The Society of British Neurological Surgeons

Neurosurgical National Audit Programme

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Surgeon

Mr John Leach MA (Cantab) BMBCh (Oxon) FRCS (Neuro Surg)
Professional Title Consultant Neurosurgeon
GMC Number 4547712
Personal Email email address withheld
Secretary Tracy Everett 01612065562 email address withheld
SBNS Member? Yes

Hospitals

Training


MA Neurophysiology, Cambridge University 1995 BM BCh, Oxford University 1998 FRCS (Neuro Surg), Edinburgh 2007
2009
Cambridge University Medical School 1992-1995 Oxford University Medical School 1995-1998
Neurosurgery Registrar, Royal Melbourne Hospital, Australia 2002-3 Oxford Neurosurgery Training Program 2003-9 Neurosurgery Fellow, The Alfred Hospital, Australia 2008

Professional Activity


Honorary Senior Lecturer, Salford University: 2012-14
Society of British Neurosurgeons British Assocaition of Spine Surgeons
Formal expert witness trainig with Bond Solon Head injury Spine including cauda equina syndrome, disc disease, fractures, spinal cord injury and tumours Brain tumours

Clinical Activity


Spinal surgery including cervical disc replacement, complex spinal surgery and minimally-invasive techniques Neuro-oncology including brain and spine tumours
Clinical Lead for Neurosurgery Subspecialty Lead for Spinal Neurosurgery

Research


Principal investigator at Salford for the NERVES trial: HTA Project: 12/201/10 - A multi-centre randomised control trial comparing the clinical and cost effectiveness of trans-foraminal epidural steroid injection to surgical microdiscectomy for the treatment of chronic radicular pain secondary to prolapsed intervertebral disc herniation.
PUBLICATIONS Leach JCD, Bittar R. The safety of BMP-7 in anterior cervical fusion. The Journal of Clinical Neuroscience 2009.Nov;16(11):1417-1420 Leach JCD, Malham GM. Complete recovery following atlantoaxial fracture-dislocation and bilateral carotid and vertebral artery injury. British Journal of Neurosurgery 2009 Jan;23(1):93-4 Shad A, Leach JCD, Cadoux-Hudson TA, Teddy PJ. Use of the Solis cage and local autologous bone graft for anterior cervical discectomy and fusion: early technical report. Journal of Neurosurgery Spine 2005 Feb;2(2): 116-22 Leach JCD, King J, Garrott H, Kaye A. Solitary cerebral metastasis mimicking colloid cyst with obstructive hydrocephalus: two case reports. Journal of Clinical Neuroscience 2004 Jun;11(5):521-3 Leach JCD, Mitchell PJ, Siu K. Dissecting aneurysm of the anterior cerebral artery presenting as subarachnoid haemorrhage. Journal of Clinical Neuroscience 2004 Apr;11(3):334-7 Leach JCD, Maixner W. Spinal epidural lipomatosis. Images in neuroscience. Journal of Clinical Neuroscience 2003 Jul;10(4):465 Khong S, Leach JCD. Meningioma mimicking puerperal psychosis. Obstetrics and Gynaecology 2007 Feb; 109(2) Lawson-Smith M, Leach JCD, Cadoux-Hudson TAD. Lateral medullary syndrome caused by penetrating head injury: a short report. Journal of Clinical Neuroscience 2006 Aug;13(7):792-4 Chakraborty A, Leach JCD, Kitchen N. Chiari I Malformation presenting as trigeminal neuralgia Minim Invasive Neurosurg. 2003 Feb;46(1):47-9 Leach JC, Carpenter RH. Saccadic choice with asynchronous targets: evidence for independent randomisation. Vision Research 2001; 41(25-26): 3437-45 BOOK CHAPTERS 1) Leach JCD, Stacey R Head Injury Chapter 22, Bailey & Love’s Short Practice of Surgery 25th Edition 2) Leach JCD, Kerr RSC Elective Neurosurgery Chapter 40, Bailey & Love’s Short Practice of Surgery 25th Edition 3) RD Johnson, JCD Leach, WA Liegenberg, N Maartens, SA Cudlip Spinal Surgery Chapter 4 Landmark Papers in Neurosurgery, OUP ORAL PRESENTATIONS AT SCIENTIFIC MEETINGS Halliday J, Leach JCD Readmission rates following foramen magnum decompression for Chiari malformation Podium presentation at SBNS, Spring 2013 Rodriguez D, Nadig A, Harte T, Coope D, Leach JCD Intramedullary spinal cord tumours Podium presentation at BASS, Norwich March 2013 Glover J, Cadoux-Hudson TAD, Leach JCD Clinical significance of C1/2 anatomy in pateints undergoing C1/2 fusion Podium presentation at Britspine, Newcastle, May 2012 Leach JCD, Cadoux-Hudson TAD Rheumatoid cervical spine: atlanto-axial CT-based measurements and influence on surgical planning Podium presentation at Britspine, Liverpool 2010 Thomas P, Goldschlager T, Leach JCD, Camulglia J, Malham G, Rosenfeld J The risk of insertion of intraparenchymal ICP devices compared to EVDs in brain injured patients Poster presentation at Neurosurgical Society of Australasia, 2009 Leach JCD, Bittar R The safety of BMP in anterior cervical surgery Oral poster presentation at BASS, BCSS, Sheffield, Feb 09 Accepted at Spine Society of Australia, Brisbane, April 09 Accepted at SBNS, Birmingham, April 09 Leach JCD, Malham Surgical management of complicated hangman’s fractures of the axis Oral presentation at Neurosurgical Society of Australasia, Auckland, September 2008 Accepted at Spine Society of Australia, Brisbane, April 09 Leach JCD, Chandran H, Pereira E, Cadoux-Hudson TAD Multi-level cervical disc disease managed by stand-alone interbody cages: safe and effective Oral presentation at Spineweek, Geneva, May 2008 Oral presentation at BASS & BCSS, Sheffield, Feb 09 Leach JCD, Hughes R, Griffiths S, Cadoux-Hudson TAD Early operative experience with a polyaxial cervical spine instrumentation system (OASYS) for craniocervical and atlantoaxial fusion Oral presentation at British Cervical Spine Society Meeting, Newcastle, November 2007 Leach JCD, Patel A, Demetriades A, Onsorge O, Bojanic S Cerebral metastases from unknown Primary Tumours Oral poster presentation at SBNS, Preston, Autumn 2006 Browning L, Leach J, Watts C, Kuker W, Stacey R Lymphoma within a posterior fossa ganglioglioma Poster presentation at British Neuropathologists Society, January 2006 Published in Journal of Neuropathology and Applied Neurobiology Leach JCD, Bassi S, Richards PG Informed consent for children: do we underestimate their understanding? Oral poster presentation at SBNS Manchester, Spring 2004 Leach JCD, Chakraborty A, Kitchen N Cranioplasty: a ten year experience Poster presentation at SBNS, Autumn 2001 POSTERS AT SCIENTIFIC MEETINGS Leach JCD, Malham GM Early technical experience with mini-open transforaminal lumbar interbody fusion (TLIF) BASS, Sheffield, Feb 09 Leach JCD, Malham GM Minimally displaced unilateral cervical facet fractures: factors affecting failure of non-operative treatment BASS, Sheffield, Feb 09

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
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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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