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  1. Thomas Peukert,
  2. Gavin McDonnell,
  3. John Craig
  1. Royal Victoria Hospital, Belfast


Background The number of patients attending A&E with neurological symptoms in Northern Irelands largest hospital has more than doubled in the past nine years. Over half of those that present to A&E will be admitted; more patients are admitted with neurological symptoms than gastroenterology or cardiology.

Objectives To pilot a rapid access neurology clinic (RANC) and examine its effect on hospital admissions.

Methods The pilot ran for four weeks from October to November 2013. Three clinics were held per week with 4 slots available per clinic; slots were filled directly by senior A&E staff.

Results A total of 45 patients were seen in the RANC and 28 admissions were avoided. The average waiting time to be seen was 8 days. The two main presentations referred to the RANC were headaches and seizure. The average hospital stay for a patient with a neurological presentation admitted to the medical ward is 5.5days at a cost of £541 per day; by avoiding 154 hospital nights cost savings were calculated at £83,314.

Conclusion Regular access to a RANC could lead to a reduction of unnecessary hospital admissions and substantial cost savings.


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