by Dr Rob Skelly
I was appointed as consultant geriatrician in Derby in 2000. My predecessor, Dr Mishra, had established a multidisciplinary PD clinic and had left things in good order. Although I had done some movement disorder clinics as a registrar, I often struggled to know how best to advise patients. Hoping to fill a knowledge gap, I attended the second Parkinson’s Academy MasterClass in Cornwall in 2003. Some knowledge gaps were filled of course but here in 2015 I still often find myself powerless in front of suffering patients. Patients of course realise somewhat sooner than their doctors the limitations of their treatments – but a sympathetic ear is often appreciated.
For MasterClass I conducted a patient survey which confirmed good access to therapies. Some patients found our one-stop shop clinic too lengthy, so we now offer an option of having therapy assessments the week before the consultant assessment or all assessments on the same day. It is quite right that service users have a say in the way services are delivered and developed. It was clear from the projects presented that further surveys and audits would be a useful tool in improving and developing services.
After the MasterClass we took steps in Derby to work more closely with neurology colleagues. A steering group was set up and soon patients with PD under neurologists were enjoying access to therapies previously only enjoyed by the elderly.
The secret of success in PD is having a good team. Good teams don’t just happen even if you have the best individuals. I believe regular team meetings are most important for building and nurturing a team. Multidisciplinary teams need to meet regularly to discuss patients and ensure information about patients’ goals and progress is shared. Regular meetings lead to greater respect for the skills and special expertise of the different disciplines. There is also opportunity for sharing knowledge and discussing service development.
In 2007 the team in Derby were awarded the Hospital Doctor PD team of the year award. Later the team was recognised a centre of excellence by the National Parkinson Foundation. I am proud of the team I work with not because we get everything right – we don’t – but because we acknowledge service failures and try to improve.
The Parkinson’s Excellence Network was launched at the beginning of this year. As I see it, the aims of the Network are to improve standards of care for people with Parkinson’s by sharing good practice, educating staff, encouraging participation in research and empowering patients. The Network has six theme groups looking at: service development, research, patient involvement, education, under-served populations and evidenced based care.
To ensure the Network has relevance and traction throughout the UK regional groups were established. I was asked to lead the Network in the East Midlands. I was keen to involve as wide a variety of people as possible. Parkinson’s Excellence Network East Midlands (PENEM) has a steering group with representation from seven acute trusts and from a variety of backgrounds. Members of the steering group are leading a range of projects including: improving inpatient care, palliative care, admission avoidance and improving links with mental health services.
I hope to see Parkinson’s professionals in the region adopting and adapting guidelines and good practice from elsewhere in the region. There is no need to re-invent the wheel. Ultimately the success of the network will be judged by higher standards of care for people with Parkinson’s as judged by the national Parkinson’s Audits, in particular patient reported outcome measures.
The Parkinson’s Excellence Network is great way to meet people dedicated to improving Parkinson’s care. You may be able to pinch great ideas or catalyse improvements in care beyond your own hospital, so please get involved in your regional network.