General practitioners (GPs) in England lack confidence in initially assessing and referring onward people with neurological symptoms, especially those with multiple sclerosis, and believe they could benefit from better training in identifying and managing neurological patients.
One result, according to a report published by the Neurological Alliance, titled “Neurology and primary care: improving the transition from primary care for people with neurological conditions,” is its earlier research finding that a majority of patients now wait more than a year between the time they begin noticing symptoms and the time they first see a specialist.
Because most neurological conditions are progressive and early treatment is critical to reducing disease progression and severity, such delays in accessing secondary care can have strong consequences for the patients.
In this report, researchers focused on the perspective of GPs regarding problems in the assessment and management of people with neurological signs and symptoms.
The team found that although the vast majority (94%) of GPs are “somewhat confident” or “extremely confident” in assessing and referring potential diabetics, that confidence declines considerably for patients with neurological conditions. Only 81% expressed confidence in making an initial assessment and referral for epilepsy, 73% for Parkinson’s disease, and 47% for multiple sclerosis.
In addition, 85% of GPs in England were either “somewhat concerned” or “extremely concerned” about the time it took for a potential neurological patient to be examined by a neurologist. More than half (almost 60%) also felt that local services and systems in their area were not sufficient for patients to receive a timely diagnosis.
A vast majority of GPs, 84%, also felt they could benefit from further training in identifying and managing people with multiple sclerosis, Parkinson’s, or other neurological conditions.
The report includes nine recommendations to strengthen GP experience and confidence during initial visits from these patients. These include a call for the development of a pan-neurological “watch list,” identifying the 10 common signs and symptoms that GPs need be aware of during patient interactions in primary care settings, and a call to increase the number of local neurologists who receive referrals from primary care, as well as their capacity and resources.
“It is essential that NHS [National Health Service] England and the Department of Health respond to these findings and engage with the concerns of GPs and people living with neurological conditions,” Arlene Wilkie, CEO of the Neurological Alliance, said in a press release. “Without an effective pathway through primary care, patients will continue to suffer the consequences of undue delays to referral, diagnosis and treatment, and outcomes will continue to suffer.”
The Neurological Alliance describes itself in the report as the “collective voice” of more than 80 national and regional organizations across England working to help people with neurological conditions.