Good hand surgery clinical practice includes collecting data on patient's pre and post operatively. This allows a clear and objective assessment as to a patient's response to their hand and wrist surgery treatment. The data is also valuable for research and audit purposes in which mike has a keen interest. As from 1st September 2008, Mike Hayton will offer all his new and follow up hand, wrist and elbow patients the opportunity to fill out a quick 30 point questionnaire. The questionnaire is called the DASH and is a well recognized upper limb validated scoring system. DASH stands for Disability of the Arm, Shoulder and Hand. Wrist patients will also be offered the new Wrightington Wrist score which will be available in due course.