Demand for LPs in neurology is increasing in diagnostics, therapeutics and in assisting inexperienced junior doctors in acute medicine, necessitating good DGH based services.

Specialist nurses with an interest in multiple sclerosis or headaches seem obvious choices for this role.

We report our 30 months experience (May 2019-December 2021) of 138 LPs (initial 20 under training super- vision), average 4/month, range 0-7.

Main putative diagnoses were MS 88 and idiopathic intracranial hypertension (IIH) 34. Failure rate was 18/138 – 8/34 in IIH patients and 10/104 in the others.

Follow up phone calls to over 90% of patients revealed only 4 prominent post LP headaches none of whom needed a blood patch.

The delay from request to LP being carried out was 3 days to 3 weeks, average 2 weeks.

UK neurological services are increasingly moving from regional centres to DGHs. Little attention has been given to the training and delivery of DGH LP services. GIRFT recently suggested DGHs consider estab- lishing such a service. Our experience shows a dedicated specialist nurse supported by an interested Consultant can provide an excellent service and that the demand in a typical DGH is sufficient to justify establishing such a service.