Published in May, the NICE guidelines makes recommendations about which symptoms and signs should prompt a referral for further neurological assessment. It also covers some examinations, assessment tools and investigative tests for helping to decide whether a person with a suspected neurological condition should have further investigation or be referred to a specialist.
Suspected neurological conditions account for about one in 10 GP consultations and around 10 per cent of emergency admissions (excluding stroke) and result in disability for 1 in 50 of the UK population [1].
People with suspected neurological conditions often go to their GP with symptoms that are difficult to diagnose. A recent survey by the Neurological Alliance [2] found that nearly a third of respondents had to see their GP five or more times about the health problems caused by their condition before being referred to a neurological specialist. It also found that around 40 per cent of respondents waited more than a year from when they first noticed their symptoms to seeing a specialist.
The NICE guideline aims to make a difference to anyone who might have a neurological condition by making sure:
GPs can recognise when symptoms could have a neurological cause
GPs and doctors in emergency departments know when to refer people to a specialist straight away and when to do more tests first
People who most need to see a specialist can see one sooner
People are not referred to a specialist if they don’t need to be.
Dr Paul Chrisp, director of the Centre for Guidelines at NICE, said: “People with suspected neurological conditions often need referral to a specialist to be diagnosed. However, we know that some people with neurological conditions are initially misdiagnosed or have a delayed referral to a specialist, and some referrals are unnecessary. These issues with referral can come from non-specialists not recognising neurological conditions.
“This new guideline should help improve outcomes for people with suspected neurological conditions by providing, for the first time, a comprehensive assessment of the key signs and symptoms across the range of possible neurological conditions that should trigger referral to a specialist.”
Richard Grunewald, Chair of the guideline committee, said: “A non-specialist cannot be expected to keep up with the rapid changes in knowledge and practice in clinical neurology. This new guideline will help non-specialists recognise patients with neurological symptoms, such as dizziness and sleep disturbance, to prompt their referral to specialist assessment and care.”
References:
1. Local adult neurology services for the next decade: report of a working party, Royal College of Physicians.
2. The Neurological Alliance: The invisible patients: revealing the state of neurology services. January 2015.
