16 December 2011
A new report, ‘Services for people with neurological conditions,' has found that although spending on neurological services has increased since the introduction of the National Service Framework for Long-term Conditions (2005), implementation of the Framework has been poor.
The findings, published by the National Audit Office (NAO), follow a study which focused on people with Parkinson’s disease, multiple sclerosis and motor neurone disease.
Summary
The report says the Department of Health “put in place no specific arrangements for monitoring how commissioners implemented the Framework… (and therefore) has no way to measure the effect of the additional spending on services or patient outcomes.”
However, since its introduction:
- waiting times for inpatient and outpatient neurology have improved
- the number of adults with a physical disability receiving social services has fallen
- while emergency bed days for people with long term neurological conditions have reduced by 12 per cent, the number of people admitted to hospital as an emergency has increased significantly
- an audit of 11 sites across England found that not one had fully met a single quality requirement
- people experienced varying quality of the diagnosis process
- information and advice to patients and carers is poor
- a survey of people with Parkinson’s disease, multiple sclerosis and motor neurone disease found that only 22 per cent had a personal care plan
- access to services for people with neurological conditions and their carers varies significantly depending on where they live
- people with neurological conditions admitted to hospital as an emergency often receive care from health professionals without neurological training
- examples of good practice eg. specialist nurses need to be championed.
Recommendations
The report says the Department of Health needs to:
- define the different accountabilities between itself, the NHS Commissioning Board and local commissioners
- establish clear baselines and common information standards to allow robust performance management
- understand the costs and benefits of different service delivery models.
It also says that local commissioners should:
- require hospital trusts to ensure all neurologists, at the point of diagnosis, give patients information packs about their condition, including contact details for local and national services and charitable organisations
- work with local providers to make sure that patients have a personal care plan for health and social services, with a single professional in charge of coordinating an individual’s care.
Next steps
The Neurological Alliance, MS Society, Motor Neurone Disease (MND) Association, Parkinson’s UK and Neurological Commissioning Support are urging the Government to create a targeted and properly resourced national strategy for neurological conditions.
Neurological Alliance (of which Action for M.E. is a member), will be giving evidence at a hearing of the Public Accounts Committee, 18 January.
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