Neurology care ‘patchy and inefficient’ | Society | guardian.co.uk

The NHS is failing to provide proper care for up to 10 million Britons who have a neurological condition such as migraine, multiple sclerosis or Parkinson’s disease, physicians warn in a report.

Too many patients requiring specialist attention do not get to see a neurologist, while badly organised services may mean that some people’s treatment is less than ideal, it is claimed.

The criticisms are contained in a study by the Royal College of Physicians, which represents hospital doctors, and the Association of British Neurologists. It highlights how patients need different types of services: as an acute admission to hospital, as an inpatient, and for long-term care. “These are currently poorly organised and badly integrated, leaving many patients unable to access the right specialist at the right time and often far from home,” the RCP said.

Dr Steve Pollock, vice-chair of the working group that produced the report, said: “Problems of the central nervous system are extremely common. At their best UK neurological services lead the world, but too often local hospital and community provision does not meet the patients’ needs, being patchy, inefficient and poor value for money.”

Of the 10 million people in the UK who have a neurological condition it is estimated that some 456,000 suffer from epilepsy, 100,000 from MS and 120,000 from Parkinson’s disease.

One in 10 visits to a GP involves a neurological problem, as does a similar number of emergency admissions to hospital, not including strokes. Between 0.6% and 1% of the population is diagnosed with such a condition each year, while 2% of the population is disabled by one of them, the report says.

Despite that, it identified problems such as:

• Too many district general hospitals lack an adequate number of neurologists due to the NHS’s network of large regional neuroscience centres, which conduct research and devise new treatments.

• “Services for patients admitted to hospital with an acute neurological illness are particularly worrying because they are rarely provided by neurologists,” whereas stroke patients will see a specialist immediately.

• The UK has one neurologist per 125,000 people, compared to one for every 40,000 in Europe and the US.

The Department of Health said the report showed why the NHS needed an overhaul. “This is exactly why we need to modernise the NHS. Support for people with long-term neurological conditions has not been good enough,” a spokesman said. Plans to give clinicians more control over commissioning treatment and to closer integration of health services as part of the reorganisation of the NHS in England should improve the situation, he added.

Simon Gillespie, chief executive of the MS Society, said: “Care for people with neurological conditions such as MS is far too patchy. It can take months, often years, of undiagnosed symptoms before a person is referred to a neurologist. Well co-ordinated planning and commissioning, and care programmes where professionals from all parts of the health service work together, will really achieve the best outcomes.”

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