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Patients with emergency brain disorders are denied specialist sare

18 Mar 2002

The majority of patients who are admitted to hospital as an emergency with brain-related disorders, such as stroke, epilepsy, brain haemorrhage, meningitis and encephalitis will never be seen by a neurologist, according to a new report.

A report, 'Acute Neurological Emergencies in Adults', published by the Association of British Neurologists (ABN) describes the alarming inequality and lack of specialist treatment throughout the UK because there are simply not enough neurologists to provide adequate care.

Figures show that within the NHS Northern Ireland, Wales, Trent, the Midlands and the South West have the lowest number of neurologists, each serving a population of well over 200,000 in their region. Patients, however, in the Thames regions, Anglia and Oxford benefit from a greater proportion of neurologists, but this is still way below anything like a sufficient number.

Professor Charles Warlow, from Western General Hospital in Edinburgh and president of the ABN said at the launch of the report:

“We believe that all hospitals should have a neurological service around the clock to give prompt and accurate diagnosis and treatment to all patients who are admitted with acute neurological illnesses. This is routinely achieved in other European countries, such as the Netherlands. The numbers of neurologists around this country vary significantly, showing there is great disparity in the level of care patients may receive.”

The ABN is calling on the Government and health authorities to increase the number of neurologists from 350 to 1400 over the next ten years in order to establish a UK-wide and fully comprehensive service. Currently there is just one neurologist for every 177,000 people in the population, which is dramatically worse than all other European countries where these data are available.

The report makes a series of recommendations for how this could be achieved. Dr Peter Humphrey, consultant neurologist at the Walton Centre for Neurology and Neurosurgery in Liverpool who chaired the ABN working party said:

“The early correct diagnosis and management of acutely ill neurological patients can make the difference between life and death. We, therefore, need a four-fold increase in the number of neurologists to 1400 to provide a 24-hour service to patients requiring urgent care. The service we provide must inevitably include access to neurological beds, intensive care facilities and neuroradiology."

To achieve this, the report claims, requires new strategies for more trainees and better teamwork with nurses and therapists trained to manage neurological patients. Patients whose illness does not demand immediate attention should be assessed by a neurologist within 24–48 hours.

'Acute Neurological Emergencies in Adults' report