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Neurological problem solving

This week HSJ found another trust in the West Midlands that is a victim of a national shortage of consultant neurologists.

Commissioners in Shropshire have revealed their main provider of neurology services, Shrewsbury and Telford Hospitals Trust, had 369 patients in June waiting longer than they should for their appointments.

This follows our story last week about Burton Hospitals FT, a small district general hospital in Staffordshire, which had a neurology waiting list of more than 1,000 patients.

At the time, Burton made a good point that it was difficult for smaller DGHs to attract and retain specialist consultants.

However, news that neurology waiting lists at SATH have exceed 300 suggests the problem goes deeper.

Despite being a major acute provider, the trust has struggled to recruit substantive consultant neurologists and these workforce woes have meant the trust had to stop accepting new neurology referrals earlier this year.

Other trusts in the Midlands are also struggling under the weight of demand on neurology services, with Walsall Healthcare Trust raising concerns about its ability to provide services and Derby Teaching Hospitals announcing it could no longer accept out of area referrals after a 26 per cent increase in demand. (Although this was largely blamed on Burton closing its doors to new referrals last year.)

However, the drought in neurology services might not be not specific to the region.

Figures from the Association of British Neurologists suggest the UK is well behind the rest of Europe in its ratio of neurologist to patients, with just one neurologist to every 83,000 people, compared with one to every 15,000 in Europe.

There is clearly a lack of consultant neurologists in the Midlands but these figures suggest the NHS could face a national problem if the workforce shortages aren’t addressed.

NHSE dragged into drug row

NHS England has been accused of being “totally unethical” after proposing to stop paying for a thyroid drug that is the “difference between living properly and not doing so” for patients.

In its consultation on stopping the routine prescription of some drugs, NHS England is using clinical guidance to justify the withdrawal of the drug liothyronine against the apparent recommendation of the medical association that produced the research.

HSJ has also learned NHS patients may be putting themselves at risk by buying the drug abroad after trusts and clinical commissioning groups stopped prescribing it. The medicine is used to treat hypothyroidism.

NHS England proposed to stop the routine prescription of the drug in March, to save £39m a year. A consultation on the proposal began last month and will run until October.

HSJ has seen evidence suggesting NHS England intends to stop paying for the drug despite its consultation still officially being open.

In response to a patient’s inquiry on the issue, an NHS England employee, who did not provide their job title, said this month: “I can confirm that the decision has been taken to remove liothyronine from the CCG prescribing list and for this drug to be replaced with an alternative.”

HSJ has also learned CCGs and trusts are also telling patients they will no longer be prescribed liothyronine – well in advance of the consultation closing. They include Dudley CCG, a joint committee of Derbyshire CCGs and Brighton and Sussex University Hospitals Trust.