Rationale Neurological symptoms are a common presentation in primary care and emergency medicine. The acute clinic provides a rapid access service, aimed at reducing unnecessary admissions, outpatient waiting times, inappropriate investigations and achieving a prompt diagnosis. Data on service utilisation will inform future service design and delivery.

Aim To evaluate the acute neurology clinic service and training experience in the University Hospital of Wales.

Method Data was collected prospectively on acute referrals over 6 months.

Results 52 patients were seen; 51% were referred from primary care. The median slots filled per clinic was 3 (range 1–6). Median time from referral to review was 3 days (range 1–7). The most common presenting symptom was headache (38%), followed by limb weakness (25%). The commonest clinical syndrome was a myelopathy (15%) and 62% had abnormal neurological signs. 75% of patients were investigated, 10% admitted and 7% discharged. In retrospect, 56% of patients warranted urgent referral.

Conclusion The acute neurology clinic provides a useful service to primary care. This data suggests it is presently under-utilised and that similar clinics and novel strategies could be enlisted to help reduce admissions and waiting times, and help manage patients with neurological symptoms in primary care.