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Patients face postcode access to neurology appointments

42% of CCGs fail to offer fair access to neurology outpatient appointments

Adrian O'Dowd

Friday, 28 August 2015

Significant numbers of patients in England are not being given fair access to neurology appointments, according to new statistics.

The first-ever data on neurology appointments shows significant variation in access to services by CCG areas.

A newly published briefing from Public Health England’s Neurology Intelligence Network draws on hospital outpatient data for 2012-13 to provide the first ever figures on the number and location of neurology appointments in England.

The Neurological Alliance, a collective voice for 80 organisations working to improve health for people with a neurological condition, said the figures should raise concerns amongst CCGs who needed to do better for their local populations.

Figures show that access to neurology services within hospitals varies significantly depending on geographical location, with some parts of the country offering no access at all to consultant neurologists or nurses, resulting in people often having to travel long distances to access necessary care, or not receiving it all.

Specialist neurological expertise is vital for good treatment and management of neurological conditions.

The new data showed that there was high local and regional variation in rates of access to a neurological consultant to diagnose and treat complex neurological conditions.

Local rates of new consultant adult neurology outpatient appointments varied hugely by CCG area, from 2,531 per 100,000 resident population in Camden to as low as 165 per 100,000 population in Doncaster.

In total, there were 89 CCGs (42%) in which the number of new consultant adult neurology outpatient appointments was significantly higher than the national average of 913 per 100,000 population. At the same time, there were 83 CCGs with significantly lower rates.

The regions that had the highest proportion of CCGs with low rates of access to a neurology consultant were the South West, Wessex, East Midlands and Northern England.

Shortages of neurology facilities was also revealed in the data, which showed that areas of the country that were well-provided with such facilities were able to offer good access to consultant services, but more than a fifth (22%) of CCGs offered no local consultant neurology services at all.

Only around a third (37%) of CCGs provided more than 80% of appointments within the local CCG area. Many of these CCGs were in the North West of England and the East Midlands. Large parts of these regions offered no local neurology provision at all.

By contrast, the largest concentration of specialised neurology centres was in London, which also contained 19 of the 24 CCGs with the highest rates of new consultant appointments.

In CCGs that did provide neurology services, there was still significant variation in the number of appointments provided to patients locally. Some CCGs required patients to travel out of their local area for almost every neurology consultant appointment.

In Swale, Wokingham and South East Kent CCGs, only 1% of new appointments were provided locally. By contrast, Liverpool CCG provided 99.3% of new appointments locally.

Arlene Wilkie, chief executive of the Neurological Alliance, said: “The postcode lottery in neurology must come to an end. Timely diagnosis and treatment is essential to the effective management of these complex conditions, and this requires access to the appropriate specialist neurological expertise.

“It is crucial that commissioners engage with these findings and take steps to ensure good access to care and support for patients in all parts of the country.”

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