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Alliance urges NHS England and NHS Improvement to appoint a national clinical director for neurology


The Neurological Alliance has written an urgent letter – backed by over 30 groups supporting people with neurological conditions – to the NHS England and NHS Improvement Medical Director, Professor Steven Powis, calling for the appointment of a National Clinical Director (NCD) for neurology. The call comes as the NHS in England is undergoing substantial reform.

An NCD for neurology would provide leadership, advice and expertise across a range neurological conditions and neuroscience services, to help deliver the pledges of the NHS Long Term Plan.

The appointment of an NCD would mark an important moment to capitalise on the progress made via the National Neuroscience Advisory Group (NNAG) the Getting it right first time (GIRFT) neurology review and transformation programmes. These programmes very clearly shown the unwarranted variation in access and delivery of services throughout England as well as what optimum models of care and commissioning should look like. An NCD would now ensure clear clinical leadership is in place to support positive changes across NHS.

Transformation requires clinical leadership within NHS England and NHS Improvement

NHS England and NHS Improvement are currently undertaking a neuroscience transformation review, which is considering the future specialised commissioning model for neurology and neurosurgery.

An NCD for neurology would help to ensure the needs of people with neurological conditions are further represented at a national level and clinical leadership is further strengthened. Appointing an NCD for neurology would also give neurology parity of leadership with other specialisms, such as stroke and dementia, for which NCDs have already been appointed.

Various other initiatives at a national level may have an impact on services for people with neurological conditions, including a transformation programme for outpatient services. However, there is currently no clear overarching clinical or strategic oversight within NHS England and NHS Improvement of these initiatives. An NCD for neurology would provide clear overarching clinical and strategic oversight of these initiatives.

The neuroscience clinical reference group (CRG) provides advice for specialised neuroscience services The National Neuroscience Advisory Group (NNAG), which the Alliance Co-Chairs alongside CRG Chair Professor Adrian Williams, was set up when the previous NCD for neurology role was cut in 2016  – a decision which The Neurological Alliance strongly opposed.

An NHS committed to improving outcomes for people with neurological conditions

Georgina Carr, Chief Executive of The Neurological Alliance, said:

“As the NHS in England experiences some its most fundamental reforms in nearly a decade, it is essential this moment is used to embed clinical leadership in neurology within NHS England and NHS Improvement.

The pandemic has highlighted the vulnerabilities of services for people with neurological conditions, with waiting lists soaring and a workforce under unprecedented pressure. At the same time, hugely exciting treatments and interventions which could transform quality of life for millions of people with neurological conditions are being developed.

The appointment of an NCD, with the right administrative support and a clear ambition to work closely with people with neurological conditions and the voluntary sector, would show NHS England and NHS Improvement is genuinely committed to improving the lives of the one in six people in England who live with a neurological condition. We urge Professor Steven Powis and NHS England and NHS Improvement to adopt our recommendation, which over 30 patient groups support, and appoint a NCD for neurology.”

Caroline Rassell, Chief Executive of Parkinson’s UK, said:

“Now is the time for NHS England and NHS Improvement to invest in a Clinical Director for Neurology. As the NHS recovers from the pandemic people with Parkinson’s and other neurological conditions need an internal NHS champion to ensure these major NHS transformation programmes really deliver better health and care services for people living with neurological conditions. 

We know our supporters face significant challenges to access the care and treatment they need to stay well and the pandemic has only made this more difficult. We want the NHS’s finite resources to really make a difference for the neurological community now and in the future and we believe a new Clinical Director will help raise the profile of neurological services and put the speciality on a similar footing as cancer, dementia and heart disease.” 

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