Trusts stop referrals for under pressure specialist service

Four trusts in the region have raised concerns over their ability to provide the services, with two of the providers deciding last month to stop accepting some referrals.

Shrewsbury and Telford Hospital Trust has suspended outpatient neurology services for six months due to inability to secure locum and substantive staff. HSJ understands The Royal Wolverhampton Trust has agreed to provide outpatient neurology services for Shrewsbury and Telford in the interim.

Derby Teaching Hospitals Foundation Trust said it will not accept out of area neurology referrals, after a 26 per cent increase in neurology referrals in a year.

A spokeswoman for the trust said the rise in activity was driven by the lack of neurology services at Burton Hospitals FT, which stopped accepting referrals last July due to difficulties recruiting staff.

Walsall Healthcare Trust has also raised concerns over its ability to provide neurology services. A board paper published on 2 March said the trust’s acute neurology services are “locum based” and have “relied on a succession of locum consultants” since July 2015.

The decisions follow a report last month by the Association of British Neurologists that said six trusts in the UK have no acute neurology service and 37 hospitals only provide neurology ward consultations three days a week or less. Burton was identified as one of the providers with no acute neurology service.

East Staffordshire Clinical Commissioning Group, which has Burton as its main provider, held an urgent meeting on 6 March to seek a resolution to the lack of neurology services, following Derby’s decision. The CCG’s governing body papers, published on 30 March, said NHS England was aware of the situation.

Shrewsbury and Telford’s 30 March board papers said its patients are waiting 30 weeks for their first routine neurology appointment and nine weeks for an urgent referral – the national standards are 7-9 weeks and 2-4 weeks respectively.

“The service has consistently been flagged to commissioners and NHS Improvement as being a particularly challenged speciality with constraints in delivering national access targets due to consultant workforce gaps…

“There are currently two substantive general neurology consultants in post. This is supported by one whole-time equivalent locum post. The national average position is one neurologist per 80,000 people, ie: six whole-time equivalents.”

A spokeswoman for Derby said: “We have seen a significant 26 per cent increase in neurology referrals at Derby Teaching Hospitals over the past year and as a result we have been left with no option other than to cease accepting new referrals from those patients who are outside our catchment area. It is important that we remain focused on maintaining a high quality service for our commissioned population in southern Derbyshire.”

A spokeswoman for Burton said: “There is a national shortage of neurologists and as such it has been extremely challenging to recruit to this speciality at an acute trust of our size. Patient safety and care is our priority and we are considering options for the sustainability of this service.

“In the meantime, we are closed to new referrals to our neurology service and are committed to working through follow up care with existing patients in partnership with Virgin Care, East Staffordshire CCG, our local GPs and specialist providers.”

Shrewsbury and Telford Hospital Trust and Walsall Healthcare Trust were also approached for comment.