Clinical neurophysiology clinical outcomes

Clinical outcomes are broadly agreed, measurable changes in health or quality of life that result from our care.  Constant review of our clinical outcomes establishes standards against which to continuously improve all aspects of our practice.

About the Clinical Neurophysiology Service

Neurophysiology looks at how the body is working, particularly the brain and nervous system. A variety of methods are used to measure how the electrical signals from the brain and nervous system are changing, and the results are then used to make diagnoses and plan treatment. Conditions we are involved in monitoring and providing information about include mainly epilepsy and muscle disorders, but we also do clinical investigations on children referred from many specialties within the Hospital.

There are six consultant clinical neurophysiologists in the department supported by 16 clinical physiologists and two clinical scientists. We also have administrative staff, who are responsible for keeping the department running smoothly.

We offer diagnostic services to all the departments in GOSH and also specialist services to children’s departments in hospitals across the South-East and more widely across the country.

1. Investigations

Table 1 Number of investigations, 2016/17 to 2018/19

Type of investigation 2016/17 2017/18 2018/19
EEG 1,670 1,527 1,404
EMG 869 873 841
Evoked potentials 87 117 107
Video telemetry - home - - 66
Video telemetry – inpatient* 709 689 682
Intraoperative monitoring 321 325 303

* Bed nights (may be 1-4/patient)

approx. 30 bed nights lost to periods of ward closure

Glossary

  • EEG (electroencephalography) - recordings of the brain’s electrical activity (‘brain waves’) recorded from the scalp.
  • EMG (electromyography) - measurements of electrical activity in nerves and muscles.
  • Evoked Potentials - measurements of electrical signals produced by stimulating the senses (visual, auditory, skin).
  • Video telemetry - prolonged EEG recording (over hours to days), linked to video recording of the child’s behaviour. This can be done at home or in hospital depending on the question asked by the clinical team.
  • Intra-operative monitoring - Continuous monitoring of evoked potentials to assist the surgeon.

2. Referrals

We aim to see all patients within six weeks of referral to ensure that assessment is undertaken in a timely manner and to avoid delays in treatment. The table below shows the percentage of patients seen at GOSH within six weeks of receipt of referral, as per the NHS standard. Patients seen more than six weeks from referral were all seen within the time specified by the referring clinician.

Table 2 Percentage of outpatients of the Clinical Neurophysiology Service who are seen within six weeks of new referral, 2016/17 to 2018/19

2016/17 2017/18 2018/19
865/869 (99.5%) 871/873 (99.8%) 838/841 (99.6%)

This information was published in November 2019 and will be updated in November 2020.