Provision of 24 hour acute neurology care by neurologists: manpower requirements in the UK
dc.contributor.author | Carroll, Camille | |
dc.date.accessioned | 2015-07-29T12:43:21Z | |
dc.date.available | 2015-07-29T12:43:21Z | |
dc.date.issued | 2004-03-01 | |
dc.identifier.issn | 0022-3050 | |
dc.identifier.issn | 1468-330X | |
dc.identifier.uri | http://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.extent | 406-409 | |
dc.format.medium | ||
dc.language | en | |
dc.language.iso | eng | |
dc.publisher | BMJ | |
dc.subject | Adolescent | |
dc.subject | Adult | |
dc.subject | Aged | |
dc.subject | Aged, 80 and over | |
dc.subject | Emergency Service, Hospital | |
dc.subject | Epilepsy | |
dc.subject | Female | |
dc.subject | Headache | |
dc.subject | Hospital Bed Capacity | |
dc.subject | Hospitals, Community | |
dc.subject | Humans | |
dc.subject | Length of Stay | |
dc.subject | Male | |
dc.subject | Middle Aged | |
dc.subject | Nervous System Diseases | |
dc.subject | Neurology | |
dc.subject | Patient Admission | |
dc.subject | Practice Guidelines as Topic | |
dc.subject | Prospective Studies | |
dc.subject | Referral and Consultation | |
dc.subject | Stroke | |
dc.subject | United Kingdom | |
dc.subject | Workforce | |
dc.title | Provision of 24 hour acute neurology care by neurologists: manpower requirements in the UK | |
dc.type | journal-article | |
dc.type | Journal Article | |
plymouth.author-url | https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000188970000014&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=11bb513d99f797142bcfeffcc58ea008 | |
plymouth.issue | 3 | |
plymouth.volume | 75 | |
plymouth.publication-status | Published | |
plymouth.journal | Journal of Neurology, Neurosurgery & Psychiatry | |
dc.identifier.doi | 10.1136/jnnp.2003.018010 | |
plymouth.organisational-group | /Plymouth | |
plymouth.organisational-group | /Plymouth/Faculty of Health | |
plymouth.organisational-group | /Plymouth/Faculty of Health/Peninsula Medical School | |
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/FoH - Applied Parkinson's Research | |
plymouth.organisational-group | /Plymouth/Research Groups/FoH - Community and Primary Care | |
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/Research Groups/Plymouth Institute of Health and Care Research (PIHR) | |
plymouth.organisational-group | /Plymouth/Users by role | |
plymouth.organisational-group | /Plymouth/Users by role/Academics | |
dc.publisher.place | England | |
dc.identifier.eissn | 1468-330X | |
dc.rights.embargoperiod | Not known | |
rioxxterms.versionofrecord | 10.1136/jnnp.2003.018010 | |
rioxxterms.licenseref.uri | http://www.rioxx.net/licenses/all-rights-reserved | |
rioxxterms.type | Journal Article/Review |