2016/17 JSNA Neurological Conditions
Who is at risk and why?, Level of need in the population, Current services in relation to need, Projected service use and outcomes, Users views, Evidence of what works and policy drivers, What are the top five issues/priorities from the needs assessment or analysis and what are we going to do as a result?, Key contacts
Who is at risk and why?
There are approximately 10 million people in the UK with a neurological condition. Of this 10 million:
- An estimated 350,000 people with a neurological condition in the UK require help with their daily living activities
- Over 1m are disabled by their neurological condition
- 8m are affected by their neurological condition but are able to manage their lives on a daily basis
Each year in the UK:
- 600,000 people are newly diagnosed with a neurological condition
- 10% of visits to Accident and Emergency are for a neurological problem
- 17% GP consultations are for neurological symptoms
- 19% of hospital admissions are for a neurological condition requiring treatment from a neurologist or neurosurgeon
- 200,000 children have an acquired brain injury
There are a range of over 100 different neurological conditions including Multiple Sclerosis; Motor Neurone Disease; Acquired Brain Injury (ABI); Parkinson’s disease; Epilepsy; Dementia; Cerebral Palsy; Myalgic encephalopathy/Chronic fatigue syndrome and Stroke.
It is estimated that more than 7,000 people in Milton Keynes are living with a neurological condition. This is expected to increase to more than 8,000 by 2026.
A range of services are commissioned regionally and locally for people with neurological conditions. These include:
- Specialist Neurological services delivered by Oxford Centre for Enablement
- Milton Keynes Neurological Rehabilitation Service delivered by Central and North West London (CNWL) Community Services
- Clinical Specialist services for neurological conditions – delivered by CNWL
- Residential Acquired Brain Injury services from The Brain Injuries Rehabilitation Trust
- Hyper acute stroke services from Luton & Dunstable Hospital
- Acute Stroke Care – Milton Keynes Hospital
- Early Stroke Rehabilitation Team delivered by CNWL
- Adult Social Care services to support people at home
- Specialist local provision at Grafton Manor; Oakleaf Care and St Andrew’s Hospital, delivered on an individual commissioned basis for people with ABI
- Community equipment services to help support people to live independently in the community
It is likely that the estimated numbers will be greater than predicted as some conditions are more prevalent in older adults. As the population ages, then we can expect the proportion of people with a neurological condition to increase.
Due to this ageing population, it is expected that there will be a corresponding increase in the number of people living with a neurological condition and other co-morbidities. This may result in increased need for care and support from a range of professionals working in a multi-disciplinary team to manage their care.
A neurological conditions strategy group meets on a quarterly basis to support the development of the commissioning strategy. Service users and carers are represented on this group and have given their views on all aspects of care and treatment for people with neurological conditions.
As this work develops, local focus groups will be arranged with service users and carers so that we can ensure their experiences feed into the proposals contained in the strategy.
Implementation of the recommendations in the long-term conditions national service framework (LTC NSF), particularly:
- The need for prompt and appropriate referral to specialist clinicians for diagnosis and treatment (QR2, 3)
- Support and rehabilitation (QR4-6)
- Care and support for families and carers
Recognition of the wider determinants of health and their role in enabling people to live as independently as possible is important. This may include access to housing adaptations or relocation and support in claiming benefits.
Services provided need to be adaptable to meet individual need and respond effectively to changes in patients’ condition. Links with self-care and their resources for this group of patients is vital to improving self-management of their disease.
The promotion of access to timely palliative care for patients may help delay or prevent deterioration, support people to affect meaningful recovery or provide end of life care.
Various specific NICE guidelines on a range of neurological conditions are now available and these should be implemented wherever possible by primary and secondary healthcare and social care. These are available from the NHS Evidence website.
What are the top five issues/priorities from the needs assessment or analysis and what are we going to do as a result?
The priorities for neurological conditions in Milton Keynes are:
- To develop the commissioning strategy to provide a framework and action plan to improve co-ordination between local services
- To complete the review of stroke services and commission accordingly an outcomes-based service that meets the needs of people who have had a stroke
- To maximise opportunities for the use of assistive technology
If you have any questions about this topic please e-mail:
Last Updated: 30 November 2017