7 February 2020

Low neurologist workforce confirmed

New data published last week shows that the UK’s workforce of consultant neurologists significantly lower than might be expected. Our workforce is significantly lower than that of France and Germany, with areas outside of London particularly badly served.

Far fewer neurologists per person

The Association of British Neurologists (ABN) workforce survey received responses from almost half (46%) of all consultant neurologists, and over a third (35%) of neurology trainees. They found that for neurology consultants involved in patient care, the number of full time equivalent (FTEs) is 1.1 per 100,000 (1 per 91,175 population). This is far fewer than expected for similar high income European countries such as France and Germany, which both have over 1 FTE consultant neurologist per 25,000 population.

An emerging workforce crisis

The ABN identified an emerging workforce crisis due to the combination of an increase in newly appointed part-time consultants, and the increased number of early retirements. There are already long-standing vacancies in some areas of the country. The report suggests that there are not enough new neurologists are being trained to stem emerging workforce problems.

 

They also found significant regional variation, with by far the greatest concentration of consultant neurologists being situated in London/the south east, with over a third (35%) of the national total. This is followed by Scotland with 11% of the total, and Merseyside and the Northwest, with 9%.

Clear impact for people with neurological conditions

Clearly, the relatively low number of neurologists is concerning in relation to impact people living with neurological conditions, as the report itself states. Access to the right neurologist at the right time can mean swifter diagnosis, access to effective treatments and the right care as a condition, and needs, change.

 

“This inevitably has an impact on quality of care provided for patients with a neurological condition especially with regards to equitable and timely access to a consultant neurology opinion throughout the UK.”  – ABN neurology workforce survey

 

Our patient experience survey showed that for far too many people with neurological conditions, there is a long wait for a confirmed and accurate diagnosis. In some cases, this is followed by a wait of several months for treatment to start. This is almost certainly related to the workforce challenges seen around the country.

 

Delayed diagnosis and treatment is bad for people. They lack certainty about why they’ve been feeling ill, which can be very worrying, and continue to experience symptoms without appropriate support to manage these. The uneven number of neurologists around the country almost certainly contributes to some of the regional variation we see in people’s experiences of care, as shown by our patient experience survey.

Future-proofing our neuro workforce

Commenting on the findings, Georgina Carr, Chief Executive of the Neurological Alliance, said:

 

“This research provides further evidence about the need for greater investment in neurological services, including our neuro workforce. Healthcare professionals and people with neurological conditions alike continue to tell us about the increasingly long wait to access specialist care, and the decreasing clinic time available to discuss treatment and care with your neurologist. We urgently need to reverse these trends.

 

“There has been a marked and welcome increase in therapies for neurological conditions, and strong treatment pipeline for the future. If people are to access these therapies, we have to build a workforce fit for the future. We need to learn from areas making the most of neurologist expertise through innovative models of care, and make neurology as attractive as possible for prospective neurologists. We are calling on NHS England/Improvement to act now, and commit to a National Neurology Plan which sets out how we will future-proof our workforce, and ultimately improve treatment, care and support for the 1 in 6 people living with a neurological condition.”