Neurological Conditions

Baroness Brinton Excerpts

Thursday 9th June 2022 Grand Committee

[Baroness Brinton (LD) [V]]

My Lords, I, too, thank the noble Lord, Lord Dubs, for securing this important debate. I also thank the Neurological Alliance, the Chartered Society of Physiotherapy, the Royal College of Occupational Therapists, Parkinson’s UK, the MS Society and Merck for their helpful briefings. I declare my interest as a vice-president of the Local Government Association.

The noble Lord, Lord Monks, spoke movingly of his son’s personal experience: that, despite the excellent treatment, the service feels in constant crisis, not least because of staff shortages—not just clinicians. As the noble Baroness, Lady Fraser, outlined, the Neurological Alliance surveyed more than 8,500 people with neurological conditions, including Parkinson’s, about their experiences. It found a shortage of neurology specialists, as outlined by other noble Lords. It is shocking that the UK was ranked 44 out of 45 European countries for the number of neurologists. The Royal College of Physicians found that 48% of consultant geriatricians in England are set to retire within the next 10 years.

Mental health services, which we have debated quite a lot in your Lordships’ House recently, are an absolutely integral aspect of care for people with neurological conditions, but a Written Answer to a Parliamentary Question two years ago revealed that the Government were on course to miss the recruitment target for expanding the mental health workforce by 50%. I do not think the last two years have helped that.

Delays to treatment and care can change your life for ever. More than half of adults, children and young people living with a neurological condition experienced delays to routine appointments with specialists last year. The Neurological Alliance is calling on the UK Governments to establish a neurology task force to get to the bottom of these problems and create real change.

Along with the noble Baroness, Lady Murphy, I am particularly interested in wider healthcare support, including rehabilitation, and was delighted to receive the briefings from physiotherapists and occupational therapists because, with my own long-term condition, I am very reliant on their expertise. The Royal College of Occupational Therapists surveyed staff working in rehab multidisciplinary teams, including physios, speech and language therapists, nurse specialists, dieticians and many more. Its survey found that 82% had seen an increase in demand for rehab support in the past six months. It is vital to those with chronic and deteriorating long-term conditions to have access to rehabilitation, so the ability for patients to access rehab is a lifeline, frankly. If it is not there, deterioration can speed up.

This is an area that cannot continue to work in constant crisis. One of the main problems in the short staffing in the MDTs is the load on clinicians. This is not just the allied healthcare professionals but those invisible administrators, who have a key role in smoothing access to the full range of services for patients. That is why the alliance is seeking a fully funded national two-year rehab strategy to ensure that people who have seen significant deterioration in their condition have the therapeutic support they need.

Too often, one key part of public services is involved too late. It is one that society—particularly the health sector, I am afraid—just does not plan for. I am referring to housing. Research over many years by Habinteg, a housing association that campaigns for the raising of accessibility standards in new homes, shows that for a small amount extra to pay at the time of a new build or major renovation, adaptations for patients with mobility problems can be overcome cheaply and easily. One thing that many patients with neurological conditions say is that the adaptions to their home are difficult and expensive.

Finally, one expert is too often overlooked. The expert patient programme is for people with long-term conditions, where patients take a six-week course and are trained and supported, often by tutors who have a long-term condition themselves. The course aims to give patients the confidence to self-manage their health and be active participants in the care of their condition. The course looks at general topics, including healthy eating, dealing with pain, relaxation techniques and coping with negative feelings, along with very specific advice on their condition. I know of it from the rheumatology sector, but I know friends who are expert patients in the MS community. Multidisciplinary teams welcome their expert patients. A patient’s understanding of when to seek help means more timely interventions and, often, improved outcomes. It is not just beneficial for the patients, it is cost-effective.

Is there specific support to spread the expert patient programmes to more neurological conditions? Will the Minister respond to the Neurological Alliance’s recommendation of a neurology task force? When do the Government plan to publish a workforce strategy for the neurology workforce? As we discussed a lot in debate on the then Health and Care Bill, this is one element of wider workforce planning that really needs to happen now and be visible. Therefore, how will the Government ensure that any such strategy delivers a sufficient number of health professionals to fill the gaps in staffing for neurological conditions?