I am a surgeon and a member of the head and neck team in Glasgow – my home now for nearly two decades.

It is a privilege to have an opportunity to participate in the BAHNO debate and particularly on this key topic. I am firmly of the view that empiricism has to be the core of clinical practice and that means contributing to trials where there is clinical equipoise; recognising that observational studies have a place but also significant limitations. While there is an ethical imperative on all of us to contribute to the evidence basis for clinical practice there are substantial barriers to overcome in doing so for NHS clinicians.

My clinical practice encompasses oral and oropharyngeal cancer, cutaneous cancer of the head and neck and salivary gland disease. I am a member of the Glasgow skull base team and represent the head and neck surgical oncology teams at the Scottish National Sarcoma MDT. Reconstructive free tissue transfer surgery occupies a prominent place in my clinical duties.

I have an interest in quality assurance and quality improvement and have been part of the steering committee for the UK Quality Outcomes in Maxillofacial Surgery project since its inception.