Pople IK. Chronic hydrocephalus in adults. Brain Pathol 2004;14:325-336.

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
Image

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
Image

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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