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dc.contributor.authorCarroll, Cen
dc.contributor.authorZajicek, Jen
dc.date.accessioned2015-07-29T12:43:21Z
dc.date.available2015-07-29T12:43:21Z
dc.date.issued2004-03en
dc.identifier.issn0022-3050en
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.

en
dc.format.extent406 - 409en
dc.languageengen
dc.language.isoengen
dc.subjectAdolescenten
dc.subjectAdulten
dc.subjectAgeden
dc.subjectAged, 80 and overen
dc.subjectEmergency Service, Hospitalen
dc.subjectEpilepsyen
dc.subjectFemaleen
dc.subjectHeadacheen
dc.subjectHospital Bed Capacityen
dc.subjectHospitals, Communityen
dc.subjectHumansen
dc.subjectLength of Stayen
dc.subjectMaleen
dc.subjectMiddle Ageden
dc.subjectNervous System Diseasesen
dc.subjectNeurologyen
dc.subjectPatient Admissionen
dc.subjectPractice Guidelines as Topicen
dc.subjectProspective Studiesen
dc.subjectReferral and Consultationen
dc.subjectStrokeen
dc.subjectUnited Kingdomen
dc.subjectWorkforceen
dc.titleProvision of 24 hour acute neurology care by neurologists: manpower requirements in the UK.en
dc.typeJournal Article
plymouth.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/14966156en
plymouth.issue3en
plymouth.volume75en
plymouth.publication-statusPublisheden
plymouth.journalJ Neurol Neurosurg Psychiatryen
dc.identifier.doi10.1136/jnnp.2003.018010en
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/Faculty of Health
plymouth.organisational-group/Plymouth/Faculty of Health/Peninsula Medical School
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA03 Allied Health Professions, Dentistry, Nursing and Pharmacy
plymouth.organisational-group/Plymouth/Research Groups
plymouth.organisational-group/Plymouth/Research Groups/Institute of Translational and Stratified Medicine (ITSMED)
plymouth.organisational-group/Plymouth/Research Groups/Institute of Translational and Stratified Medicine (ITSMED)/CCT&PS
plymouth.organisational-group/Plymouth/Users by role
plymouth.organisational-group/Plymouth/Users by role/Academics
dc.publisher.placeEnglanden
dc.rights.embargoperiodNot knownen
rioxxterms.versionofrecord10.1136/jnnp.2003.018010en
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.typeJournal Article/Reviewen


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