AIS Annual Report 2013-14

Executive Summary

1 Activity

1.1. Summary of activity for year ending March 2014







Anterior Cingulotomy







1.2. Referrals

Fifty-five referrals were received during the reporting period (24 men and 31 women); with a mean age of 45.3 years. There were 48 referrals (87.3%) from Scotland, and 9 referrals (9.1%) from England. Two referrals (3.6%) came from Northern Ireland.

1.3. Assessments

Twenty-six assessments were conducted during the 2013/14 financial year. Twelve men and 14 women were seen, with a mean age of 44.9 years (range 18.4 – 63.1 years). Most (92.2%) assessments were for Scottish patients. Two assessments were conducted outwith the SLA.

Compared to previous years, a greater proportion (42.3%) of patients had a diagnosis of OCD, with 15.4% having major depression. A range of other disorders were also represented – these reflect the diagnosis made by the AIS, not the referrer, and reflect the nature of complex and comorbid mental disorders reaching tertiary and quaternary services.

1.4. Procedures

Two Anterior Cingulotomies were performed during 2013/14. Both were Scottish patients.

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 8.5 ± 2.6 weeks. This is slightly shorter than the previous year. The percentage of Scottish patients seen within 12 weeks was 87.5%, with documented reasons for delays for the three patients that waited slightly longer.

4 Quality of Care

4.1. Formal Complaints

There was one formal complaint (unrelated to the neurosurgical or intensive OCD pathway) which was resolved within the NHS Tayside complaints procedure.

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 2013-14. It is not possible to generalise to all patients undergoing the procedure.


Size of change in symptom scores (categories are exclusive)

Indication for surgery





Depression (N=7)





OCD (N=1)






6 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 in fields such as: neurosurgery; ablative neurosurgery; vagus nerve stimulation; neuroimaging; and neuropsychology.

The service is research active, and members of the team continue to publish extensively in journals.

7 Service Developments and Future Plans

Three patients have been treated as part of the intensive OCD treatment programme. Two-thirds of patients (who were all severely unwell) were responders after inpatient treatment.

8 Summary and Conclusions

Referrals to the service for patients with OCD have increased and this is likely to be due to our ability to deliver specialist intensive treatment programmes as part of our SLA. Neurosurgical activity remains only one part of an extensive treatment service which involves close working with patients, carers, and mental health services.

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