Reducing the 52-week burden in neurology

Published: 20th March 2024
GIRFT's handbook 'Further Faster Neurology' provides best practice guidance to accelerate the reductions of neurology waiting lists. Here's where remote 'virtual locum' NHS consultants fit in.
Reducing The 52 Week Burden In Neurology

Getting It Right First Time’s (GIRFT) latest handbook, ‘Further Faster Neurology,’ provides best practice guidance to help accelerate the reduction of neurology waiting lists.

The key challenge is the local clinical capacity to deliver the tasks suggested. This is where our National Consultant Network (NCN) of remote NHS consultants comes into play.

Two of the clinical tasks highlighted in the guidance lend themselves to being done remotely- in the short- or long-term:

1. Effective system in place to manage referrals for specialist advice and guidance

Consultant neurologists on our NCN review advice and guidance queries on local systems as they come in (e.g. e-RS). With an average turnaround time of under 24 hours.

A recent example covered over 1,200 new-in neurology e-RS advice and guidance requests over 8 months:

  • 83% of patients were returned to primary care with a detailed management plan
  • 16% of cases were converted to a referral
  • 1% of cases required further information

2. All referrals are clinically triaged and referred to sub-specialties or returned with appropriate specialist advice and guidance (as appropriate) before offering a first outpatient appointment.

There should also be good systems in place to ensure diagnostics are undertaken prior to the first appointment:

Consultant neurologists on our NCN reviewing referrals are able to identify correct pathways, prioritise urgencies and write up management plans where appropriate. NCN consultants follow local pathway guidance and work under the leadership of the local clinical lead.

We recently completed over 3,800 referral reviews:

  • Up to 51% of referrals were safely removed from the waiting list (e.g. returned to primary care with a management plan or redirected to a more suitable service)
  • The remaining referrals were directed to the right place first time (e.g. upgraded to 2WW, accepted as a routine appointment either with/without diagnostics prior to the appointment, etc.)


For more information:

If you have any questions or would like to discuss how our Referral Triage and Validation service or the National Consultant Network can support your area, email: or call us: 01865 261 467.

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