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Where did the money go?
The National Audit Office (NAO) (2011) report on services for people with neurological conditions revealed that the Department of Health (DH) has been wasting millions of pounds on unnecessary hospital admissions for people with conditions such as Parkinson's disease, multiple sclerosis and motor neurone disease.
The National Service Framework (NSF) for Long-term Conditions (DH 2005) focused on improving the management of neurological conditions and outlined 11 quality requirements. It was hoped that this would lead to improvement in services. This has not happened. A Neurological Commissioning Support (NCS) review (Thomas et al 2010) of the NSF found that no primary care trust in England had achieved even a single quality requirement.
The NAO report showed that between 2005 and 2010 there was an increase in spending of almost £1 billion for neurology services in England. However, the DH does not know how this extra money has benefited patients. There are still many problems with services, including long delays in receiving a diagnosis, lack of access to information, and fragmented and poorly co-ordinated care. A specialist nurse is one of the most important professionals available to support people with a neurological condition, and to provide better quality care and cost efficiencies, but still many people are denied access to one.
New, clinically led commissioning structures may have some impact if we can place neurology on the agenda. Quality, Innovation, Productivity and Prevention (QIPP) programmes are foremost in commissioners' minds, and neurology should be a major part of them. The NCS is urging the government to implement the changes recommended in the NAO report and create a targeted and properly resourced national outcomes strategy. This would help to reduce the distress caused by such conditions and deliver value for the public purse.
Editorial | February 2012 | Volume 22 | Number 1
References
National Audit Office (2011) Services for People with Neurological Conditions. NAO, London.
Department of Health (2005) National Service Framework for Long-term Conditions. DH, London.
Thomas S, Davies A, Peel C (2010) Halfway Through: Are we halfway there? A Mid-point Review of the National Service Framework for Long-term conditions. Neurological Commissioning Support, London.
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Primary Health Care aims to inspire excellence in practice by informing, supporting and educating nurses working in community and primary care. Primary Health Care is editorially independent and the opinions expressed are not those of the RCN, nor of any contributor's employing organisation, unless specifically stated.
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