Will neurology ever move higher up the policy agenda?

Abstract

The party conference season is over and one of the highlights for Neurological Commissioning Support (NCS) was being able to wave the flag for neurology in a fringe meeting at all three party conferences. The meetings included politicians who gave response to the ask of the NCS policy: ■Neurology networks should be established in the same way that the cancer networks have been, to support service planning and delivery ■Neurology must be represented on all commissioning structures—every clinical senate, incorporated into Joint Strategic Needs Assessments, and considered thoroughly by Health and Wellbeing Boards ■There must be a neurology advisory panel to advise the NHS Commissioning Board on how best to commission for neurology. Reshuffling the deck—time to deal a better hand for neurology (NCS, 2011a; 2011b; 2011c) spelt out that neurology still has a low public profile despite the number of people living with a neurological condition being far greater than those living with cancer. There are 10 million people in the UK living with a neurological condition, compared with 2 million people living with cancer (Maddamns et al, 2008; National Cancer Intelligence Network, 2010). Of those 10 million, one million people are disabled by their condition; 350 000 require help with most of their daily activities, 850 000 are carers. These people also account for 20% of acute hospital admissions and are the third most common reason for individuals visiting their GP (Neurological Alliance, 2003). The numbers of people dying with a neurological condition are also under-rated because it is rare that a persons’ neurological condition will be cited as their cause of death and as a result, statistics on mortality are limited and can be misleading (South West Public Health Observatory, 2010) (Table 1). Every day in the UK, 75 people are diagnosed with epilepsy and there are nearly half a million people with epilepsy who are taking medication in England alone. It has been estimated that the avoidable cost of providing the current poor NHS services to people with epilepsy costs the economy £189 million annually (All Party Parliamentary Group on Epilepsy, 2007). Approximately 1 000 people each year die from epilepsy and around 40% of all deaths in adults and 59% in children are avoidable. A number of reports and recommendations have been made to improve epilepsy management yet despite these, new research shows that epilepsy mortality is actually rising. Deaths from epilepsy rose by 31% in males and 39% in females between 1995 and 2005 (Ridsdale et al, 2011) at a time when survival rates for cancers are improving.