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Major breakthrough in understanding neurological conditions sparks rethink on improving care

19 April 2016

A report has been published that brings new insight into how people with various neurological conditions can be better supported to stay well.

The Neurology Intelligence Report is the result of close working between a number of organisations* including the National Institute for Health Research, which is the research arm of the NHS.

Over 2 million hospital attendances and admissions from 2009-2014 for conditions ranging from Parkinson’s, multiple sclerosis, epilepsy, neuromuscular conditions (like motor neurone disease [MND]) and headaches were analysed to understand more about them.

The data was taken from Hospital Episode Statistics (HES) data routinely collected by hospitals on the number of people using NHS inpatient and outpatient facilities.

The report authors found that in many cases, minor illnesses, which could potentially have been assessed and treated and managed proactively, were responsible for admissions in people with neurological conditions. In addition overall they identified a significant rise in the number of people with neurological conditions who were admitted to hospital, or seen as outpatients.

Dr Christopher Kipps is Clinical Director for the Strategic Clinical Network at NHS England (Wessex) for Mental Health, Dementia and Neurological Conditions, and is also NIHR CLAHRC Wessex lead for Dementia: “Until now it has been hard to pull together a complete picture of the health and care of people with neurological conditions in our region and nationally. This report really helps understand how people with neurological conditions end up in hospital and where we can act earlier and work together to improve their lives.

“There are huge challenges in improving care in people with neurological conditions, but having good information, makes it a little easier to understand how we can be more effective.”

David Bateman, National Clinical Director for Adult Neurology Conditions for NHS England, praised Dr Kipps and his team saying: “This report takes that intelligence a step further, analysing more closely how people with different neurological conditions utilise hospital services and why. It demonstrates a substantial local increase in demand for neurological services over the past five years.

“It further highlights how, for example, a stronger focus on integrated care pathways and the earlier treatment of infections in the community could significantly impact the number of emergency hospital admissions for people with long-term neurological conditions. The report also emphasises practical measures, already implemented in various parts of the country that could be used locally to improve community and emergency care in neurology.”

Anya De Iongh, studied medicine at Cambridge until her neurological conditions** forced her to leave: “I have a number of conditions which meant a fair few admissions to hospital at the beginning. It’s really disruptive to day to day life as a young person, and can knock your confidence of managing a condition. Anything that supports hospital stays to be shorter and fewer is good, along with the right support out in our communities.”

Anya, lives in Dorset and now works to promote self-management for people with long term illness. She also works with research teams to promote the patients’ voice.

Outline findings:

·         High rate of fractures, falls and injuries in Parkinson’s, and high levels of urinary and respiratory tract infections.

·         High levels of urinary tract pathology (including infection) in multiple sclerosis, with other factors including falls and pressure ulcers also responsible.

·         Epilepsy data identified a high level of injury associated with the condition, and may represent a safety signal with respect to adequacy of community care.

·         Neuromuscular conditions significantly associated with respiratory dysfunction, suggesting the way care is planned for patients could be improved.

·         Headaches are responsible for a high number of emergency admissions, but many of these could potentially be managed better in the community

More facts and figures:

Over a five year period the cost of treating people admitted to hospital with neurological conditions in the Wessex region rose from £51 million to over £73 million per annum.

The number of people admitted to hospital with a neurological condition rose by 49% from 2009-2014, and the number of people seen in neurology outpatient clinics increased on average by 78% in the same time period.

The amount of money spent on treating people with these conditions varies considerably across the region.

Epilepsy and headaches are by far the most common reason for people to be admitted to hospital with a neurological condition, however their stay is usually brief. Yet other conditions like Parkinson’s, multiple sclerosis and other neuromuscular conditions (like MND) had longer hospital stays, and often have other medical problems (comorbidities) directly responsible for, or contributing to, their admission.

Sue Thomas, Chief Executive for NHiS Commissioning Excellence: “I believe this information, which has been a huge task to collate, really improves our knowledge of neurological conditions and why people use hospital facilities. It’s useful to have this detail across a population of 2.8 million people because it gives us very practical insights into how we can change healthcare in the region.

“Those changes will make a real difference to those people living with the conditions, helping them in some cases to remain healthy and independent for longer.”

Notes to editors:

Dr Chris Kipps, Sue Thomas and two people living with neurological conditions will be available to interview under embargo from Monday 18 April in Southampton.

The launch of the report itself takes place at the De Vere Grand Harbour Hotel in Southampton from 10.00am on Tuesday 19 April.

For those wishing to book a place please go to: http://www.nhis.com/events/wessex-neurology-intelligence-report-launch

For further details please contact:

Jamie Stevenson, Communications and Marketing Manager, NIHR CLAHRC Wessex
023 8059 7974 e:
jamie.stevenson@soton.ac.uk

Sue Thomas, Chief Executive, NHiS Commissioning Excellence
07467 149147  e:
sue.thomas@nhis.com


Organisations involved*

About NHiS: NHiS was founded in 2007 in response to a growing need in the marketplace for quantitative and qualitative data to inform service redesign and pathway efficiencies. NHiS’s services are split across two directorates – Commissioning Excellence, which helps NHS organisations to plan and commission patient services, and Healthcare Insight, which provides business intelligence and insight solutions to pharma.
NHiS is part of healthcare intelligence provider Wilmington Healthcare, which also incorporates Binley’s, OnMedica and Wellards. For more information, log on to
www.nhis.com


About SCN and CLAHRC Wessex: Wessex Strategic Clinical Network is part of NHS England and works across the NHS to improve the health and wellbeing of people in the Wessex region. This research is funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care Wessex at University Hospitals Southampton NHS Foundation Trust.

About The National Institute for Health Research: The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. The NIHR is the research arm of the NHS. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (www.nihr.ac.uk).

About Dr Chris Kipps, Clinical Director for the Strategic Clinical Network at NHS England (Wessex) for Mental Health, Dementia and Neurological Conditions

Dr Christopher Kipps is a Consultant Neurologist with subspecialty interest in behavioural neurology and cognitive disorders. He has worked for University Hospital Southampton since 2007, and leads the Cognitive Disorders service. He is the clinical lead for Neurology at Hampshire Hospitals Foundation Trust, regional DeNDRoN (Dementias and Neurodegenerative Disease Research Network), and Huntington's disease, Specialty Group lead for Nervous System Disorders for Hampshire & Isle of Wight CCRN and a theme lead in the Wessex NIHR-CLAHRC. He is an Honorary Clinical Senior Lecturer at the University of Sydney, and is the principal investigator for a number of clinically-based research studies in Huntington's disease and dementia. He trained in general neurology in Sydney before working as a movement disorder fellow for a year and obtaining a diploma of clinical epidemiology. He spent a year as a clinical fellow in Oxford before completing a PhD in Cambridge in Cognitive Disorders before moving to Southampton.

About Anya De Iongh**

Anya has been diagnosed with POTS (Postural tachycardia syndrome), Chiari malformation and Guillain-Barré Syndrome as well as other long term conditions (LTCs).

She writes a blog to help people understand and manage long term illness (sometimes called self-management) and is a keen sailor. Anya works with CLAHRC Wessex as a patient champion, to help design and advise on the health research it conducts.

 

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