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People with neurological conditions must be prioritised

The Brain and Spine Foundation welcomes today's report on services for people with neurological conditions by the Public Accounts Committee (PAC), and urges NHS England and the Department of Health to prioritise neurology and ensure that all recommendations are implemented as quickly as possible.

The PAC found a number of issues with neurology services including that “diagnosing neurological conditions takes too long, services in hospitals are variable and local health and social care services are often poorly coordinated.” It warns that “neurological conditions are not a priority for the Department of Health (the Department) and NHS England, and we are concerned that the progress that has been made may not be sustained.” The PAC made a series of recommendations which include the following:

1) NHS England should retain the role of national clinical director for adult neurology.

2) NHS England should set out by April 2016: how it will use the new commissioning for value data packs to help clinical commissioning groups improve neurological services and reduce the variation in services and outcomes; and how it will then hold clinical commissioning groups to account for their performance in this regard.

3) NHS England should set out clearly by April 2016 which neurological services are specialised services to be commissioned by NHS England and which services should be commissioned locally by clinical commissioning groups.

The report comes at a time when neurology services have come under scrutiny for falling behind other condition areas. The latest NHS England GP patient survey shows that patients with long-term neurological problems report both some of the worst states of pain and some of the highest levels of anxiety or depression, with the lowest health outcome scores of any long-term conditions. Despite these issues, neurology has largely been ignored by local commissioners and continues to lag behind other condition groups in service quality, availability and access. A 2014 Freedom of Information audit sent to every CCG found extremely high levels of disengagement from neurology, with only 20% of CCGs able to identify the number of people using neurological services within their area.

Despite these longstanding issues, NHS England announced in January that the role of National Clinical Director for adult neurology would be cut from March onwards, leaving neurology services with no source of clinical leadership at the national level.

Neurology in summary:

  • The number of neurological cases in England has now reached approximately 12.5 million – this equates to 59,000 cases per clinical commissioning group

  • 1.3 million hospital admissions were recorded for people with a neurological diagnosis in 2012/13 – representing an increase of more than 500,000 over a five year period

  • The NHS spent over £4.4 billion on neurological conditions in 2012/13 alone

  • NHS expenditure on neurological conditions increased by over 200% between 2003/4 and 2012/13

More information on the latest neurological statistics can be found here in “Neuro Numbers”.