Access to specialist support for complex conditions

Access to specialist support for complex conditions

Parkinson's is a very complex condition. It has over 40 recognised symptoms that impact on every aspect of daily living, and every individual is different. It is progressive and there is no medical treatment that can slow down, stop or reverse its progress. With the right treatment and support, people can live well for some time with Parkinson's. Without that expertise it can be different story. We're concerned about how hard it can be for people with complicated, life changing conditions like Parkinson's who live in more remote and rural parts of Scotland to access the expert multi disciplinary care that they need. 12% of people with Parkinson's live in remote rural areas or remote small towns. Parkinson's is not rare - over 12,000 people in Scotland have a diagnosis, and 30 people are diagnosed each week. But it's not straightforward to diagnose or to treat, which is why specialist care is needed from a range of professionals, including doctors, nurses, allied health professionals, mental health services and social care. People with Parkinson's are at very high risk of unplanned hospital admissions (more than a quarter of people are admitted to hospital each year, some more than once). A lack of access to expert Parkinson's clinicians increases the risk of preventable admissions to hospitals and care homes. Where specialist care is needed in remote areas, it is sometimes delivered by the local board (as in the North of Highland, Grampian, Tayside, Ayrshire & Arran, Borders and Dumfries & Galloway), and sometimes under contract from a much larger provider board. These arrangements aren't always transparent, and we're aware of inequalities. Similar issues may apply to other conditions. Parkinson's consultant services in Western Isles and parts of Argyll & Bute are delivered by NHS Greater Glasgow and Clyde. For the Northern Isles, Parkinson's specialist medical care is led by NHS Grampian. But in Orkney and Shetland, visiting neurology consultants conduct face to face clinics a few times a year, alongside virtual consultations, and are available to people of all ages. In Western Isles, the neurology service is virtual only, and people need to travel to Glasgow for a face to face clinic. We've become aware that there's no access to expert diagnosis for people aged 65+ with suspected Parkinson's which is extremely concerning. We also have significant concerns about the high workloads of neurology nurses in Shetland and the Western Isles who cover a number of neurological conditions and have no local access to Parkinson's consultants.


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