FICM comments on GIRFT Cranial Neurosurgery Report

14 July 2018

Back in April, the FICM issued a statement on the release of the GIRFT Cardiothoracic Surgery report.  The GIRFT programme has now released a report on Cranial Neurosurgery, which recognises many of the same issues relating to capacity issues in critical care.  In April we said the report highlighted “the importance of critical care services to the efficient management of cardiac surgery.  It importantly also recognises the considerable issue of bed management that critical care teams manage on a daily basis, which is often compounded by the lack of wards beds to discharge patients to.”  It is not surprising that this report highlights exactly the same problem. 


The report goes on to recommend that GIRFT “develop a model pathway for critical care to improve bed usage and patient flow”.  There is a GIRFT critical care programme which has begun its series of site visits and will issue its own report, including accurate information on the supply of beds in critical care and data on the variability of admission and outcome.  In parallel, the FICM is taken forward a project on postoperative enhanced care that will establish a best practice guide that can aid commissioning.  It is essential that GIRFT learns from these two outcomes before recommending wholesale changes informed by services that individually feed into critical care.  The issue is complex and the English NHS will need the kind of informed national review of critical care capacity that Wales has recently established.