A report published by NHS Quality Improvement Scotland has shown that in many parts of the country, people with a neurological condition are not receiving the standard of care they should.

 

The report’s findings, following a review across all NHS boards in Scotland, show the provision and delivery of neurological services are fragmented across the country.  Some health boards do not have plans in place for the provision of neurological services; they have no clear idea of the neurological services they deliver or the resources available in these services.

 

NHS Quality Improvement Scotland is today hosting a meeting to discuss its plans for the development of standards for Neurological Services in NHS Scotland, which it is hoped will help to address the deficiencies identified in the report.

 

The objective of the review was to identify service provision for those with a neurological condition in Scotland, in terms of inpatient and outpatient facilities, staff numbers including consultants, nurses, allied health professionals and other resources.

 

The research also highlighted the need for better follow-up care, more specialist medical staff and established links with other organisations such as voluntary organisations.

 

Mark Hazelwood, Director of the MS Society Scotland and Chair of Neurological Alliance Scotland said:

 “The findings in this report come as no surprise to us.  We have been aware of the inequity of both the provision and delivery of neurological services for a number of years.  The part of Scotland in which you live will probably determine the type and quality of service you receive. The priority you are given will also probably depend on the type of neurological condition you have.

 

Of particular concern are the inequalities between health boards in the level and quality of rehabilitation they receive.  Rehabilitation is vital for people with neurological conditions and it can make a huge difference to their independence and quality of life.

 

The numbers of people with neurological conditions is going to grow sharply in the next two decades.  It is vital to address the standard of neurological services now.”

 

Particular issues highlighted in the report include:

·         A lack of specialist posts and lack of posts for trainee doctors choosing to specialise in an area relevant  to a neurological condition - This means a patients with a neurological condition are more likely to be seen by general medical staff and are unlikely to be seen or overseen by a neurology consultant.

·         Waiting times for follow up appointments - As follow up appointments do not have to meet national targets; there is a greater focus on waiting times for new patient referrals.

·         Palliative care tends not to be provided by the NHS for those with a neurological condition.

·         There is an imbalance of funding across neurological conditions within the NHS

·         Acute admissions may not be transferred to specialist neurological services

·         A lack of joined up working between acute and primary care services and with social services due to a lack of formalised communication links

·         Public transport issues

·         Information provision

·         Rehabilitation

 

Stroke is one condition which seems to come off better than other neurological conditions – mainly due to the fact that it is a national priority.  There isn’t the same issue with the number of inpatient beds as there are for other neurological conditions.  There are also more Managed Clinical Networks for stroke conditions than any other neurological condition.

 

Maddy Halliday, Director Scotland of The Stroke Association, which is a member of the Neurological Alliance said,

 

“Stroke services in some areas do seem to be much better compared to services for other neurological conditions.  However, there are still challenges with respect to stroke care in Scotland such as the inconsistency of services across health board areas and  rehabilitation and long term support for stroke survivors.”

 

Mark Hazelwood added:

“Scotland’s NHS services should be properly equipped to deliver consistent neurological services to a range of patients in a number of locations.  We are calling for all neurological conditions to be treated as a priority.  We want to see more funding and greater focus on neurological services to enable them to be provided at the right level and quality throughout Scotland.”