COVID-19: Neurology service guide

May 2020

Scope

This information provides guidance on the management of neurology patients across Torbay and South Devon during the Covid-19 pandemic. The information is based on Association of British Neurologists Guidance on COVID-19 for people with neurological conditions and NICE guideline NG127 referral of suspected neurological conditions

National guidance

NICE website NG127 on referral

​2WW referrals

There is no neurology 2WW referral service.

Anyone suspected of having a brain or spinal tumour should have structural imaging organised and they should be referred directly to the regional tumour MDT.

​Conditions with specific guidance

Headache: (outpatient)

Most patients with headache require symptomatic treatment. If a structural lesion is suspected, then request a brain scan. There is an excellent National Headache Management System guideline designed to allow headache management in primary care on Headache management system website. This information is also on BASH UK website.

Treatment options can be found on the South & West Devon Formulary.

Management of Migraine

Adult Tension Headache Treatment

First seizure:

Refer via the first seizure pathway. Referrals will be reviewed by a consultant neurologist and, where appropriate, seen in a face-to-face clinic on an urgent basis.. For patients with a diagnosis of epilepsy please seek advice if needed through the specialist nurse or their consultant. Do not refer them anew via the first seizure pathway.

​Urgent referrals

Referral should be through the NHS e-Referral Srervice. The referrals are reviewed and prioritised by a consultant neurologist and the referral will receive advice and guidance or the patient will be offered an appointment.

Referrers may be asked to supply additional information where the referral information is insufficient to allow proper assessment to be made.

Urgent patients who need face to face appointments will be seen in outpatients and their appointment will be preceded by a telephone call.

​Routine referrals

Referrals should be sent through the choose and book system as usual but will not be seen during the COVID-19 pandemic

Referrals should be sent through the NHS e-Referral Service as usual during the COVID-19 pandemic

All new routine referrals will be clinically triaged and will either be added to a waiting list or, if appropriate, A&G will be given.

They may have to wait for a long time and the referrer should consider asking for advice specifically rather than requesting a referral. Use NICE NG127 to aid in the making of a referral decision.

Please ensure that a practice-based system is in place to check daily for returning referrals with A&G.

Prior to making a routine referral, please ensure that any appropriate Policy or CRG has been reviewed and that all the suggested investigations and management options have been considered.

Existing new and follow-up routine appointments have been cancelled and changed to telephone / video consultation where appropriate.

Urgent advice

Urgent advice can be obtained via telephone call (telephone: 01803 654827) from GP to consultant neurologist 09:00-17:00.

The neurology department should be contacted and will be able to direct this call appropriately. For patients already under our care, there is specialist advice available for multiple sclerosis (MS), epilepsy and Parkinson's disease (PD) (telephone: 01803 655513) and movement disorders via the specialist nurses.

​Advice & Guidance

Advice and Guidance will continue to be available through NHS e-Referral Service (e-RS).

Alternatively, advice and guidance can be sought via the weekday telephone service:

Urgent advice can be obtained via telephone call (telephone: 01803 654827) from GP to consultant neurologist 09:00-17:00.

The neurology department should be contacted and will be able to direct this call appropriately. For patients already under our care, there is specialist advice available for multiple sclerosis (MS), epilepsy and Parkinson's disease (PD) (telephone: 01803 655513) and movement disorders via the specialist nurses.

COVID-19 High risk patient advice

Patients at high risk will have been contacted by the national high-risk advice contact that is already in progress. Additionally, patients considered at high risk based on the Association of British Neurologists Guidance on COVID-19 for people with neurological conditions, will be contacted by the consultant team with any additional advice.

Torbay and South Devon neurology contact information

Neurology advice for acute management or urgent advice via GP to consultant telephone contact. Available 09:00-17:00. See above.

Individual consultants: consultant's secretary telephone: 01803 654827 – Dr Knight and Dr Straukiene's Secretary

Weekend and evening (17:00 to 21:00) via Torbay switchboard telephone:0300 456 8000 (local rate) or 01803 614567

and on call neurology registrar.

Pathway Group

This guideline has been signed off on behalf of the NHS Devon Clinical Commissioning Group

Last updated: 15-05-2020

 

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