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Neurology Services in Northern Ireland

Neurology Services in Northern Ireland. Dr Raeburn Forbes Consultant Neurologist Southern HSC Trust. Northern Ireland Demography. 1.7 million people 5 HSC Trusts Most regional services provided via Belfast HSC Trust, but also has a DGH function

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Neurology Services in Northern Ireland

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  1. Neurology Services in Northern Ireland Dr Raeburn Forbes Consultant Neurologist Southern HSC Trust

  2. Northern Ireland Demography • 1.7 million people • 5 HSC Trusts • Most regional services provided via Belfast HSC Trust, but also has a DGH function • DGH neurologists appointed from 2003 onwards • HPSS commissioned Neurology Reviews – 1999 and 2002 and ?2012 • Still long waiting times (26 weeks not unusual for routine, 9 weeks for urgent – trust-trust variability++) • Non-recurrent independent sector provision to maintain access targets • Recurrent funding difficult to secure • Growth in numbers of neurologists offset by reduction in ability of general medicine to absorb non-complex secondary care neurology • NB - Most neurological care is delivered in primary care by GPs

  3. Current Manpower • Regional Neuroscience Centre – Belfast HSC Trust • 16 beds • 10.5 WTE consultants (7 have outreach clinics) • 8 Registrars • 3 Epilepsy Nurses, 4 MS Nurses, 2 PD Nurses, 1 MND Care centre Co-ordinator • 4 DGH based services • Craigavon – 2 Consultants, 1 Registrar, 1 visiting consultant, 1 Epilepsy, 1 PD and 2 MS Nurse Specialists • Ulster Hospital – 2 Consultants (developing GPwSI headache) • Altnagelvin – 2 Consultants, 2 visiting consultants, 1 Epilepsy and 1 MS Nurse Specialist • Antrim Area Hospital – 1 consultant, 2 visiting consultants

  4. Innovations • Email triage services • Dr Victor Patterson, Western HSC Trust • Virtual Clinic • Dr Raeburn Forbes / Dr Orla Gray • Southern HSC Trust • 20% triaged to investigation • 90% of these do not need to attend • 10% of these will still attend • Development of smart triage systems to support decision making egeCeptionist software

  5. Regional Specialist Clinics • Epilepsy • Movement Disorders • Multiple Sclerosis / Neuro-inflammatory • Neuro-disability/rehabilitation • Cognitive • Neuro-muscular • ??Headache • One neurologist with interest based in DGH (me) • Occipital Nerve Block, IV DHE, Botox etc provided • Still no specialist nurse for headache • GP Education and Support is Vital • Accepts tertiary referrals from other neurologists

  6. The Future • Regional review awaited ?2012 • 3 additional consultants mooted (by who?) • Neurological Alliance Gaining Momentum • Crucial if political pressure required • Re-configuration towards network model • Remove out-reach general clinics • Out-reach sub-specialty clinics • Additional DGH based general neurologists • Virtual Clinic/ Supported Triage may become essential • Joint ABN/RCP Statement of June 2011 • Reduce dependence on independent sector ad hoc provision

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