NAO report highlights neurology services need action

July 23rd 2015 category Healthcare News

In a blow for neurology, the National Audit Office’s (NAO) latest report shows that services are still failing patients.

With 12.5 million people in England who have a neurological condition, that indicates widespread failure of the NHS to address the needs of vulnerable patients, many of whom have complex health needs.

The NAO’s report follows up on progress since its 2011 review which found that there are “significant problems with current services”, stating that “The Department [of Health] does not know what the Framework [National Service Framework for Long-term Conditions] and additional spending of nearly 40 per cent over four years have achieved”.

In 2011, Amyas Morse, head of the National Audit Office on publication of the original review, said: “Services for people with long-term neurological conditions are not as good as they ought to be, despite a large increase in spending. Progress in implementing the Department's strategy has been poor and local organisations lack incentives to improve the quality of services."

The 2012 House of Commons Public Accounts Committee (PAC) made a set of recommendations for neurology and the new NAO report, published on 10th July, shows that progress against three of the recommendations has been poor, with moderate progress against the remaining two recommendations.

Last week, Amyas Morse said: “Overall, however, progress in taking the action needed to improve services for the people with these conditions has been mixed. Considerable further work is therefore needed to make more progress and to achieve better services and outcomes for people with neurological conditions.”

Key recommendations highlighted by the Neurological Alliance that have not been achieved include:

  • Access to services: The government has failed to use levers such as the CCG outcomes indicator set to improve access to neurology services across the country, and as a result neurology is mentioned in only half of local strategies.
  • Care planning: The government has failed to ensure that everyone with a long-term neurological condition has a care plan, resulting in changing care needs not being met.
  • Improving data: The government has not rectified the shortage of neurology data, which means the NHS has no actual record of the numbers of neurology service users and no effective measure of patient outcomes.

The point on data is an important one, because a dataset is essential to understanding where improvements need to be made and for measuring success in the future. The Health and Social Care Information Centre did publish a compendium of neurology data in March 2014, although it did not link health and social care data or include data on emergency readmissions as the Committee recommended.

Crisis intervention for neurology patients is all too common and costly for CCGs, and the omission of emergency readmission data is a gaping hole. Very often a handful of neurology patients within a CCG are being frequently re-admitted as emergencies (and frequently have long stays too) create spiralling costs for that CCG. A CCG needs to know if this happening in order to address the problem.

CCGs would do well to ‘think neuro’ and prioritise neurological conditions as a matter of urgency – not least to make important savings at a time when budgets are squeezed more than ever. Reviewing neurology sounds like a big task, but often simple measures (such as implementing a care plan and allocating a specialist nurse in the above scenario of frequent emergency readmissions) can deliver quick wins that help start the ball rolling for five-year transformation plans and to address QIPP.

If people with long-term neurological conditions like Parkinson’s and MS get the proactive care and support they need, patient outcomes can be drastically improved and CCGs can realise vital efficiencies.

About the Author

Sue Thomas

Sue Thomas

Chief Executive for Commissioning Excellence
View more posts by Sue Thomas

July 23rd 2015 category Healthcare News

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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