Major breakthrough in understanding neurological conditions sparks rethink on improving care

April 20th 2016 category Commissioning Excellence

Today a report is published which brings new insight into how people with various neurological conditions can be better supported to stay well.

The Neurology Intelligence Report is the result of close working between a number of organisations* including the National Institute for Health Research, which is the research arm of the NHS.

Over 2 million hospital attendances and admissions from 2009-2014 for conditions ranging from Parkinson’s, multiple sclerosis, epilepsy, neuromuscular conditions (like motor neurone disease [MND]) and headaches were analysed to understand more about them.

The data was taken from Hospital Episode Statistics (HES) data routinely collected by hospitals on the number of people using NHS inpatient and outpatient facilities.

The report authors found that in many cases, minor illnesses, which could potentially have been assessed and treated and managed proactively, were responsible for admissions in people with neurological conditions. In addition overall they identified a significant rise in the number of people with neurological conditions who were admitted to hospital, or seen as outpatients.

Dr Christopher Kipps is Clinical Director for the Strategic Clinical Network at NHS England (Wessex) for Mental Health, Dementia and Neurological Conditions, and is also NIHR CLAHRC Wessex lead for Dementia: “Until now it has been hard to pull together a complete picture of the health and care of people with neurological conditions in our region and nationally. This report really helps understand how people with neurological conditions end up in hospital and where we can act earlier and work together to improve their lives.

“There are huge challenges in improving care in people with neurological conditions, but having good information, makes it a little easier to understand how we can be more effective.”

David Bateman, National Clinical Director for Adult Neurology Conditions for NHS England, praised Dr Kipps and his team saying: “This report takes that intelligence a step further, analysing more closely how people with different neurological conditions utilise hospital services and why. It demonstrates a substantial local increase in demand for neurological services over the past five years.

“It further highlights how, for example, a stronger focus on integrated care pathways and the earlier treatment of infections in the community could significantly impact the number of emergency hospital admissions for people with long-term neurological conditions. The report also emphasises practical measures, already implemented in various parts of the country that could be used locally to improve community and emergency care in neurology.

Anya De Iongh, studied medicine at Cambridge until her neurological conditions* forced her to leave: “I have a number of conditions which meant a fair few admissions to hospital at the beginning. It’s really disruptive to day to day life as a young person, and can knock your confidence of managing a condition. Anything that supports hospital stays to be shorter and fewer is good, along with the right support out in our communities.”

Anya lives in Dorset and now works to promote self-management for people with long term illness. She also works with research teams to promote the patients’ voice.

Outline findings:

·         High rate of fractures, falls and injuries in Parkinson’s, and high levels of urinary and respiratory tract infections.

·         High levels of urinary tract pathology (including infection) in multiple sclerosis, with other factors including falls and pressure ulcers also responsible.

·         Epilepsy data identified a high level of injury associated with the condition, and may represent a safety signal with respect to adequacy of community care.

·         Neuromuscular conditions significantly associated with respiratory dysfunction, suggesting the way care is planned for patients could be improved.

·         Headaches are responsible for a high number of emergency admissions, but many of these could potentially be managed better in the community

More facts and figures:

Over a five year period the cost of treating people admitted to hospital with neurological conditions in the Wessex region rose from £51 million to over £73 million per annum.

The number of people admitted to hospital with a neurological condition rose by 49% from 2009-2014, and the number of people seen in neurology outpatient clinics increased on average by 78% in the same time period.

The amount of money spent on treating people with these conditions varies considerably across the region.

Epilepsy and headaches are by far the most common reason for people to be admitted to hospital with a neurological condition, however their stay is usually brief. Yet other conditions like Parkinson’s, multiple sclerosis and other neuromuscular conditions (like MND) had longer hospital stays, and often have other medical problems (comorbidities) directly responsible for, or contributing to, their admission.

Sue Thomas, Chief Executive for NHiS Commissioning Excellence: “I believe this information, which has been a huge task to collate, really improves our knowledge of neurological conditions and why people use hospital facilities. It’s useful to have this detail across a population of 2.8 million people because it gives us very practical insights into how we can change healthcare in the region.

“Those changes will make a real difference to those people living with the conditions, helping them in some cases to remain healthy and independent for longer.”

*Anya has been diagnosed with POTS (Postural tachycardia syndrome), Chiari malformation and Guillain-Barré Syndrome as well as other long term conditions (LTCs).

She writes a blog to help people understand and manage long term illness (sometimes call self-management) and is a keen sailor.

About the Author

Sue Thomas

Sue Thomas

Chief Executive for Commissioning Excellence
View more posts by Sue Thomas

April 20th 2016 category Commissioning Excellence

Commissioning Excellence

As one of NHS England’s recognised niche specialist commissioning support providers, we offer a full range services to assist you in improving patient outcomes. Our experience covers all long term conditions, with a particular specialism in the field of neurology.

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