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The frequency of adherence to the UK Driver and Vehicle Licensing Authority (DVLA) guidelines for patients referred to a neurovascular clinic is not known. Of 166 consecutive patients, 95 (57.2%) had a group 1 licence and 71 (42.7%) drove within a month of the event. Fifty of 85 (59%) transient ischaemic attack (TIA)/minor stroke patients had a licence and 30 (35%) drove within a month of the TIA/stroke. Compliance with DVLA driving guidelines is poor among patients referred to hospital with suspected TIA or minor strokes.

GPs prefer local NHS neurology services to independent sector contracts. GPs' evaluations should inform commissioning of neurology services. Combating neurophobia should be an integral part of responsive commissioning.

Purpose of the studyIncreasing pressure on general practice prompts innovative change in service organisation. This study sought to evaluate the impact of introducing a telephone-first consultation system in a socioeconomically deprived population.Study designAn interrupted time series of preplanned outcomes for 2 years before and 1 year postintroduction of a telephone-first system was used to measure the volume and type of general practitioner (GP) consultations and the number of patients consulted per year. Emergency department (ED) and GP out-of-hours attendances, the number of outpatient referrals, and the number of requests for laboratory tests were measured as secondary outcomes.ResultsThe telephone-first system was associated with a 20% increase in total GP consultations (telephone and face-to-face, effect estimate at 12 months, p=0.001). Face-to-face consultations decreased by 39% (p<0.001), while telephone consultations increased by 131% (p<0.001). The volume of individual patient requests for a GP consultation and the number of treatment room nurse consultations did not change. Secondary outcome measures showed no change in hospital outpatient referrals, number of requests for laboratory tests, and ED or GP out-of-hours attendances.ConclusionsA telephone-first system in a deprived urban general practice can decrease delays to GP–patient contacts. The number of patients seeking a medical intervention did not differ irrespective of the consultation system used. The telephone-first system did not affect GP out-of-hours, laboratory investigations or secondary care contacts.