MPs call for neurology tsar as plans hit by lack of leadership care

NHS plans to improve care for two million patients with neurological illnesses have failed due to a lack of leadership, MPs claim today.

The highly-critical report by the Public Accounts Committee warns differences in care could widen further in future as services are decentralised under the Government’s controversial NHS reforms.

Despite a national framework for neurological conditions drawn up by the Department of Health in 2005, MPs claimed care was poorly co-ordinated and varied depending on where people live.

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They found spending on complaints including Parkinson’s disease, motor neurone disease and multiple sclerosis rose by 38 per cent to £2.9bn in the three years to 2009-10.

But emergency admissions rose by 32 per cent and emergency readmissions within four weeks of hospital discharge went up by a quarter to 14 per cent – well above those for the NHS as a whole.

They blame poor national leadership for the failure to drive similar improvements as those delivered in cancer and stroke care even though similar numbers of patients suffer from neurological conditions as those battling cancer.

Committee chairman Margaret Hodge said there had been some improvements.

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“But unlike the strategies for cancer and stroke, the model used to implement the framework hasn’t worked. The cancer and stroke strategies were headed by a tsar and the department monitored services with clear data against clear targets,” she said.

“For this clinical area, the department left the implementation to local health commissioners but gave them no leadership at all.

“It set no baselines and failed to monitor progress and so could not hold them to account where things went wrong. The present Government needs to understand what went wrong here for the future.

“Health and social services are failing to provide an integrated range of services for people with neurological conditions.

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“Some areas simply don’t have enough expertise, both in hospitals and the community.

“The department is moving towards a decentralised health and social care landscape.

In doing so, it must set clear objectives for joint health and social care outcomes and services for people with neurological conditions.”

Steve Ford, chairman of the Neurological Alliance, said: “A neurology tsar would provide the proper leadership that is so desperately needed to sort out this crisis of care.

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“It’s time the government heeded the warning that services are simply not up to scratch for people with neurological conditions.”

Alliance chief executive Arlene Wilkie said: “Billions of pounds have been spent on neurology and yet quality still has not improved for people with neurological conditions.

“It’s now up to the Government to make the necessary improvements for people with neurological conditions and not repeat past mistakes. This is an opportunity that people with neurological conditions and the NHS simply cannot afford to miss.”

People with neurological conditions need a wide range of services which cross boundaries between health and social care, employment and benefit services, transport, housing and education.

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But the committee found that despite their complex needs, co-ordination of care was poor and there was a lack of integration between health and social services.

There was a lack of neurological expertise, both in hospitals and in the community, and access to services varied widely. Only 22 per cent of patients had care plans, compared with 80 per cent of those with long-term conditions overall.

Care Services Minister Paul Burstow said services “could and should be better”.

“The Health and Social Care Bill offers a real opportunity to improve care and ensure people living with long-term neurological conditions get the best possible outcomes.

“It supports integration at every level to make sure people get the care and support they need at the right time and right place,” he added.

NHS must supply best care and value: Page 13.