"Services for people with long-term neurological
conditions are not as good as they ought to be, despite a large
increase in spending. Progress in implementing the Department's
strategy has been poor and local organisations lack incentives to
improve the quality of services."
"It is not clear how lessons will be learnt and there
are risks to services which the Department must address to ensure
that care improves."
Amyas Morse, head of the National Audit Office, 16
December 2011
Since 2005, when the Department of Health introduced its
National Service Framework for Long-term Conditions, people with
neurological conditions have had better access to health services;
but key indicators of quality - such as the rate of emergency
hospital readmissions - have worsened. The Department does not know
what the Framework and additional spending of nearly 40 per cent
over four years have achieved.
The Framework was designed to improve care for people with
neurological conditions but progress in implementing it has been
poor. Access to health services for people with long-term
neurological conditions, such as Parkinson's disease, multiple
sclerosis and motor neurone disease, has improved and waiting times
for inpatient and outpatient neurology have decreased since 2007.
The number of elective neurological operations performed has also
increased. However, the rate of emergency admissions to hospital
has increased significantly and there is large variation in
emergency admission rates between Primary Care Trusts.
Access to services for patients also varies significantly
depending on where they live. For example, the NAO's analysis shows
variation across the country in the number of specialist nurses per
person with multiple sclerosis.
There are still significant problems with current services. Many
patients, following their diagnosis, are not given information on
their condition, about local services or on available support.
Ongoing care is fragmented and poorly coordinated and there is a
pattern of patients being referred to hospital for treatment, then
discharged and then referred to hospital again. The NAO also found
that there is poor coordination between health and social services.
The number of adults with a physical disability receiving social
services has fallen since 2005-06, because fewer people are now
eligible for these services.
Publication details:
HC: 1586, 2010-2012
ISBN: 9780102977042