by Dr Gordon Duncan
This 2011 audit looks at PD services in Newcastle provided by neurology and geriatric medicine.
Neurology operates a Movement Disorder Service with 3 consultants and 3 PDNS (2.4 WTE) covering Newcastle and the North of England. There is a medical clinic weekly, 3 nurse clinics per week and a nurse helpline.
Geriatric medicine runs a local PD service for older people which is led by 2 geriatricians with a special interest in PD in older people in a day hospital setting. There is no formal PDNS.
Positive findings for the neurology service include: all patients were referred untreated, spec review in 20 patients (80%), PDNS: 23 (92%). Side effects -ICD 14 (82%) and sleepiness 16 (60%). Medications were prescribed according to NICE guidelines and information given in 16 patients (67%).
There is some room for improvement in neurology too – no patient was seen in less than 6 weeks, only 1 patient was given written information, 1 patients was given PDNS contact information, driving and DVLA status at diagnosis was only addressed in 50% of patients. Speech and language therapy was probably underused.
In geriatric medicine positive findings included all patients were referred untreated, and all seen within 6 weeks. Patients were seen often – every 2 to 3 months. All patients were reviewed <6 months. Written information was given about side effects and there is ready access to MDT.
However improvements could be made in relation to side effect questioning – only 4 (57%) were asked about ICD, and only 6 (32%) asked about sleepiness. Addressing driving status and information provided at diagnosis could both be improved upon, and of course with no formal PDNS service there is scope to improve the service offer here.