COVID-19: Neurology service guide

Updated November 2020

Scope

This information provides guidance on the management of neurology patients across Western 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 the 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.org.uk. This information is also on BASH.org.uk website. Treatment options can be found on the South & West Devon Formulary:

Transient ischaemic attack (TIA):

Patients with a suspected TIA should still be referred via the TIA pathway. The patient will be contacted by phone and may not need to be seen directly. All patients will be contacted to decide if they need to be seen face to face.

First seizure:

Refer via the first seizure pathway (same as TIA). The same will apply to them with respect to a telephone call before any face to face contact.

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 Service. 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 NHS e-Referral Service as usual. 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

There is an urgent advice telephone service accessed through the acute GP service.

The advice is given by a consultant neurologist and the service operates 9am-5pm, Monday to Friday at present. At weekends urgent advice can be sought from the on-call neurology specialist registrar.

For patients already under our care, there is specialist advice available for multiple sclerosis (MS), epilepsy and Parkinson's disease (PD) and movement disorders via the specialist nurses.

​Advice & Guidance

There is a neurology consultant available for advice and to discuss referrals to Admission Avoidance Clinic (AAU), first fit and TIA between 11.15 and 13.15 each weekday (GP line). This should be the first port of call for discussion of all potential TIA or AAU or first fit patients.

Outside of these times advice is available via the on call neurology registrar from 0900 to 2100. However the registrar has limited ability to book a patent into a TIA or AAU clinic.

Also there is the acute GP service that can give advice and are able to receive referrals to TIA clinic outside the neurology consultant GP line times although they will advise referrers to discuss patients with an equivocal history with the neurologist directly.

The options are given on the advice and guidance telephone line.

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

​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.

Western Devon neurology contact information

Neurology advice for acute management or urgent advice through acute GP service. The advice is given by a consultant neurologist and the service operates 9am-5pm, Monday to Friday at present. At weekends urgent advice can be sought from the on-call neurology specialist registrar.

Individual consultants: contact Neurology secretaries: 01752 437698

Weekend and evening (5pm to 9pm) via switchboard telephone: 01752 202082 and on call neurology registrar.

Pathway Group

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

Last updated: 19-11-2020

 

Home > Refer-CV19 CRGs > Western CRGs > COVID-19: Neurology service guide

 

  • First line
  • Second line
  • Specialist
  • Hospital