1. Increased activity/waiting times FYFV - New models of Care
Community Headache pathway - Case for Change
Strategic context
The Vision
The Benefits
‘To develop a headache pathway that allows patients with headache who need to be seen in secondary care to do so quickly, while keeping in the community those patients with headache who can be better managed there, through supporting GPs in their independent practice and providing community headache services that are cost-efficient, easier to access and care is delivered closer to home. This improves patient care and also releases capacity in over-stretched neurology outpatient clinics’.
Dr Richard Wood, Oxfordshire CCG
Improved patient experience as seen in a timely manner closer to home
Improved patient outcomes as patients who need to see a specialist have quicker access
Increased capacity in outpatient clinics reducing waiting times
Reduced health system costs and pressures on the acute sector
Increased communication between primary and secondary care supporting learning
Increased consistency of care
Improved knowledge and skills in primary care
Closer links with third sector support in the community
Improved patient education and self management
Reduction in number of referrals to acute which can be managed in primary care
Reduction in A and E attendances due to easier access to support
Care closer to home
Increased activity/waiting times
Cost pressures
RightCare Approach
STP priorities
FYFV - New models of Care

2. Community Headache pathway – 3 key elements
Referral Triage
Set up of Community Health Clinic
Improvement in primary care
recognition of primary headaches
Including migraine and medication
overuse headache
Programme on self care management
Triage
undertaken by neurology consultant who will also provide advice to referrers, interpret imaging reports and provide clinical oversight and support to the community clinicians.
Run by headache specialist nurse or GP with special interest in headache
Management of those with
migraine, medication overuse headache, tension-type headache, cluster headache, chronic post-concussion headache
Education and Support for GP management of headache
Triage options
Back to referrer
Community Based
Headache clinic
Imaging without appt
General neurology clinic
Specialist headache clinic
Care close to home
Faster access to the right support
Clear guidelines
and proformas for diagnosis
Improved patient experience

3. Headache consultant triage MRI without outpatient appointment
Emergency referrals including symptoms of brain tumours have their own dedicated 2 week pathway
Headache pathway
Neurology outpatient clinic
Community
Headache Clinic
Patient education and advice from Pharmacy
Referral
Headache consultant triage GP
GP management
Advice
Specialist
Headache clinic
A and E
MRI without outpatient appointment