Getting It Right First Time Neurology recommendations were published recently – including reviewing readmission rates for patients with headache with a local audit of any high rates. The aim of this study was to do just that.

Data were extracted retrospectively of all patients seen in Emergency Department (ED) or admitted with a primary diagnosis of headache from April 2018 to March 2019 at the four acute trusts in Southwest London. A questionnaire was completed at each hospital to understand current practice.

11,649/705,634 (1%) of ED attendances were due to headache; 356/3,652 (9.7% – separated by trust to 2.4%, 9.2%, 10.3% and 13.2%) headache admissions were re-admitted within 30 days. The trust with a specialist nurse whose phone number was given to patients as a safety net and/or who called patients 2 weeks post discharge had the least number of re-admissions. There was no clear correlation between length of stay and re-admission rate.

Limitations of this study are: uncertain accuracy of diagnostic coding and the inability to calculate re- admission to other acute trusts.

To improve quality of care, data reliability is needed. A nurse specialist who acts as a single point of access could impact on headache readmission rate.