The changing relationship between neurology and general practice in the UK

Abstract

The full involvement of primary care in an organised and balanced health service is vital to neurological patients' health. However, the available evidence suggests that GPs are, if anything, withdrawing or being pushed out of caring for this patient group. This article tries to identify why this may be happening, considers the implications, and suggests alternative ways forward.

No more neurophobia: welcome neurology in general practice

“…Bell's palsy is acute, idiopathic, unilateral paralysis of the facial nerve 1 and most GPs will see a new case about once every 5 years. Although most patients recover well, up to 30% have a poor outcome, with persistent facial weakness, psychological difficulties, and facial pain.…”

“…1 The GP is a gatekeeper, but so too is the waiting list for specialists. More consultants' clinics lead to more service use.…”

“…Enter Paul Morrish and his paper in this edition of the Journal. 1 It raises important issues: the underdevelopment of neurology in the community for common conditions like headache, epilepsy, and Parkinson's disease; the skill mix, workforce planning, and training needed for diagnosis and long-term management; medically unexplained conditions; referral rates; and the politics of getting neurology noticed by PCTs.…”

“…Morrish also highlights that more neurologists have not led to better patient outcomes. 1 Health services researchers get a sense of déjà vu. Demonstrating that services for chronic disease make a difference, except in patient satisfaction, is difficult.…”

“…14 Morrish has expressed concern that London and other metropolitan areas with teaching hospitals, have relatively too many neurologists. 1 In an unpublished…”