In 2016, NHS England awarded Great Ormond Street Hospital (GOSH) – in conjunction with our partners at the National Hospital for Neurology and Neurosurgery (UCLH) and the Queen Square Radiosurgery Centre (QSRC) – the regional south of England service for paediatric stereotactic radiosurgery – often known as “Gamma Knife”. This is a high-tech treatment that utilises advanced image guidance to target radiation very accurately and selectively on lesions in the brain. Prior to this award, GOSH patients with vascular disease or certain brain tumours had to travel hundreds of miles to Sheffield for treatment. Now the GOSH neuro-vascular and neuro-oncology teams can treat these patients “in house”, as well as being the referral centre for other tertiary paediatric neurosurgical units around the south of England. The service is led by Greg James, Consultant Neurosurgeon at GOSH, alongside Neil Kitchen, Consultant Neurosurgeon at NHNN, and requires multidisciplinary teamwork from colleagues across both Trusts to treat children on an adult site with all appropriate expertise. The service, which started in late 2016, is about to treat its 5th patient, with the initial feedback from patients, families and staff being very positive.