An integrated approach to neuroscience care: An innovative model to support the new integrated care system

Michelle S Balaratnam; Fergus J Rugg-Gunn; Rachel Okin; Freya Powell; Stephen Prior; Panayiota Petrochilos; Dhiren Shivji; Salman Haider; Ali Alim-Marvasti; Arvind Chandratheva; Robert Simister; Charlie Lane; Roberto Macarimban; Diego Kaski; Bal Athwal; Rebecca Liu; Timothy Yates; Sanjeev Rajakulendran; Gerry Christofi; Jeremy Sandford; Alexis Ingram; Katherine Bluston; Caroline Weaver; Oluwaseun Odejide; George Glod; Gulsen Gungor; Edmund Nkrumah; Donal Markey; Gary Hotton; Katie Sidle; Jonathan Kennedy; Lisa Penniall; Helen Plum; Anthony Antoniou; Rakhee Prema; Nadia Jeffries; Carole Walters; Valerie L Stevenson; Malini Drysdale; Sabiha Tasnim; Shahrima Hussain; Lily Mackay; Ryan Baulk; Bianca IIii; David Egan; Adrian Capp; Patricia Turner; Christopher Turner

doi:10.1016/j.clinme.2024.100234

An integrated approach to neuroscience care: An innovative model to support the new integrated care system

Clin Med (Lond). 2024 Aug 21;24(6):100234. doi: 10.1016/j.clinme.2024.100234. Online ahead of print.

Authors

Michelle S Balaratnam¹, Fergus J Rugg-Gunn², Rachel Okin³, Freya Powell⁴, Stephen Prior⁵, Panayiota Petrochilos², Dhiren Shivji², Salman Haider², Ali Alim-Marvasti², Arvind Chandratheva⁶, Robert Simister², Charlie Lane², Roberto Macarimban², Diego Kaski², Bal Athwal⁷, Rebecca Liu⁷, Timothy Yates⁸, Sanjeev Rajakulendran⁸, Gerry Christofi², Jeremy Sandford⁹, Alexis Ingram⁹, Katherine Bluston⁹, Caroline Weaver¹⁰, Oluwaseun Odejide¹⁰, George Glod¹⁰, Gulsen Gungor¹⁰, Edmund Nkrumah¹⁰, Donal Markey¹⁰, Gary Hotton⁸, Katie Sidle¹¹, Jonathan Kennedy⁷, Lisa Penniall¹², Helen Plum¹³, Anthony Antoniou¹⁴, Rakhee Prema⁴, Nadia Jeffries¹⁵, Carole Walters¹⁶, Valerie L Stevenson², Malini Drysdale², Sabiha Tasnim², Shahrima Hussain², Lily Mackay², Ryan Baulk², Bianca IIii¹⁷, David Egan², Adrian Capp², Patricia Turner², Christopher Turner²

Affiliations

¹ National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK. Electronic address: m.balaratnam@nhs.net.
² National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK.
³ Camden Neurological and Stroke Service, Central and North West London NHS Foundation Trust, London, UK.
⁴ Community Neurological Conditions Management Team, Royal Free London NHS Foundation Trust, London, UK.
⁵ Camden Integrated Community Health Care (CICH), Central and North West London NHS Foundation Trust, London, UK.
⁶ National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK; St Pancras Neurological Rehabilitation Unit, Central and North West London NHS Foundation Trust, London, UK.
⁷ Neurology Department, Royal Free Hospital, Royal Free London NHS Foundation Trust, London, UK.
⁸ National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK; Neurology Department, North Middlesex Hospital, North Middlesex University Hospital NHS Trust, London, UK.
⁹ Primary Care, NHS North Central London ICB, London, UK.
¹⁰ NHS North Central London ICB, London, UK.
¹¹ National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK; Neurology Department, Whittington Hospital, Whittington Health NHS Trust, London, UK.
¹² Islington Community Neurological Rehabilitation Team, Whittington Health NHS Trust, London, UK.
¹³ Enfield Adult Community Therapies, North Middlesex University Hospital NHS Trust, London, UK.
¹⁴ Haringey Integrated Community Therapy Team, Whittington Health NHS Trust, London, UK.
¹⁵ Neurological Rehabilitation Centre, Royal Free London NHS Foundation Trust, London, UK.
¹⁶ St Pancras Neurological Rehabilitation Unit, Central and North West London NHS Foundation Trust, London, UK.
¹⁷ Primary Care, NHS North Central London ICB, London, UK; Age UK, Barnet, London, UK.

PMID: 39173716
DOI: 10.1016/j.clinme.2024.100234

Abstract

Integrated care systems join up health and care services, so that people have the support they need, in the right place, at the right time. The aims include improving outcomes in healthcare, tackling inequalities in access and enhancing productivity and value for money. This is needed for neuroscience care as the traditional delivery of neuroscience care is inefficient, outdated and expensive, and can involve complex referral pathways and long waiting times. In preparation for the formation of the integrated care system (ICS), a novel innovative collaboration across multiple NHS trusts developed across North Central London in 2021. We developed a model where neuroscience specialists engage in collaborative care with clinicians outside the specialist hospital setting. Pivotal to the pathway is a multidisciplinary meeting, and collaborative working enables joint clinical reviews, diagnostics and medication initiation. This innovative collaboration has already significantly improved access, addressed inequalities due to borough variation and enhanced the delivery and quality of neuroscience care in our ICS. It is a translatable model that can be adapted to suit other regions in the UK. It fulfils many of the objectives of the integrated care system and these benefits are seen without the need for significantly more resource.

Keywords: Integrated Care; Integrated Care Board; Integrated Care System; Neuroscience.