Commenting on the National Audit Office (NAO) report on services for people with neurological conditions, Dr David Bateman, chair of the joint Royal College of Physicians (RCP) and Association of British Neurologists (ABN) report Local adult neurology services for the next decade, said:
Many of the findings in this report are identical to those in the joint RCP and ABN report published earlier this year. Many of the problems identified by the NAO are due to limited availability of local neurologists to see emergency neurology admissions, limited access to outpatient clinics and lack of coordinated planning and commissioning of neurology services across hospitals, primary care and social care. Our report made three key recommendations to improve care for neurology patients:
- an expansion and improvement of local services with a shift in emphasis from scheduled to emergency care
- organised care for patients with long-term neurological conditions, managed in part through an enhanced role for specialist nurses and general practitioners with a special interest in neurology
- better local planning of services with increased clinical involvement within a commissioner/provider forum, creating a neurological network to improve clinical outcomes and better value for money.
The new commissioning structures being introduced into the NHS offer a major opportunity to implement these changes and improve the lives of patients with neurological conditions, who deserve the high-quality services available to patients with other medical conditions.
The RCP is also delighted to see that the NAO has recognised the value of the National audit of services for people with multiple sclerosis undertaken by the RCP in conjunction with the MS Trust, which has recently been completed for the third time.
Professor Derick Wade, chair of the RCP MS Audit steering group, made the following recommendations:
Services for MS patients in particular will only be resolved if every health district has a specialist multi-disciplinary neurological rehabilitation team that includes social workers, as per guidance in the NICE MS guidelines. These teams must:
- have a hospital base and sufficient inpatient beds as well as see patients elsewhere including in their own homes, nursing homes and GP surgeries
- have access to sufficient resources including staff
- be able to organise and supply all equipment needed (as per NAO reports 2000, 2002)
- include seamless working with social services, probably with a single management and budget.
In addition, every organisation must have a named individual who is fully responsible for the services provided to people with long term neurological disorders. That individual must also be responsible for liaison with all other organisations and must report to the organisation's board with data on performance against the National Service Framework quality requirements.
Every commissioning organisation must also take an active role in auditing services, preferably using the method used by the RCP’s MS audit.
For further information, please contact Andrew McCracken, RCP Communications and New Media Adviser, on +44 (0)203 075 1354 / 07990 745 608, or email andrew.mccracken@rcplondon.ac.uk