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AIS Annual Report 2015

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1 Activity

1.1. Summary of activity for year ending March 2015

 

Actual

Planned

Assessments

35

24

Anterior Cingulotomy

1

3-5

Follow-up

7

12

Intensive OCD treatment

4

4-6

 

1.2. Referrals

Forty-eight referrals were received during the reporting period (23 men and 25 women); with a mean age of 44.1 years. There were 47 referrals (97.9%) from Scotland, and 1 referrals (2.1%) from England.

1.3. Assessments

Thirty-eight assessments were conducted during the 2014/15 financial year for 35 patients. Fifteen men and 20 women were seen, with a mean age of 44.8 years (range 16.9 – 66.6 years). Most (97.1%) assessments were for Scottish patients. One assessment was conducted outwith the SLA.

We have continued to see a high number of people with OCD (22.9%), with 20.0% having major depression. A range of other disorders were also represented – these indicate the diagnosis made by the AIS (rather than the referrer) and reflect the nature of complex and comorbid mental disorders reaching tertiary and quaternary services. Of note is that 11.4% of assessments were given a diagnosis of autism spectrum disorder.

1.4. Procedures

One neurosurgical procedure (Anterior Cingulotomy) was performed during 2014/15. The patient was Scottish.

2 Mortality Data & Adverse Effects

There have been no deaths and no post-operative infections during the reporting year. Rates of adverse effects were largely unchanged from previous years, and are consistent with the published literature on the procedures undertaken.

3 Waiting Times

The average (±SD) waiting time (from referral to assessment) for Scottish patients was 8.9 ± 5.7 weeks. This is consistent with the previous year. Overall, 50% of Scottish patients waited less than 8 weeks to be seen. Only 11.4% waited longer than 12 weeks and there were unavoidable reasons for all of these.

4 Quality of Care

4.1. Formal Complaints

There were no formal complaints.

4.2. Improving the Patient Experience – Patient Satisfaction

Patient satisfaction for outpatient assessment and inpatient admission continues to be high, with the overwhelming majority reporting positive experiences of the service.

5 Best Value Healthcare – Clinical Audit and Outcomes

5.1. Outcome Data for Cingulotomy

The following table only includes those patients reviewed in 2014-15. It is not possible to generalise to all patients undergoing the procedure.

 

Size of change in symptom scores (categories are exclusive)

Indication for surgery

≤20%

≥20%

≥35%

≥50%

Depression (N=5)

2

1

0

2

OCD (N=1)

0

0

0

1

 

6 Intensive OCD treatment

Four patients have been treated as part of the intensive OCD treatment programme. Three completed a course of treatment. At the point of discharge from hospital two patients (66.6%) were responders and one patient (33.3%) was a non-responder.

7 Teaching and Research Activities

Members of the team continue to deliver presentations at a regional, national, and international level and publish in peer-reviewed journals. The research output of the service continues to be of a high-standard and is internationally-recognised.

8 Service Developments and Future Plans

The retiral of the neurosurgeon in the service meant that we established a partnership with experienced neurosurgeons at the National Hospital for Neurology and Neurosurgery in London. More information is provided below in section C1.

8 Summary and Conclusions

The service has experienced a temporary interruption to the provision of neurosurgery during this financial year but we have been able to ensure continued provision due to partnership with the NHNN in London. The intensive OCD programme has run successfully over the last year and outcomes are comparable with other specialist centres. The number of referrals and assessments continues to be above the planned level.

National Services Scotland

Advanced Interventions Service
Area 7, Level 6
South Block
Ninewells Hospital and Medical School
Dundee, DD1 9SY. UK.
Tel: +44 (0)1382 496233

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