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  1. Paul Morrish
  1. Correspondence to Dr P Morrish, Consultant and Honorary Senior Lecturer in Neurology, Gloucestershire Royal Hospital, Great Western Road, Gloucester GL1 3NN, UK; Paul.Morrish{at}

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Ethiopia, Kwa-Zulu Natal, Laos—and now Gloucester (figure 1). Why Gloucester? Because with a population of 550 000 there is interesting neurology to be discovered here, 40 miles away from the nearest neuroscience centre, and with no visa or vaccinations needed.

Figure 1

Gloucester Cathedral, from the neurology ward. Inside is the mediaeval tomb of King Edward II, victim of an early botched attempt at key hole surgery.

Gloucester isn't actually quite as native as many UK district general hospitals (DGHs). David Stevens first brought neurology to these backwaters in 1974 and it has become a well established camp; four consultant neurologists (last year briefly becoming multicultural with locums from Germany and the Czech Republic), excellent clinical neurophysiology, neuroradiology, brain injury rehabilitation and even (say it quietly in the ultra-efficient NHS where no bed is specialty reserved) a ward to call our own. Many DGHs only receive a visiting neurologist once a week but the Gloucestershire model could be a blueprint for the future of DGH neurology in the UK.1

Why work in ‘the periphery’ rather than in a neuroscience centre? Put simply, because there is a lot of neurological work to be done in the periphery. And there is a challenge in providing a comprehensive service that includes …

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  • Competing interests None.

  • Provenance and peer review Commissioned; not externally peer reviewed.

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