It wasn’t until half way through neurologist Lara Teare’s training that she really considered a special interest in movement disorders. It was working alongside Dr Andrea Lindahl that changed that. ‘I was inspired by her enthusiasm’, Lara says, explaining that from that point, she worked hard to experience as many different forms of Parkinson’s clinic as possible.

When she qualified, Lara landed in a team of Parkinson’s specialists led by fellow Faculty member Andrea and MasterClass graduate Dr Lucy Strens, who had already begun work transforming local services. However, the challenge to get the best possible care to the people who needed it was far from over.

‘I was fortunate to join a growing team of different people all trying to improve care; our key aim now is to achieve service parity.’

The team are working hard to extend their services’ reach, providing Parkinson’s clinics, often alongside a community specialist nurse, in each of the regions’ district general hospitals (DGHs). As well increasing the availability of specialist clinics in a wider variety of areas, Lara and her colleagues are working hard to increase awareness of Parkinson’s among the non-specialist clinicians within those hospitals.

‘So much of the role in achieving parity is around education’, Lara notes. Not the first Star to mention Bas Bloem’s Parkinson’sNet model, she highlights that her team have fully embraced the principle of ‘spreading good practice.’ Involved personally in teaching junior doctors and attending local GP meetings to increase basic understanding of Parkinson’s, Lara shares how this helps make sure people living with Parkinson’s have their needs better understood, especially relevant when they are being treated for something other than their Parkinson’s.

Lara’s team operate within the Midlands, across a large patch with a huge number of Parkinson’s patients and a mix of urban and rural health settings. As with all healthcare, there are resource limitations, and for Lara, the way to improve equity of services and better access to them is to think laterally.

‘We map out service locations and people – literally trying to match people to patients,’ she says. ‘Where there is an mutual interest or an existing service that could meet some needs, we can jump in there.’

Dr Sarah Marrinan with Dr Sarah Marrinan, Parkinson’s MasterClass 2017

Lara gives examples of existing generic Falls clinics, or Memory services. ‘They might not be Parkinson’s specific but we can support them to offer elements of Parkinson’s care, such as maintaining someone’s mobility, or helping to manage their dementia.’ By both identifying possible relevant services and adding that education element in, Lara and her team are able to facilitate better access to care and support closer to people’s homes. There can sometimes be resistance to this approach of taking on specialist patients within more general clinics. These services understandably have limited resources too. Building positive relationships across services and with individuals is essential to manage this.

Lara’s advice to colleagues who are just starting out in a specialist role follows the theme of relationships too.

‘Talk to other people,’ she advises. ‘Find your local colleagues, join the Excellence Network. It can feel like you’re on your own, but there are lots of people trying to do the same things, and they can support you.’

 

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