Accountability Framework Neurological Alliance (Feedback Loop) Proposed s National Structure National NHS England National Medical Director National Advisory Group (s) Regional NHS England Sub-Regional Medical Director Strategic Clinical Network (s) Secondary / Tertiary Care Trust CEO / Medical Director Programme Board / Clinical Service Lead(s) Primary / Community care CCG Clinical Accountable Officer Primary / Community Care Interface
Tertiary / Secondary Care Pain Management Neurosurgery / Radiosurgery Neurology Radiology (Diagnostic / Interventional) Trust Operational Management Neuropsychiatry GP Interface Stroke / Trauma / A&E / Gen Med Centre Programme Board / Clinical Lead(s) Theatres SCN Neurophysiology Pathology Rehabilitation Neuroophthalmology Nursing
Primary / Community Care Centre Patients Social Care Third Sector Providers Spinal Physio / MSK Triage Primary / Community Care Interface (GP Led) Centre Programme Board Nursing / Other AHPs GPs NHS Community Providers (Rehab) Nominated Lead CCG Pharmacy
Regional Commissioning NHS England Clinical Senate CCGs Health & Wellbeing Board Multi- Disciplinary Expert Advisory Groups Parkinson Disease Multiple Sclerosis Epilepsy Headache Vascular / SAH Cranial Neurosurgery Spinal Neurosurgery Functional Neurology Acute Neurology Rehabilitation Neuromuscular/MND Centre Programme Board(s) Strategic Clinical Network National Advisory Group DGH Neurologists Operational Management Third Sector Providers Service Providers NIHR / Trials Academic / NIHR / Trials Lead(s) More formalised framework for Business case submission and service reconfiguration
National Neurological Alliance R&D / Trials / Academia Strategic Clinical Network Leads CHAIR Professional Societies Association of British Neurologists Society of British Neurological Surgeons Professional Bodies for Radiology (interventional), Neurophysiology, Rehabilitation, Pathology, Nursing, Therapies etc Quality & Data Quality lead HSCIC NICE National Advisory Group Clinical Reference Groups Adult Neurosurgery Complex Spinal Surgery s CNS Tumours NHS England CCG Representation Health Education England Public Health England Commissioning & Workforce Allied CRGs / Networks Specialised Rehabilitation Major Trauma / Critical Care Dementia / Neuropsychiatry Stroke Radiosurgery
ALL TIME ALL SETTING REHABILITATION & RE ENABLEMENT PARALLEL PATIENT EDUCATION & ACTIVITY PROGRAMME NEUROLOGICAL DISEASE & DISABILITY IS COMMON SOME ACUTE MUCH TREATABLE : THE PYRAMIDAL CELL 3 RD SECTOR: NEUROLOGICAL ALLIANCE / INDIVIDUAL CHARITIES (NEURO) PSYCHIATRY / MENTAL HEALTH MEMORY DEMENTIA STROKE REGIONAL NATIONAL ACADEMIC NEUROSCIENCE (NIHR) TRIALS REGIONAL NEUROSCIENCES CENTRE 24/7 ON CALL GOOD = NEUROLOGICAL SURGERY: TUMOURS. SAH. TRAUMA. SPINAL. PD- EPILEPSY. SKULL BASE/PITUITARY. PAIN. RADIOSURGERY. INTERVENTIONAL & DIAGNOSTIC NEURO-RADIOLOGY -24/7. NEUROPHYSIOLOGY/ V-TELEMETRY / SLEEP STUDIES. MDTs open to DGHs. NEUROPATH/COMPLEX BLOODS. NEURO ITU. NEUROLOGY BEDS eg.gbs/ai ENCEPHALITITS / MYASTHENIA.+ PATIENTS OFF MEDICAL TAKES & A/E.PLASMAPHORESIS / DAY UNITS eg. IVIG-LPs- DMTs. Specialist NURSES/PHYSIO/Sp THERAPY/OT. PSYCHOLOGY. NeuroGERIATRICS. NEUROLOGY SPECIALIST CLINICS: EPILEPSY/PD(APO/DUODOPA)/DYSTONIA/MS/NMUSCULAR/MND/ HEADACHE(BOTOX)/SLEEP. REHAB. NEURO-GENETICS- OPTHALMOLOGY ENT PSYCHIATRY - RESPIRATORY/NIV/PEG. ONCOLOGY TRAINING/CME/TEACHING/QUALITY AUDIT & GOVERNANCE. REHAB IP UNITS NORSE / HOT clinics INTEGRATED DGH (ACUTE)NEUROLOGY + STROKE TWINNED CENTRE BETTER TRANSFER RETRANSFER SYSTEMS 3-5 NEUROLOGISTS OP + IP / MEDICAL TAKE & A/E. INTEGRATION with STROKE. SOME SPECIALIST CLINICS / NURSES/PHYSIO/SPEECH THERAPY. 5-10 BEDS (not counting Stroke)with REHAB.MRI/CT (?24/7) & some Neurophysiology. MDTs eg. with GM &A/E/Audit/Teaching/Training. Patient tracking. FEEDBACK ENHANCED COMMUNITY NEUROLOGY MULTI- DIMENSIONAL GP-CONS BI-DIRECTIONAL FEEDBACK REFERRAL & TRIAGE SYSTEM. ADVICE & GUIDANCE. PROTOCOLS. SPECIALIST COMMUNITY NURSES eg. EPILEPSY/MS/PD (REDUCING ADMISSIONS). HOME VT/complex DRUG DELIVERY. SPECIALIST GPs? Satisfaction Levels ASSERTIVE EXPERT COMMUNITY REHABILITATION & SOCIAL SERVICES CASE MANAGEMENT CARE PLAN PACKAGES A MULTIDISCIPLINARY RIGHT CARE AS LOCAL AND AS RESPONSIVE AS POSSIBLE MODEL MULTIDISCIPLINARY & MULTIAGENCY TEAMS. DISTRICT NURSES. CONTINENCE ADVISORS. PALLATIVE & 24/7 END OF LIFE CARE. EQUIPMENT. COMPLEX TECHNOLOGY. PSYCHOLOGICAL SUPPORT.
Margaret Mead - Anthropologist Never doubt that a small group of thoughtful citizens can change the world. Indeed it is the only thing that ever has.