National policy achievements
The importance of clinical leadership
Effective clinical leadership at national level is an important vehicle for driving service improvement and transformation in a particular disease area. The Neurological Alliance has campaigned for clinical leadership in neurology for many years.
The National Neuro Advisory Group (NNAG) was created in 2016 as a direct result of The Neurological Alliance’s campaigning activity. It marked the start of a new chapter in national policy activity for The Neurological Alliance.
The role of the Public Accounts Committee
Prior to NNAG’s establishment, the Public Accounts Committee (PAC) was a significant policy lever for neurological service improvement. It is the PAC’s role to scrutinise the value for money of public spending. It does this through a programme of inquiries. The Committee usually bases its enquires on ‘value for money’ reports from the National Audit Office. Additionally the Committee takes account of representations made by interest groups – such as the Neurological Alliance.
Through our engagement with the PAC, The Alliance was instrumental in a number of national developments for neurology, such as the establishment of Strategic Clinical Networks, the appointment of a National Clinical Director for Neurology and the creation of the first national data set for neurology.
Timeline of activity
Here we set out a timeline of activity prior to the creation of NNAG:
- National Audit Office (NAO) report on neurology services finds that progress in implementing the 2005 National Service Framework for long-term conditions has been poor
- Public Accounts Committee review of neurology services makes a number of recommendations for improvement, including the creation of regional clinical networks for neurology, the development of a national data set, and the appointment of a National Clinical Director
- Establishment of regional clinical networks for neurology, and appointment of Dr David Bateman as National Clinical Director
- Neurological Alliance members write to then-PAC chair, Margaret Hodge, to ask for a progress review of the 2012 recommendations
- The Treasury issues a review of progress towards the PAC’s recommendations
- Creation of the first national neurology data set and the Neurology Intelligence Network
- Neurological Alliance engages with the National Audit Office in January to ask for a progress update on neurology services and the PAC’s 2012 recommendations
- NAO progress review take place in April. Finds poor or moderate progress against the PAC?s 2012 recommendations
- Neurological Alliance members write to the new PAC chair, Meg Hillier, to call for a PAC inquiry based on the NAO’s findings
- NICE announces the development of a general guideline on neurological conditions, as recommended by the PAC in 2012. Publication scheduled for 2018
- PAC inquiry takes place with evidence from Neurological Alliance CEO Arlene Wilkie, National Clinical Director Dr David Bateman, and Simon Stevens, CEO of NHS England among others.
- PAC recommendations published.
- Government response published. This included the rejection of the PAC’s recommendation to retain the position of National Clinical Director for adult neurology.
- The Neurological Alliance Chair Steve Ford and Chief Executive Arlene Wilkie met Sir Bruce Keogh, National Medical Director, NHS England to make the case for continued clinical in neurology. At this meeting the Neurological Alliance was offered the opportunity to design a new collaborative and sustainable leadership model for neurology.
- The result was the creation of the National Neuro Advisory Group, which met for the first time in 2016.