Patterns of harm in UK neurosurgery: what patients need to know about negligence investigations

Across the UK, neurosurgery and neuro-oncology services at several NHS Trusts have been subject to independent reviews, regulatory scrutiny and (in some cases) Police investigations. Media reporting has raised serious questions for patients and families about whether care was safe and failures systemic, as well as what those affected can do next.

Here, brain and spinal tumour experts Fiona Tinsley and Becky Addison delve into what’s meant by ‘patterns of harm’, what has been publicly reported (by location), how different types of investigations work and the types of care failures that can arise. 

If you or a loved one has been affected, we also offer a series of practical steps to follow to help you understand what has happened and seek justice.

What does ‘patterns of harm’ in neurosurgery mean?

In a clinical and legal context, a pattern of harm refers to repeated or systemic failures in care, rather than a single isolated mistake. 

In neurosurgery and neuro‑oncology, this may include issues such as:

• Poor clinical governance or supervision.
• Inadequate multidisciplinary team (MDT) decision‑making.
• Unsafe surgical techniques or verification processes.
• Delayed escalation of post-operative complications.
• Inappropriate treatment pathways or prolonged drug therapies.

When similar concerns affect multiple patients over time, this can trigger independent service reviews, regulatory intervention by the Care Quality Commission (CQC) or — in the most serious cases — Police or public‑inquiry scrutiny. While these processes don’t automatically prove medical negligence, they can uncover evidence that’s highly relevant to patient safety and potential civil claims.

Reviews, ratings & investigations: what’s the difference?

Patients are often confronted with confusing terminology in headlines. These processes aren’t the same and each serves a different purpose.

1. Independent or invited service reviews

These are usually commissioned by an NHS Trust or NHS England and focus on systems, governance and clinical pathways. In neurosurgery, a review may examine MDT functioning, operative planning, complication rates, escalation processes and leadership culture. The aim is improvement and learning — not assigning legal liability.

2. CQC inspections & ratings

The CQC is the statutory regulator. Inspections assess whether services meet national standards under domains such as Safe, Effective and Well‑led. A rating of “requires improvement” or “inadequate” can highlight risk but isn’t a legal finding of negligence.

3. Police investigations & public inquiries

Police involvement applies a criminal threshold, such as alleged gross negligence manslaughter or corporate manslaughter. Public inquiries may examine both individual practice and systemic failures. These processes run separately from civil negligence claims but may generate important evidence.

What has been reported? Neurosurgery concerns by location

Cambridge neurosurgery review — Addenbrooke’s (Cambridge University Hospitals)

In January 2026, Sky News reported that Cambridge University Hospitals (CUH) ordered a “rapid but thorough” independent review of its neurosciences service. The Trust stated that the review spans a several clinical teams, focuses on strengthening clinical governance and that findings will be published. 

Independent service reviews of this nature typically examine pathways of care, MDT oversight, complication governance, incident reporting and leadership arrangements. They’re framed as patient-safety scrutiny, not findings of wrongdoing. 

For patients, such reviews may identify systemic weaknesses that help to explain unexpected outcomes or delays in care.

Birmingham neurosurgery investigation — University Hospitals Birmingham (QEHB)

As reported by the BBC in 2022, an independent review found poor clinical outcomes for Deep Brain Stimulation (DBS) in movement disorders. More than 150 cases were investigated and surgery suspended while safety improvements were introduced. 

Neurosurgery outcomes depend on meticulous targeting, robust intraoperative verification, clear team communication and timely post‑operative response — all areas highlighted by reviewers. The CQC has also rated aspects of surgical services at QEHB as “requires improvement”.

Brighton neurosurgery police investigation — Royal Sussex County Hospital (University Hospitals Sussex)

In 2025, the Guardian and BMJ reported that Sussex Police was considering corporate manslaughter and gross negligence manslaughter in a probe into general surgery and neurosurgery (covering the period from 2015 to 2021), which expanded from ~40 deaths to more than 200 cases of serious harm/death under review. 

University Hospitals Sussex has published a freedom of information (FOI) disclosure confirming an invited service review by the Royal College of Surgeons (RCS) into neurosurgery, including a redacted report and board level documentation.

Police investigations and Royal College reviews may uncover contemporaneous concerns about safety, supervision and escalation.

Coventry neuro-oncology concerns — University Hospitals Coventry & Warwickshire (UHCW)

We’ve previously reported extensively on allegations of prolonged temozolomide (TMZ) chemotherapy in neuro‑oncology, with claims that patients received treatment far beyond usual protocols, leading to significant side effects. It has been reported that an external review by the Royal College of Physicians was commissioned and that the CQC was notified. 

Subsequent reporting has highlighted wider concerns across Coventry and Warwickshire, including MDT oversight, decision-making and pharmacy escalation in cancer care.

Multiple outlets — including the BBC, The Independent and The Times — have set out accounts from patients alleging extended TMZ courses. These were often beyond the usual six- to 12-month range, with significant side effects. 

Treatment decisions in neuro-oncology are highly protocol driven and departures from accepted practice are clinically and legally significant.

What should I do if I’m worried about neurosurgical or neuro‑oncology care?

If you or a loved one has concerns — whether or not negligence has already been confirmed — the following steps are often helpful:

1. Request your full medical records 

Ask for complete patient records including operation notes, MDT minutes, pathology, imaging (DICOM files) and pharmacy prescriptions. NHS Trust FOI webpages explain how to request non‑personal documents. Personal clinical records are accessed via Subject Access Requests.

2. Ask about PSIRF responses

Under the Patient Safety Incident Response Framework (PSIRF), Trusts may open a learning response. You can ask whether one exists and request the terms of reference and any shareable outputs (often redacted).

3. Engage with the Police or relevant public inquiry processes

Where Police investigations or public inquiries are active, families can ask about liaison arrangements, scope and timescales. These processes run separately from clinical reviews). 

4. Seek specialist legal advice

Independent advice from lawyers experienced in neurosurgery and neuro-oncology negligence can help you to understand whether care fell below acceptable standards, what evidence is needed and which options are available.

Specialist advice on neurosurgery negligence

If you’re concerned about possible negligent neurosurgical or neuro‑oncology care, our nationally recognised medical negligence team can help. 

We regularly investigate patterns of harm across NHS Trusts, review imaging and pathology, interrogate neurosurgical decision‑making and obtain expert evidence from leading consultants in neurosurgery, neuroradiology, neuropathology and oncology.

We offer free initial consultations and most cases proceed on a ‘No Win, No Fee’ basis.

Taking the first step can make all the difference. Talk to us by giving us a call on 0333 004 4488, sending us an email at medneg@brabners.com or completing our contact form.