Neurology services remain a postcode lottery

September 16th 2015 ...in category Commissioning Excellence

Figures published last week show that access to neurology services remains significantly varied across the country.

Figures published last week show that access to neurology services remains significantly varied across the country.

The figures come from Public Health England’s Neurology Intelligence Network (NIN) which has published its first intelligence briefing on neurological outpatient activity in England.

The briefing shows that some CCGs offer no access at all to consultant neurologists or nurses, leaving many people to either travel long distances to access care or not receiving the care they need.

The findings, usefully summarised here, reiterate many of the issues highlighted by the Neurological Alliance’s recent report ‘The Invisible Patients’ showing that neurology patients are tumbling through the gaps because commissioners have an alarming lack of understanding around local neurological populations and their needs.

Arlene Wilkie, its Chief Executive said of the NIN’s figures:

“The postcode lottery in neurology must come to an end. Timely diagnosis and treatment is essential to the effective management of these complex conditions, and this requires access to the appropriate specialist neurological expertise.

“We welcome the publication of this data which sheds new light on the issues affecting neurology services. It is crucial that commissioners engage with these findings and take steps to ensure good access to care and support for patients in all parts of the country.”

With such poor local provision in many places – for example over a fifth of CCGs offer no local consultant neurology services at all – our concern is that this has a detrimental impact on neurology patients who are often least able to cope with travel due to their condition and complex needs. Because of this many patients are not receiving the care they need.

Furthermore the figures find there is little or no local provision of nursing services for neurology in 50% of CCGs. Nurses, especially specialist neurology nurses, play a critical role in the care of neurology patients, providing support, information and crucially proactive care that helps to prevent avoidable problems that may otherwise reach a crisis. Without investment in this type of essential local service that is responsive to patient needs, more people with neurological conditions end up in crisis suffering from preventable problems such as urinary infection and falls, which ultimately means more unplanned admissions and costs CCGs more money.

While the NIN highlight the possible reasons why variation in local service provision may occur – including differences between local areas in prevalence of neurological conditions, capacity for assessing those with neurological problems, and the use of alternative assessment pathways – the briefing shows that commissioners need to make neurology a priority if they are to drive improvements and effectively manage the demand for neurological care. Disappointing as the NIN’s new figures may be, this type of baseline assessment is needed as a stark reminder if CCGs are to begin on the path towards improvement and service redesign.

About the Author


Sue Thomas

Sue Thomas

Chief Executive for Commissioning Excellence

sue.thomas@nhis.com
View more posts by Sue Thomas

September 16th 2015
...in 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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