Patients across the East Midlands who have neurological diseases and disorders are facing long waits due to staffing problems at Nottingham University Hospitals. The Nottingham-based neurology services treat people with conditions such as Parkinson's, epilepsy and Motor Neurone Disease and serious concerns have been raised over patient safety.
The Nottingham University Hospitals (NUH) neurology services serve Nottinghamshire, Leicestershire, Lincolnshire and Derbyshire, with 15 consultants dedicated to working across this region. This is, however, half the number that work in Sheffield, for example, which serves a similar-sized population.
And concerns were raised after there had been a "significant increase" in the number of people being sent back to GPs following referrals. Dr Irfan Malik, a GP in Sherwood, says the emergence of a two-tier healthcare system and the introduction of a new virtual triage system has made it more difficult for patients to access specialist neurology services.
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He had said "every referral is becoming a battle and a struggle", with patients being sent back to GPs with a letter detailing "advice and things to do and other referrals to make." These worries were discussed during a meeting of Nottingham City Council's health scrutiny committee on July 14 following complaints from residents and GPs.
During the meeting at Loxley House it was revealed the service is "very understaffed". Dr Jonathan Evans, head of service for neurology, said: "It is certainly true that our capacity has decreased and we are, you know, this is something close to my heart, relative to neuroscientist centres of a similar size considering populations of a similar size, we are very understaffed in neurology.
The service, based in Nottingham primarily at the Queen's Medical Centre, has to deal with referrals from Leicestershire, Derbyshire, Lincolnshire and Nottinghamshire and the patients across this region, Dr Evans says, "are potentially faced with months if not years of waiting". He added: "The fact we have organised our services so we are able to deliver care to those who need it sooner has in some ways disadvantaged us, but I think the fundamental thing is I care about patients in neurology whether they are in Leicestershire, Derbyshire or wherever, I want these patients to be seen promptly."
The committee was told the service sees roughly 250 to 300 patients every month. Councillor Georgia Power, the chairwoman of the committee who represents Bestwood, said a letter had been seen in January which detailed the capacity of the service and how staffing issues would be resolved. She said: "We are six months on from that so where is the position to where you were in January?"
Dr Evans responded: "We have appointed two more substantive consultants but they have not started yet. When they do start the situation is their clinics are already booked with patients. It is a difficult climate in which to get funding for new positions at this time."
Councillor Power then asked whether the region has enough neurologists and what is being done to get more, to which Dr Evans replied: "No."
He added: "One can only work within the system that one has, so we are in the process of creating a business case to support more neurologists. If I would be allowed to say one comment, historically the way for a case for expanding consultant numbers was to let your referrals, your waiting time, creep up as high as it possibly can.
"I think that is irresponsible and unprofessional and what we need to do is look at the resources are available to us, make a case based on what we want to do with the service as a positive thing and use the positive impact that has and take it from there."
But Meadows councillor Michael Edwards argued the service needed "step-change, not a business case". Health bosses argued they were now targeting wait times of no more than 10 weeks.
Medical director for NUH, Keith Girling, said a priority had been about decreasing the amount of time people spend in hospitals, and one of the ways this is being done is through virtual clinics. Dr Evans added virtual appointments can be an "effective strategy" to some of the prevailing issues.
Detailing the committee's recommendations councillor Power added: "What I would like to see is that there is better, or actually any, consultation with GPs, primary care and most importantly patients when changes like this are made. That has to be a priority.
"I would also like to see consultation with us as a committee."
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