Think Neurology!

April 28th 2015 ...in category Healthcare News

As the election draws nearer, much of the focus on the NHS has been about funding.

The NHS says it needs an extra £30 billion to cover the gap in the coming years. It is suggested that £8bn would come from extra taxpayers’ money, and the remaining £22bn would come from NHS efficiencies.

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That’s a big ask, and the key question is how does the NHS realise these efficiencies?

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There are several opportunities that offer great savings for the NHS but which currently aren’t being tapped into by many cash-strapped CCGs. A great place to start is neurology.

One in six people in England has a neurological condition and their needs are usually long-term and complex. Huge numbers of neurology patients are admitted to hospital as emergencies when they reach a crisis, with expensive accompanying investigations and hospital stays. However, many of these patients need not be in crisis in the first place.

When it comes to Parkinson’s patients in England, a recent study (1) found that they have higher rates of emergency admissions with longer hospital stays, higher costs and in-hospital mortality. The authors conclude that the situation needs urgent attention to reduce the burden of hospitalisation for patients, carers and healthcare systems.

Neuro Numbers: a brief review of the numbers of people in the UK with a neurological condition

Surprisingly, hospital admissions data reveals that the most common reason for neurology patients like these being admitted to hospital is falls and urinary or respiratory infections. These problems are largely preventable if the right assessments and supportive care are put in place proactively.

One highly effective and cost-effective intervention is to employ a specialist nurse. Specialist nurses are invaluable as a first port of call for neurology patients. They offer education and important self-management advice about staying independent (and preventing falls), and can respond supportively when a problem arises, such as a suspected infection, averting a crisis and consequent need for emergency admission and incumbent costs.

This is relatively simple step which can make financial gains for the CCG and improve outcomes for patients, and should be part of designing good services. So it’s surprising that so many CCGs are not assessing the types of services that neurology patients need.

Earlier this year the Neurological Alliance published a report ‘The Invisible Patients: Revealing the state of neurology services’, which shows that low numbers of CCGs are looking at neurology to understand the services they need to commission.

For example, the report find that only 14.7% of CCGs have assessed local costs relating to the provision of neurology services. And only 20.4% of CCGs have assessed the number of people using neurological services within their area.

Without this type of basic information it is very difficult to explore how cost savings can be made, as well as making improvements to patient experiences.

The Invisible Patients: Revealing the state of neurology services

NHiS Commissioning Excellence is working hard to address this gap. As a commissioning support provider, the team uses data to understand what’s happening in local populations of patients with complex needs (like neurology) where the hidden costs may be high. They usually finds that the best services which keep patients out of hospital and deliver excellent services are the ones that cost less too.


References:

Low V, et al., Measuring the burden and mortality of hospitalisation in Parkinson's disease: A cross-sectional analysis of the English Hospital Episodes Statistics database 2009e2013, Parkinsonism and Related Disorders (2015).



About the Author


Sue Thomas

Sue Thomas

Chief Executive for Commissioning Excellence

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

April 28th 2015
...in 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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