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ACUTE NEUROLOGY IN THE DISTRICT GENERAL HOSPITAL: THE ROLE OF THE ACUTE NEUROLOGIST
  1. G Maxwell1–3,*,
  2. J James1–3,
  3. N Archibald1–3,
  4. D Bateman1–3
  1. 1Newcastle upon Tyne Hospitals
  2. 2Queen Elizabeth Hospital, Gateshead
  3. 3Sunderland Royal Hospital

    Abstract

    Aims • To review the number of potential neurological admissions under the general medical ‘take’ in a busy district general hospital with weekly neurology liaison but no on-site neurology

    • To assess the impact of neurology review on those referred

    • To canvas views on preferred service format from users

    Methods A prospective review of all medical admissions over 21 consecutive days to the Queen Elizabeth Hospital (QEH) in Gateshead (October–November 2011). Admitting teams marked all potential neurological presentations for review. Data was collected on length of stay, diagnostic category, neurological investigations, referral to neurology and, if reviewed, impact on diagnosis. For those not referred, a judgement was made on whether neurology review would have been beneficial. A qualitative questionnaire was also distributed to all acute physicians.

    Results Potential neurological presentations made up 12% of total medical admissions (97/793). Mean length of stay was 4 days (median 2 days) and 85 requests were made for neuro-imaging. Around 10% were referred to neurology. Of the rest, around a quarter may have benefitted from review. Results of a survey on service user experience are presented in a qualitative fashion.

    Conclusions Neurological presentations made up a substantial proportion of the acute medical take and receive a large number of investigations. Only a small fraction were referred for formal neurology opinion, although more could benefit. Expanding service provision is likely to improve patient care and may reduce unnecessary investigations.

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