Margaret Wheeler on the need for a joined up and integrated strategy for neurological diseases
An important debate is taking place in the Lords tonight, initiated by Labour’s Margaret Ford will underline the fear and concern of eight million people with neurological conditions of how services will be provided and delivered under the Coalition’s reorganised NHS.
The Neurological Alliance, which represents over 70 national and regional brain and spine organisations, estimates that 600,000 people are newly diagnosed each year with a neurological condition – accounting for 19% of hospital admissions.
Annually over £4.3bn of NHS expenditure is spent on neurological conditions, as is £2.4bn of the social care budget supporting people living in their own homes and in community and residential care. With substantial cuts in both NHS and social care budgets starting to have a major impact, health and voluntary organisations are concerned that neurology will lose out in the new GP-led Clinical Commissioning Groups’ commissioning processes and by hard pressed local authorities.
Neurology disease covers a wide range of conditions, each of which requires specialist care and support across often complex and involved care pathways. For example, with Motor Neuron Disease (MND) – a terrible fatal and rapidly progressing disease of the brain and central nervous system – it is common to have at least 18 professionals involved in caring for someone at any one time. Average life expectancy is between two to five years, so specialist palliative and good end of life care is essential, involving close working and co-operation.
Also essential in the care of people with neurological conditions is the role of specialist nurses, who since Labour’s 2005 strategy for the care of people with long-term conditions, have increasingly provided specialist support for people with MND, as well as epilepsy, Parkinsons and Multiple Sclerosis. Now however, with the estimated reduction of 6,000 nurses recently identified by a Royal College of Nursing survey, there are growing signs that these vital posts are being lost.
Specialist nurses are both crucial and cost-effective: a focal point of advice and support for patients and their carers who signpost and provide important access to a range of therapies and other services. With their support, people stay independent longer and can manage their own conditions more while the number of unnecessary hospital and care home admissions is reduced.
Tonight, Labour will press the Coalition to clear up the fears and confusion over how specialist services are provided by publishing long overdue Regulations setting out the commissioning responsibilities for the CCGs and the National Commissioning Board – the organisation that will run the NHS from April 2013. We will also push the Health Minister Earl Howe to spell out whether the government will take a lead and ensure the number of specialist nurse posts is maintained and increased.
The government must now recognise the urgent need for an overall strategy for neurological diseases – one which joins up and integrates provision with that for the higher profile conditions such as dementia and stroke.
Baroness Margaret Wheeler is a member of the Shadow Health team in the Lords
Published 20th November 2012
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