With 1 in 6 people currently affected by a neurological condition such as MS, epilepsy or Parkinson’s Disease, it would be expected that neurology services provide excellent care to all those who access them. However, a report by Neurological Alliance highlights the lack of care received by this group of patients from the NHS and goes as far to say that it could be termed as neglect. The Neurological Alliance, which represents over 70 national and regional groups for people with a condition affecting the brain or spinal cord as a result of illness or injury, has identified three key areas where the NHS is currently failing these patients and has provided recommendations for how neurological services can be improved.
Where the NHS is failing patients with neurological conditions
The first area where patients are being failed is the length of time they have to wait to receive a diagnosis of their condition. Not only is this wait an anxious one for patients, but the longer that time elapses between presentation of symptoms and diagnosis, the more the condition has advanced in the meantime. Even once a diagnosis has been made, many patients are not provided with adequate information about their condition or the treatment options available, so they are unable to make an informed decision regarding the care that they will receive. Lastly all too often patients with neurological conditions are admitted to hospital as emergency cases, which is an indicator that their conditions are not well managed in the community. Hospital admissions aren’t just unpleasant for patients, but they are not an efficient use of money either.
Spending on neurological services
Although 5% of the total NHS budget is spent on neurological services, which represents the eighth largest spend within the NHS, this spending is not evenly distributed across the country, so the much talked about “postcode lottery” is in play regarding treatment and services for neurology. One example is that Central Lancashire PCT spends £11.37 million for every 100,000 people, while Haringey Teaching PCT spends just £4.31 million per 100,000 of the population it serves. Differences also were apparent in the proportion of neurological service spending that goes on emergency admissions, with Liverpool, Wandsworth and Sunderland being amongst the worst offenders spending around half their money on this. It has been suggested that without changes to new NHS reforms the situation will only worsen, a trend that needs to be dramatically reversed, as at present the rate of diagnosis of neurological conditions is at half a million people per year and this is set to rise further.
The NHS has announced that it is going to develop a Strategic Clinical Network for neurology and that the NHS commissioning boards are planning to work on improvements to services for neurology. While this is certainly a step forward, the NHS needs to be sure that it assesses services for neurology against both clinical outcomes for patients and those factors which are important to patients using the services, allowing problems to be highlighted, monitored and steps towards improvements to be put into place. Not only will services be assessed this way, but it will be a good indicator of whether the decision makers have made the right call regarding local neurology services, so is a way to monitor them also. A national survey of patients living with neurological conditions has been suggested by the Neurological Alliance as the best way to understand the difficulties faced by this patient group. Knowing this information will allow neurological services to be tailored more to meet their needs. Only by involving patients will the NHS be able to work on improving services so that patients are able to access what they require, when they are most needed and at the location that is most acceptable.
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