Clinical Medicine (Nov 2024)
An integrated approach to neuroscience care: An innovative model to support the new integrated care system
- Michelle S Balaratnam,
- Fergus J Rugg-Gunn,
- Rachel Okin,
- Freya Powell,
- Stephen Prior,
- Panayiota Petrochilos,
- Dhiren Shivji,
- Salman Haider,
- Ali Alim-Marvasti,
- Arvind Chandratheva,
- Robert Simister,
- Charlie Lane,
- Roberto Macarimban,
- Diego Kaski,
- Bal Athwal,
- Rebecca Liu,
- Timothy Yates,
- Sanjeev Rajakulendran,
- Gerry Christofi,
- Jeremy Sandford,
- Alexis Ingram,
- Katherine Bluston,
- Caroline Weaver,
- Oluwaseun Odejide,
- George Glod,
- Gulsen Gungor,
- Edmund Nkrumah,
- Donal Markey,
- Gary Hotton,
- Katie Sidle,
- Jonathan Kennedy,
- Lisa Penniall,
- Helen Plum,
- Anthony Antoniou,
- Rakhee Prema,
- Nadia Jeffries,
- Carole Walters,
- Valerie L Stevenson,
- Malini Drysdale,
- Sabiha Tasnim,
- Shahrima Hussain,
- Lily Mackay,
- Ryan Baulk,
- Bianca IIii,
- David Egan,
- Adrian Capp,
- Patricia Turner,
- Christopher Turner
Affiliations
- Michelle S Balaratnam
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK; Corresponding author at: National Hospital for Neurology and Neurosurgery Queen Square, London WC1N 3BG, UK.
- Fergus J Rugg-Gunn
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- Rachel Okin
- Camden Neurological and Stroke Service, Central and North West London NHS Foundation Trust, London, UK
- Freya Powell
- Community Neurological Conditions Management Team, Royal Free London NHS Foundation Trust, London, UK
- Stephen Prior
- Camden Integrated Community Health Care (CICH), Central and North West London NHS Foundation Trust, London, UK
- Panayiota Petrochilos
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- Dhiren Shivji
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- Salman Haider
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- Ali Alim-Marvasti
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- Arvind Chandratheva
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK; St Pancras Neurological Rehabilitation Unit, Central and North West London NHS Foundation Trust, London, UK
- Robert Simister
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- Charlie Lane
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- Roberto Macarimban
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- Diego Kaski
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- Bal Athwal
- Neurology Department, Royal Free Hospital, Royal Free London NHS Foundation Trust, London, UK
- Rebecca Liu
- Neurology Department, Royal Free Hospital, Royal Free London NHS Foundation Trust, London, UK
- Timothy Yates
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK; Neurology Department, North Middlesex Hospital, North Middlesex University Hospital NHS Trust, London, UK
- Sanjeev Rajakulendran
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK; Neurology Department, North Middlesex Hospital, North Middlesex University Hospital NHS Trust, London, UK
- Gerry Christofi
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- Jeremy Sandford
- Primary Care, NHS North Central London ICB, London, UK
- Alexis Ingram
- Primary Care, NHS North Central London ICB, London, UK
- Katherine Bluston
- Primary Care, NHS North Central London ICB, London, UK
- Caroline Weaver
- NHS North Central London ICB, London, UK
- Oluwaseun Odejide
- NHS North Central London ICB, London, UK
- George Glod
- NHS North Central London ICB, London, UK
- Gulsen Gungor
- NHS North Central London ICB, London, UK
- Edmund Nkrumah
- NHS North Central London ICB, London, UK
- Donal Markey
- NHS North Central London ICB, London, UK
- Gary Hotton
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK; Neurology Department, North Middlesex Hospital, North Middlesex University Hospital NHS Trust, London, UK
- Katie Sidle
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK; Neurology Department, Whittington Hospital, Whittington Health NHS Trust, London, UK
- Jonathan Kennedy
- Neurology Department, Royal Free Hospital, Royal Free London NHS Foundation Trust, London, UK
- Lisa Penniall
- Islington Community Neurological Rehabilitation Team, Whittington Health NHS Trust, London, UK
- Helen Plum
- Enfield Adult Community Therapies, North Middlesex University Hospital NHS Trust, London, UK
- Anthony Antoniou
- Haringey Integrated Community Therapy Team, Whittington Health NHS Trust, London, UK
- Rakhee Prema
- Community Neurological Conditions Management Team, Royal Free London NHS Foundation Trust, London, UK
- Nadia Jeffries
- Neurological Rehabilitation Centre, Royal Free London NHS Foundation Trust, London, UK
- Carole Walters
- St Pancras Neurological Rehabilitation Unit, Central and North West London NHS Foundation Trust, London, UK
- Valerie L Stevenson
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- Malini Drysdale
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- Sabiha Tasnim
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- Shahrima Hussain
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- Lily Mackay
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- Ryan Baulk
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- Bianca IIii
- Primary Care, NHS North Central London ICB, London, UK; Age UK, Barnet, London, UK
- David Egan
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- Adrian Capp
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- Patricia Turner
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- Christopher Turner
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- Journal volume & issue
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Vol. 24,
no. 6
p. 100234
Abstract
Integrated care systems join up health and care services, so that people have the support they need, in the right place, at the right time. The aims include improving outcomes in healthcare, tackling inequalities in access and enhancing productivity and value for money. This is needed for neuroscience care as the traditional delivery of neuroscience care is inefficient, outdated and expensive, and can involve complex referral pathways and long waiting times.In preparation for the formation of the integrated care system (ICS), a novel innovative collaboration across multiple NHS trusts developed across North Central London in 2021. We developed a model where neuroscience specialists engage in collaborative care with clinicians outside the specialist hospital setting. Pivotal to the pathway is a multidisciplinary meeting, and collaborative working enables joint clinical reviews, diagnostics and medication initiation.This innovative collaboration has already significantly improved access, addressed inequalities due to borough variation and enhanced the delivery and quality of neuroscience care in our ICS. It is a translatable model that can be adapted to suit other regions in the UK. It fulfils many of the objectives of the integrated care system and these benefits are seen without the need for significantly more resource.
