Neurology services critically understaffed - report

Sunday 14 February 2016 22.58
The report cited "unacceptable" waiting lists of up to a year or more in some cases
The report cited "unacceptable" waiting lists of up to a year or more in some cases

The country's neurology services are critically understaffed, with long waiting times and little or no access to post-treatment rehab, according to a new HSE-backed report.

The report cited "unacceptable" waiting lists of up to a year or more in some cases for initial diagnostic MRI brain scans, impacting service delivery to the 700,000 people here who are estimated to suffer from one or more neurological conditions.

None of the 11 neurology centres surveyed for the report had MRI access for routine referrals in under two months, while in seven of the 11 centres, access to brain scans took a year or longer.

Delays in MRI scans are linked to delayed diagnosis and treatment, posing significant patient risks.

And the report found a "critical lack" of post-treatment neuro-rehabilitation services in the community, meaning neurology patients who did manage to get initial diagnosis and treatment, were taking up hospital beds when they should be treated in their own community.

The report was carried out by the Neurological Alliance of Ireland (NAI), the umbrella body for over 30 neurological charities, in collaboration with the HSE's National Neurology Programme. The report's findings are expected to be released in the coming days.

Speaking on RTÉ’s This Week, the clinical lead for the National Neurology Programme, Professor Tim Lynch, said that the report highlighted the existence of geographic "black holes" where the number of consultant neurologists were far below acceptable levels across large areas of the country.

Prof Lynch said it meant that the work of some consultant neurologists serving vast areas of the country was "impossible" and the resulting delay in accessing services was unfair to patients.

Best practice, according to the British Neurology Association, is for one neurologist per 70,000 people. However, the report found the ratio here was far in excess of that ideal.

The best served area here, for neurologists per capita, was one per 114,280 in one area of Dublin, but the ratio was as high as one per 185,000 in the west/northwest and one per 200,000 in Limerick and the rest of the mid-west.

Magdalen Rogers of the NAI said the report highlighted what was long understood by charities working in the neurological sector; that people who accessed neurology services were happy with the standard of treatment, but there were significant delays in getting access to diagnostic treatment in the first place, and a worrying lack of community-based, post-treatment rehab.

"When you've got conditions as serious as neurological conditions, that's a distressing time to be waiting that long. And then in terms of access to multi-disciplinary care, it really is a lottery, depending on where people live. So we see centres like Waterford, Sligo, Limerick, just not having the necessary multi-disciplinary teams in place.

Speaking on RTÉ's This Week, Magdalen Rogers said: "And that means that patients are realistically going without that service, or they are getting less of that service than people in other parts of the country."

With one-in-five cases presenting to Accident and Emergency estimated to have a neurological background, Prof Lynch said he believed that if deficits in the country's neurology services were addressed, this could greatly assist in managing the recurring problems associated with A&E outputs.

The report also found a lack of dedicated beds, with only six of the 11 centres having dedicated beds for neurology patients. Those which did were constantly under pressure from other departments, resulting in patients with treatable neurological conditions such as multiple sclerosis often having to wait for a bed and treatment.