First of all welcome to the new year, and I hope the journal continues to provoke interest.
Submissions remain healthy, so there is something of a backlog to appear in print. This may at some point become a historical issue as most journals now are accessed online, and this journal may well move in that direction. Meanwhile, those articles that have been accepted are published online and can be fully cited. If there is a lobby of the readership keen to see the print edition survive, then please let me know!
I don't have much new to comment on in the British neurosurgical medical politic that I have not mentioned before in previous editorials. I am however sure that none of these issues will go away, although the timetable has perhaps moved slower than it might, and then issues around commissioning will no doubt come to the fore. Possibly also on the agenda will be the configuration of services (there is a hint of this in one of the articles regarding NF-2 and radiation treatment for the same). Seven days a week working is perhaps a ‘newer idea’; whilst neurosurgeons have not ever been able to escape this, it is certainly true that other support services within a hospital do not and never have worked more than a five-day weeks. I can easily see the argument that supermarkets, petrol stations, transport, and even public houses are all available seven days a week (imagine the complaints otherwise in the last case…); so why not medicine? Leaving out the legal system, parliament (5 days a week chaps), the area of society that must impact most – given the number of practitioners that are likely also to be parents of school age children – will, I imagine, be the education service, which remains resolutely organized around Monday to Friday – I don't see plans for schools to move to seven days a week education.
The subject I hope will advance is that of proper recording of meaningful clinical outcome data. I support the SBNS efforts in this regard and hope they will keep to this brief. Perhaps it is helpful to think that if the data was submitted as part of a scientific paper, then a failure to include meaningful clinical outcome date – and to include in this longer term outcomes where necessary – would mean the paper would be rejected. I'd suggest a similar standard should apply to our own audit. I would include also the question of operator specific outcomes. I use the noun ‘operator’ deliberately as in many instances now the primary provider of treatment will be an inteventionalist, or perhaps a radiation specialist. As I have alluded to before, the really difficult data to collect is that pertaining to patients not treated. One obvious and easy way to improve outcomes is to use careful case selection – some will remember the now historical data presented by notable neurosurgical facilities for delayed aneurysm clipping (i.e. around 10 – 14 days) – excellent outcomes, but only for those treated!
Happily the articles in the journal have little to do with such politic – refereshingly perhaps they are completely to do with clinical problems or research, and I hope you enjoy these.
Announcement
The British Journal of Neurosurgery notes with regret the news that Mr John Bartlett, senior member of the SBNS and former SBNS President (1996–1998) passed away on 6th January 2014. Our condolences go to his family and friends.