Background Quantification of the economic burden within long-term neurological conditions pathways is difficult, and little evidence is available on how best to approach this. With the ambition to deliver care differently through digital mechanisms, and enhanced provision of self-management support, it is impera- tive that we develop mechanisms that can help measure the economic impact of pathway interventions in long-term neurological conditions. An impact inventory is a recognised initial step in defining the costs of an intervention from a range of perspectives including health/non-health and known/unknown cost items

Methods We used thematic analysis to analyse survey data on events causing an increase in care needs, grouped these as health- or care-related, calculated reported event frequencies and then applied NHS (National Tariff workbook) and social care reference costs (PSSRU, 2020) to them.

Results We identified 728 events comprising 35 event types across 5 long-term neurological conditions. Six events were common across conditions, and 13 were condition-specific. Post-event care costs were significantly greater than health-related costs (mean 7.9 times), and total pathway event costs varied nearly five-fold across conditions (£5,395 vs £23,258).

Conclusion Costs can be quantified in neurological pathways using an impact inventory to characterise events that change care requirements.