POC24 Subspeciality demand in a regional neurology service

Aim To determine pattern of out-patient neurology referrals in Lanarkshire. Background The population of Lanarkshire (635 000) is served by three district general hospitals with six visiting consultant neurologists from Glasgow undertaking general clinics. Services are undergoing redesign to meet demand and achieve waiting time targets. Methods Neurology referrals from primary care were prospectively screened by one neurologist (JPL) during two separate vetting periods in 2008 (23-week duration) and 2009 (29-week). Referrals were classified according to subspeciality with referrals designated as General Neurology if no subspeciality was apparent. Results A total of 2819 patients were referred during both periods. 1030 (36.5%) were designated general neurology, 270 (9.6%) epilepsy, 315 (11.2%) first seizure, 392 (13.9%) headache, 112 (4.0%) movement disorder, 50 (1.8%) multiple sclerosis and 21 (0.7%) neuromuscular. 629 (22.3%) were named referrals to individual consultants and were not categorised. 1113 patients (48.8 per week) were referred in the first period and 1706 (58.8 per week) in the second vetting period. Discussion Changing patterns of referrals necessitate constant re-evaluation of services. Demand has risen by 21% between the vetting periods, and if subspeciality neurology clinics are to be established and maintained, clinical need must be assessed and monitored.