People with complex neurological disorders often benefit from a specialist multidisciplinary team approach; however access can be logistically difficult. We run a spasticity management service offering all aspects of treatment including intrathecal baclofen and phenol. Recognising the problem faced by patients living in rural communities, we tried a video linked clinic.
How Referrals were approved by GP's and treating neurologists. The patients gave informed consent and attended their local community hospital with family/carers, they were joined by their community physiotherapist who was involved in the consultation and was able to demonstrate aspects of examination. At the neurological centre a Consultant Neurologist, specialist nurse and physiotherapist were present. All patients and clinicians were interviewed afterwards by an independent health research team.
Findings Feedback was extremely positive.
Patients A “local” service with less travel. Having both groups of clinicians present made patients feel more involved in decisions about their care. They felt at ease asking questions.
Clinicians Shorter/faster care pathway; enhanced communication; seamless, patient-centred care planning.
Conclusions Patients with complex disability require comprehensive assessment and care management. Creating a local, seamless and patient-centred service for this patient group is both challenging and exciting; using a telemedicine approach seems both feasible and effective.
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