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Patients waiting more than 18 weeks for Parkinson’s or Motor Neurone Disease diagnosis at NUH

Patients have waited more than 18 weeks for an appointment at Nottingham Hospitals’ neurology department, leading to a delay in diagnosis for Parkinson’s or Motor Neurone Disease.

Some patients are also waiting a year to be seen again by NUH once they have been diagnosed with a serious condition of the nervous system.

Doctor Jonathan Evans, consultant neurologist and head of service for neurology at Nottingham University Hospitals NHS Trust has described the pressure as ‘formidable.’

He said: “This is not the service we want to be able to provide for our patients.”

Health bosses will now face questions from Nottingham City Councillors at a health and adult social care scrutiny committee on Thursday, July 14 over the problems affecting the service.

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Neurology deals with disorders of the nervous system including brain, spinal cord and muscles and includes epilepsy, dementia, multiple sclerosis, strokes, Parkinson’s disease, and muscular dystrophy.

The service is mainly based at Queen’s Medical Centre with some clinics at the City Hospital.

Cllr Georgia Power (Lab), chair of the committee, has raised concerns with Nottingham University Hospitals NHS Trust.

She said: “I have been contacted by a number of concerned residents and GPs regarding access to the neurology department at NUH.

“They are becoming increasingly concerned that in their experience GP referrals are being turned down and patients are unable to access the service they need.”

Mr Evans responded to her letter stating the service serves not only the people of Nottingham and Nottinghamshire but Leicester, Derbyshire, and Lincolnshire. It has 15 consultants.

He said: “At NUH, we have large cohorts of patients with conditions including Parkinson’s disease, Multiple Sclerosis, Epilepsy, Myasthenia Gravis and Motor Neurone Disease, as well as smaller numbers of patients with chronic nerve or muscular disorders which need regular monitoring.

“The demands that the care of patients with long term disorders places upon a neurology department are formidable.

“Our service had challenges even before the pandemic with patients frequently waiting more than 18 weeks to receive an outpatient appointment, which often meant a delay in diagnosis for some diseases, such as Parkinson’s or Motor Neurone Disease.

“With our current capacity we are able to see patients with Parkinson’s disease at a minimum of seven month intervals, and for epilepsy and multiple sclerosis the figure is closer to 12 months. This is not the service we want to be able to provide for our patients.”

He said the department receives more than 150 weekly referrals but can only offer in the region of 60 to 70 appointments per week.

He said: “As you can see the capacity doesn’t quite meet the needs hence the historical (over 18 week) waiting times for a neurology outpatient appointment.”

He said the department had made some changes with referrals now triaged by a team of five consultant neurologists in rotation.

The consultant will then triage the referral to a general neurology clinic (video or face-to-face depending upon the nature of the presentation), a specialist clinic (for example, the movement disorders clinic in a patient suspected of having Parkinson’s disease) or take simple management steps that can be undertaken first in primary care.

He added: “To re-iterate, we are not doing less work, and we are not seeing fewer patients. We are, as a department re-aligning what we do to prioritise time for patients with a higher probability of an underlying neurological disease.

“These patients will be seen, diagnosed, and treated far more promptly than they would have otherwise been.

“Similarly, making these changes has allowed us to continue to see for follow-up our large cohorts of patients with debilitating long term neurological conditions, many of whom are exceedingly vulnerable, on a regular basis.”

He also said there had been a loss of consultants in recent months and there will be a further round of recruitment with a target to have waits of no longer than 10 weeks.

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