NHS neurological services not good enough

MPs reporting into NHS neurological services, used by over 4 million people in England,  find that they are not good enough. 

There is a wide difference in being able to access services and the outcomes for patients across the country.  This not only affects a patient’s experience, poor care also costs the NHS.  For example, it spends £70 million handling emergency admissions of epilepsy patients, many the result of poor care.  

Neurological services are also poorly integrated with social care which is itself under extreme funding pressures.  Of real concern is the fact that there have been little improvements in services, leading MPs to conclude that neurological services are not a priority for NHS England.  In particular the MPs found:

  • Wide variations in services and outcomes for people with neurological conditions. Diagnosing neurological conditions took too long.  Services in hospitals are variable and local health and social care services are often poorly coordinated.  Differing services results in a variation of outcomes for people with neurological conditions.  For example, the number of adults receiving epilepsy treatment who remained seizure-free for 12 months ranged from 87% in SW Lincolnshire to 47% in Hull.

     

  • NHS England is also failing to meet its objective that everyone with a neurological condition should have a personalised care plan by 2015. They are important to coordinate people’s treatment and helping to manage their conditions in the community. Just 12% of neurological patients have a written care plan

     

  • Give patients better access to neurologists - use existing resources more effectively. Over the last decade the number of neurologists in the NHS has grown by around 5% per year.  There are now about 650 full-time equivalent consultant neurologists working in the NHS in England however they are distributed unevenly and in some hospitals, a specialist neurologist may be available on only one or two days each week.  There is potential to make better use of existing neurologists by making more use of specialist nurses to carry out tasks currently undertaken by neurologists.

     

  • Abolition of the role of national clinical director for adult neurology would lead to a loss of clinical leadership and accountability. NHS England appointed a national clinical director for adult neurology in 2013. He has had a positive impact by providing clinical leadership at national level and promoting service improvement.  However NHS England is not planning to reappoint the national clinical director for adult neurology

     

  • NHS England has no plans to improve the linking of health and social care data beyond the ‘care.data’ initiative, which is unlikely to be implemented before 2020 at the earliest.  Health and social care data should be linked to provide a complete view of all the services that patients are receiving.  However the care.data initiative is not expected to be in place before 2020.  

     

  • Confusion over commissioning responsibilities is leading to ineffective commissioning of neurological services. Reforms to the health system in 2013 means NHS England now commissions specialised neurological services with local clinical commissioning groups responsible for other neurological services.  However, for neurology, what constitutes specialised services is unclear.  This confusion over who should be commissioning services means clinical commissioning groups have tended not to engage effectively with neurological services.  In April 2016, NHS England plans to clarify that all neurology outpatient services will be commissioned by clinical commissioning groups.

     

Head Injury UK: Head Injury Claim Experts

Our specialist head injury solicitors support many of the criticisms of neurological services in the NHS and its poor links with social care support.  Whilst there are some good services, it is a post code lottery for many patients, who deserve just as good care as more high profile health areas like cancer.  For head injury or brain injury victims, we are often able to help obtain private neurological treatment, however hopefully this report will help focus attention on the needs of all neurological patients.  If you or a loved one has suffered a brain injury caused by someone else and want to know how we can help, please please contact Andy Shaw or call us on 0800 073 0988.

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