ACUTE NEUROLOGY SERVICE PROVISION AT A DISTRICT GENERAL HOSPITAL

Background It has long been the opinion within neurology that acute neurology service provision needs increasing. With the exception of stroke and transient ischaemic attacks, many patients presenting to accident and emergency (A+E) or medical assessment units (MAU) with neurological complaints do not see a neurologist before an outcome—either admission or discharge—is reached. Aims To determine firstly whether the number of patients presenting is sufficient to warrant considering implementation of an acute neurology service, and secondly what the current outcomes of these patients are in order determine whether these outcomes may be altered with initial specialist input. Method A prospective audit of patients attending the A+E or MAU department over a 4 week period, recording both how many present with neurological complaints and what the initial outcome for these patients was. Results In total 6.8% of all acute attendances were neurological in origin. Of these 49.2% were admitted and 10.2% referred for outpatient appointments. Conclusion Neurological complaints make up a significant proportion of acute attendances to the RGH and of these nearly 60% require further care. Thus these findings would suggest that implementing an acute neurology service could potentially alter the outcome for sufficient numbers of people.