More than 1,000 patients have been left waiting for follow up appointments because of capacity problems at a struggling specialist service.

Burton Hospitals Foundation Trust told HSJ there were 1,022 patients on a waiting list who are overdue a neurology follow-up.

Its main commissioner said it was “causing distress and is understandably frustrating”.

The trust is planning to stop providing the service in April next year and in July last year stopped accepting new referrals, because of a capacity and workforce shortage.

There is concern about the patients who are waiting for follow-ups seeking emergency care.

An East Staffordshire clinical commissioning group board paper in June stated that 334 of those waiting at that point had attended the emergency department in the prior 12 months.

It is unclear whether they attended with neurology related complaints but the board paper stated that, in a slightly different period, “only one patient had presented to ED with a definitely ongoing neurological problem”.

The CCG’s chief nurse has asked for further information on whether any harm was caused to this patient.

The commissioner’s board paper adds: “The chief nurse remains concerned that as the [then] 1,279 patients on the follow up waiting list have not yet been review[ed] by a consultant neurologist then there is a potential risk that there could be incidents of harm within the back log that we do not yet know about.”

Burton Hospitals FT told HSJ that as of 6 August the trust had reduced the waiting list to 1,022.

Earlier this year, HSJ reported that four West Midlands trusts had raised concerns about their ability to keep up with demand in neurology services, with two of them refusing some new referrals.

Derby Teaching Hospitals FT has claimed it saw a 26 per cent rise in out of area referrals following Burton FT’s decision to stop accepting new referrals. In June this year, Derby Teaching Hospital and Burton announced their intention to merge.

East Staffordshire CCG told HSJ that Burton Hospital and Virgin Care – which is involved in a lead contracting arrangement - are currently searching for an alternative provider for patients on the list.

According to the trust’s board papers published on 6 July, it was in talks with Medinet, an independent provider of clinical services and staff, about support with the backlog.

East Staffordshire CCG chair Charles Pidsley said: “We are aware that the lack of follow up appointments for a large number of patients is causing distress and is understandably frustrating.

“The trusts have taken steps to ensure those patients on the waiting list, who are most in need of a follow-up appointment are prioritised.”

Burton chief operating officer Duncan Bedford said: “Nationally, there is a known shortage of consultant neurologists and as a smaller district general hospital, we have been challenged, like others, in recruiting on a permanent basis to this specialist service in order to sustain it for the longer term…

We have appointed an interim consultant on a full time basis to systematically review every follow-up and ensure patients are safely monitored. To date, there have been no concerns raised in terms of these follow-up reviews.

“This work is being monitored week to week at the highest level within our organisation to ensure a safe and effective process for these follow-up patients. We are also working closely with our commissioners to identify a long term solution, given that we can no longer provide this service to new patients given the lack of substantive consultants available to work at our trust. Looking ahead, we want to explore whether linking with tertiary centres with specialist expertise that can be more readily pooled and offered, may be a way forward.”