Cranial neurosurgery is a term covering a vastrange of surgical procedures carried out on the brain or on nerves located in the skull. It includes potentially life-saving surgery to stop bleeding in the brain and remove tumours, as well as procedures to address debilitating pain caused by nerve damage. Cranial neurosurgeons also play a pivotalrole in monitoring patients who have suffered a head injury, who will often not need a surgical procedure. Just 24 NHS hospitals across England conduct cranial neurosurgery, together admitting around 75,000 neurosurgery patients a year. About 40% of these are emergency admissions, often of otherwise healthy patients. Once admitted, cranial neurosurgery patients typically stay longerin hospital than in many other surgical specialties due to the severity of the illness orinjury and the longerrecovery period from potentially highly invasive surgery. The Getting It Right First Time (GIRFT) programme has examined in detail the way that cranial neurosurgery is provided in England, to identify differences in procedures and practice as well as common issues in the 24 trusts.