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dc.contributor.authorCarroll, Camille
dc.date.accessioned2015-07-29T12:43:21Z
dc.date.available2015-07-29T12:43:21Z
dc.date.issued2004-03-01
dc.identifier.issn0022-3050
dc.identifier.issn1468-330X
dc.identifier.urihttp://hdl.handle.net/10026.1/3496
dc.description.abstract

OBJECTIVES: The ABN has published standards of care for patients with acute neurological disease. Derriford Hospital provides a 24 hour neurology intake service to a population of 500,000 with the equivalent of four consultants, three specialist registrars (SpRs), and four senior house officers (SHOs) with a 37 bed ward. The authors undertook a prospective study of all neurology admissions to enable calculation of manpower necessary to meet the ABN guidelines. METHODS: All admissions to the neurology department were analysed prospectively for a three month period (March to May 2002). RESULTS: There were 629 admissions (equating to 2500 per year); data were collected for 93%. 78% of admissions were emergency, 16% elective. The mean number of neurology inpatients at any time was 76, with three (4%) being elective. The main diagnostic categories were stroke (29%), headache syndrome (13%), and epilepsy or seizures (12%). With regard to emergency admissions, 94% were seen by a neurology SHO within 6 hours and 81% by an SpR or consultant within 24 hours. Twenty five percent of emergency admissions were not seen by a consultant. 55% of patients were cared for on non-neurological wards for their entire admission. Median length of stay for stroke patients was 9.5 days, compared with 4 days for other patients. 37% of patients received a neurology follow up appointment. Currently each SpR spends 18 hours per week involved in the care of acute neurology admissions. CONCLUSION: Meeting the ABN guidelines will require an increase in total neurology bed provision to at least 15 per 100,000 population, with the equivalent of 3 consultant sessions (11 hours/week). Meeting the European Working Time Directive will require a minimum of 8-10 SpRs working a full shift system, which will have a significant impact on training and other aspects of service delivery.

dc.format.extent406-409
dc.format.mediumPrint
dc.languageen
dc.language.isoeng
dc.publisherBMJ
dc.subjectAdolescent
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectEmergency Service, Hospital
dc.subjectEpilepsy
dc.subjectFemale
dc.subjectHeadache
dc.subjectHospital Bed Capacity
dc.subjectHospitals, Community
dc.subjectHumans
dc.subjectLength of Stay
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectNervous System Diseases
dc.subjectNeurology
dc.subjectPatient Admission
dc.subjectPractice Guidelines as Topic
dc.subjectProspective Studies
dc.subjectReferral and Consultation
dc.subjectStroke
dc.subjectUnited Kingdom
dc.subjectWorkforce
dc.titleProvision of 24 hour acute neurology care by neurologists: manpower requirements in the UK
dc.typejournal-article
dc.typeJournal Article
plymouth.author-urlhttps://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000188970000014&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=11bb513d99f797142bcfeffcc58ea008
plymouth.issue3
plymouth.volume75
plymouth.publication-statusPublished
plymouth.journalJournal of Neurology, Neurosurgery & Psychiatry
dc.identifier.doi10.1136/jnnp.2003.018010
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/Faculty of Health
plymouth.organisational-group/Plymouth/Faculty of Health/Peninsula Medical School
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plymouth.organisational-group/Plymouth/Research Groups/Institute of Translational and Stratified Medicine (ITSMED)/CCT&PS
plymouth.organisational-group/Plymouth/Research Groups/Plymouth Institute of Health and Care Research (PIHR)
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dc.publisher.placeEngland
dc.identifier.eissn1468-330X
dc.rights.embargoperiodNot known
rioxxterms.versionofrecord10.1136/jnnp.2003.018010
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.typeJournal Article/Review


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