Specialist healthcare services for concussion/mild traumatic brain injury in England: a consensus statement using modified Delphi methodology
Antonio Belli,
Vanessa Raymont,
Damian Holliman,
Catherine McMahon,
Peter Whitfield,
Mark Wilson,
Angelos G Kolias,
Ben Jones,
Richard Sylvester,
Mario Ganau,
Michael Parker,
Shrouk Messahel,
Peter John Hutchinson,
Clint Gomes,
Michael Grey,
Michael Griffiths,
Adel Helmy,
Kanchan Sharma,
Rupert Noad,
Peter Jenkins,
Emma Woodberry,
Elika Karvandi,
Timothy Griffiths,
Philippa Griffiths,
Tim Lawrence,
Terence McLoughlin,
Joanne Newton,
Daniel Tadmor
Affiliations
Antonio Belli
Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
Vanessa Raymont
2 Department of Psychiatry, University of Oxford, Oxford, UK
Damian Holliman
Department of Neurosurgery, Royal Victoria Infirmary, Newcastle upon Tyne, UK
Catherine McMahon
Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
Peter Whitfield
University Hospitals Plymouth NHS Trust, Plymouth, UK
Mark Wilson
Graduate Medicine, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
Angelos G Kolias
Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
Ben Jones
Carnegie Applied Rugby Research (CARR) centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
Richard Sylvester
National Hospital for Neurology and Neurosurgery, London, London, UK
Mario Ganau
3Nuffield Department of Clinical Neurosciences, Oxford University Hospitals, Oxford, UK
Michael Parker
Ethox Centre, University of Oxford, Oxford, UK
Shrouk Messahel
3 Alder Hey Children`s NHS Foundation Trust, Liverpool, Merseyside, UK
Peter John Hutchinson
Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
Clint Gomes
Royal Liverpool University Hospital, Liverpool, UK
Michael Grey
School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
Michael Griffiths
Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
Adel Helmy
Department of Neurosurgery, University of Cambridge, Cambridge, UK
Kanchan Sharma
Department of Neurology, North Bristol NHS Trust, Westbury on Trym, UK
Rupert Noad
University Hospitals Plymouth NHS Trust, Plymouth, UK
Peter Jenkins
Wessex Neuroscience Centre, Southampton General Hospital, Southampton, UK
Emma Woodberry
Department of Neuropsychology, University of Cambridge, Cambridge, UK
Elika Karvandi
Department of Neurosurgery, University of Cambridge, Cambridge, UK
Timothy Griffiths
Department of Cognitive Neurology, Newcastle University, Newcastle Upon Tyne, UK
Philippa Griffiths
Sunderland & South Tyneside Community Acquired Brain Injury Service, Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
Tim Lawrence
Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
Terence McLoughlin
1 Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
Joanne Newton
Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
Daniel Tadmor
1Carnegie Applied Rugby Research (CARR) centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
Objective To establish a consensus on the structure and process of healthcare services for patients with concussion in England to facilitate better healthcare quality and patient outcome.Design This consensus study followed the modified Delphi methodology with five phases: participant identification, item development, two rounds of voting and a meeting to finalise the consensus statements. The predefined threshold for agreement was set at ≥70%.Setting Specialist outpatient services.Participants Members of the UK Head Injury Network were invited to participate. The network consists of clinical specialists in head injury practising in emergency medicine, neurology, neuropsychology, neurosurgery, paediatric medicine, rehabilitation medicine and sports and exercise medicine in England.Primary outcome measure A consensus statement on the structure and process of specialist outpatient care for patients with concussion in England.Results 55 items were voted on in the first round. 29 items were removed following the first voting round and 3 items were removed following the second voting round. Items were modified where appropriate. A final 18 statements reached consensus covering 3 main topics in specialist healthcare services for concussion; care pathway to structured follow-up, prognosis and measures of recovery, and provision of outpatient clinics.Conclusions This work presents statements on how the healthcare services for patients with concussion in England could be redesigned to meet their health needs. Future work will seek to implement these into the clinical pathway.
