Abstract

Since 1 May 2011 Brighton Integrated Care Service (BICS) has been running a Neurology Advice pilot scheme which provides referring GPs with the opportunity to access specialist consultant advice within 3 days of making a referral. The consultant triager (Dr Saha) is able to write an advice letter to the GP, organise a telephone consultations with patients and GPs, and order and review diagnostic tests. All 12 Brighton practices participated in the pilot; the pilot is still running with over 800 new patient referrals to date. The practices were divided equally into three groups. Group 1 practices sent all their referrals to the Neurology pilot, Group 2 practices had the option of using the service and Group 3 was the control group. The data shows that Group 1 and 2 practices have seen a significant drop in the number of referrals sent on to hospital outpatient clinic. Group 3 practices have seen a rise in the number of referrals sent on to a clinic. The reduction in onward referrals was higher for Group 1 practices than for Group 2 practices. 14% of referrals resulted in a telephone consultation. Investigations were ordered for 24% of referrals and of these 37% resulted in the patient being discharged. 85% of GPs felt that their patients had benefited from the Neurology pilot and 92% felt that the pilot should continue. The neurology advice service enables the improved management of patients in a primary care setting and is likely to account for the significant reduction in onward referrals seen from practices involved in the pilot.