by Dr D Sangars¹, Dr Gledhill-Flynn², Dr  Raw³

1. Salford Royal Hospital, 2. North Manchester General Hospital, 3. Fairfield General Hospital

Background

This project is a part of UK national Parkinson’s audit and evaluation of Parkinson’s services in Pennine (covers Oldham, Fairfield and Rochdale). UK national Parkinson’s audit aim is to ascertain if the assessment and management of patients with an established diagnosis of Parkinson’s complies with national guidelines including the Parkinson’s NICE guideline and the National Service Framework for Long Term Neurological Conditions (NSF LTNC). This helps to identify areas of good practice and areas for improvement to inform local, regional and UK-wide discussions leading to action plans to improve quality of care.

Sampling methods

We have looked at twenty consecutive patients with idiopathic Parkinson’s disease as part of national parkinson’s audit. We have looked at phase of Parkinson’s disease and whether they have access to written information about their disease. We have as well looked at documentation regarding activities of daily living, non-motor symptoms, potential adverse effects of new medications, compulsive behaviour of patients taking dopaminergic drugs and cognition. We have looked at frequency of reviews as per national audit and whether they got access to physiotherapist, speech& language therapist.

Results

Majority (70% ) patients were in maintenance phase of disease while 20% in diagnosis phase. Only 10% patients were in complex phase. All of the patients had six monthly review by specialist in movement disorder. All of patients have access to written information about their disease and all of them have documentation about their activities of daily living, non motor symptoms, cognition. Most of patients (90%) had documentation of potential adverse side effects of new medication while 10% have not had documentation as they have not yet started on medication during that clinic visit. All of patients had documentation of compulsive behaviour while on dopaminergic drugs, however 70% had documentation during recent clinic visit and remaining in previous clinic visits. Majority (90%) of patients have been signposted to Parkinson’s UK. Only 10 percent of patients were referred to speech & language therapist and 30 percent referred to physiotherapist.

Conclusion

Specialist movement disorder clinic is meeting national Parkinson’s audit standards with six monthly review and documentation. Patients have access to Parkinson’s specialist nurse and signposted Parkinson’s UK. However need to improve service with multidisciplinary one stop clinic with access to therapist.

References

  1. National Institute of Health and Clinical Excellence. Parkinson’s Disease: Diagnosis and Management in Primary and Secondary Care Clinical Guidelines 35. (2006) Available at https://www.nice.org.uk/guidance/CG35
  2. Department of Health. National Service Framework for Long Term Neurological Conditions. (2005) Available at www.gov.uk/government/publications/quality-standards-for-supporting-people-with-long-term-conditions
  3. 2017 UK Parkinson’s Audit Patient management: Elderly Care & Neurology Standards and guidance.