Dependence on local control for care of neurological conditions has resulted in poorer outcomes than if there were a nationally-led strategy, according to MPs.
A report by the Public Accounts Committee contrasts the “poorly co-ordinated” and inconsistent care of conditions such as Parkinson’s disease with the impact of national targets for cancer and stroke care.
An estimated two million people in the UK have a neurological condition, the report said, but the quality of care provided varies significantly between locations.
The National Service Framework (NSF) for long-term conditions, published in 2005, contained 11 quality indicators. However, there was no national baseline for services or outcomes and no monitoring of progress.
This contrasts with the NSFs for cancer and stroke treatment, which were nationally led to drive improvements.
The report noted that despite their complex needs, spending on social services for people with neurological conditions has not increased since 2006 and healthcare provision remains below the quality requirements set out in the NSF.
This failure is reflected by a 32% increase in emergency admissions and an increase in the rate of readmissions within 28 days from 11.2% to 14%.
Finally, the report observed that only 22% of people with Parkinson’s disease, multiple sclerosis or motor neurone disease have a personal care plan.
It recommended the appointment of a national clinical lead for neurology.
Committee chair Margaret Hodge MP said that for people with neurological conditions “individual care is often poorly co-ordinated and the quality of services received depends on where you live. Some areas simply don’t have enough expertise, both in hospitals and in the community.
“For this clinical area, the department left the implementation to local health commissioners but gave them no leadership at all. It set no baselines and failed to monitor progress. The present government needs to understand what went wrong here for the future.”
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