In this episode Joff Lacey talks to Hilary Madder, consultant anaesthetist at The Alfred and former Clinical Director of Neurosciences Intensive Care at the John Radcliffe, in Oxford. They explore the growing sub-speciality of neurocritical care, including the rationale for the development of specialised neuro intensive care units, the evidence of impact on patient outcome and what may be the key determinants of improved clinical care.