1. Quality Neurology Toolkit Audit Ian Clarke Planning and Commissioning Officer Stoke on Trent Joint Commissioning Unit

2. Why Did We Do it? National Strategic Framework 2005 11 Quality Requirements – Limited Progress Locally Physical Disability and Sensory Impairment Strategy

3. Who was involved in the Professional Workshops? Consultant Neurologists Consultant Psychologists Commissioners Specialist Nurses Therapists Social Care representatives Residential/Nursing Home managers Vocational Rehabilitation Voluntary Sector Organisations

4. Key Findings Emergency and Acute management handled well Assessments are disjointed – integrated assessments are needed Lack of integrated approach across ASC and Health Specialist Nurse role is vital and valued Care closer to home – Community Clinics, Community team Better referral routes needed between agencies Better co-ordination of care required Timely and accurate information required Telehealth and Telecare needs better publicity and utilisation Better awareness required for LTNC i.e. Acute staff, GP’s etc.

5. Care Pathways Parkinson’s Disease, Multiple Sclerosis, Motor Neuron Disease, Acquired Brain Injury Added to the QNT consultation, well attended Mirrors QNT findings: 1.Care closer to home, Community team needed. 2.Better awareness of G.P’s, Acute staff. 3.Clearer pathways needed. 4.Early access to specialist advice/support required. 5.Better information is needed to aid self management. 6.Closer links to Palliative Care required. Actions integrated into the QNT action plan

6. Service User/Carer Focus Groups Feedback

7. Key Priorities Include Assessments are Co-ordinated by a keyworker to ensure an integrated approach. Service users and carers receive timely and accurate information based on the individual need. Acute care is better equipped to support people with LTNC Improved access to vocational rehab in the community Ensure a range of housing and support options are available to people with LTNC Protocols are in place for more effective working between Neurology services, palliative care staff and community health professionals Improve the uptake and understanding of carers assessments and support options available.

8. Key Actions Develop information sets for each condition. Review current resources and establish what is required to implement the keyworker role. Increase awareness of LTNC in acute settings. Establish a team of specialist neurologically skilled staff in the community. Pursue potential options to increase vocational rehab services in the community. Implement shared protocols in relation to palliative care. (Palliative care staff and community health services) Work with carers lead and voluntary organisations to increase the uptake of carers assessments and support options available.