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And finally - the NSF for Long Term Conditions

Published on 31/03/05 at 12:57pm

The National Service Framework  for Long Term Conditions has been launched by the government, which has pledged that it will be the last of its kind, but provide a useful model for improving services in a range of disease areas.

The NSF focuses on neurological diseases and aims to achieve faster diagnosis and more rapid treatment through 11 Quality Requirements (QRs).

The framework sets targets for the improvement of NHS services in disease areas like multiple sclerosis, epilepsy, motor neurone disease and Parkinson's.

Conditions such as acquired brain and spinal cord injuries have so far been overlooked, but the NSF outlines how to enhance services for dementia patients, an area also covered in the Older Persons NSF. The Quality Requirements (QR) in the new framework include:

  • Prompt diagnosis and treatment for people with long-term neurological conditions
  • A patient-centred service, with access to rehabilitation, equipment, accommodation and personal care
  • A single point of access to services via a named contact
  • Self-referral, allowing individuals to refer themselves quickly back to services

Decisions on how the new framework will be implemented will be made at local level, with local health and social services expected to meet the QR requirements over the next ten years.

Their progress will be monitored by local and national inspectors while health minister Stephen Ladyman has appointed two health czars, Kathryn Hudson and Ian Philp, who will guide the mandatory 10-year plan.

The minister declined to put a figure to the NSF but emphasised its delayed publication was to ensure its financial viability.

"We had to crawl over it to ensure that we had the funds," he admitted.

He confirmed that like many of the preceding NSFs, the new framework would  lead to an increase in prescribing, in this case, drugs for neurological diseases.

"There will be new medicines coming on the market for these conditions and the NSF, guided by NICE, will be a key driver in the increased prescribing of these drugs."

But he added that its success would not hinge on money spent but the speed of implementing workforce issues, like "retraining the way staff think so that patients are treated as individuals".

Closer relations between  primary and secondary care healthcare professionals, more education about neurological conditions, and partnerships between statutory services and voluntary organisations were also cited as key to the success of the NSF, which will be implemented in England and Wales.

"It may take us 10 years to implement it but implement it we will," said Ladyman.

The minister was keen to distance the NSF from the recent "froth of election stunts",saying that the NSF had not been written by politicians but "by stakeholders from the bottom-up".

Diana Whitworth, chair of the NSF External Reference Group (ERG) and former chief executive of Carers UK, said: "Of the millions of people with neurological conditions, 350,000 will need help with daily living. The measure of the success of this NSF will be the extent to which their quality of life is improved and their families and carers, too."

Linda Kelly, chief executive of the Parkinson's Disease Society, welcomed the move but said "the onus is now on local health and social care organisations to put this at the forefront of their local plans. The Healthcare Commission needs to ensure that the NSF is prioritised in all areas of England and Wales."

The Multiple Sclerosis Society chief executive Mike O'Donovan also praised the new plan.

He said: "At long last we are moving towards a proper balance of health and social services tailored to the needs of the individual from the time of diagnosis. The big challenge now is to match promise with delivery. Neurologists, other healthcare professionals and care workers are thin on the ground. It will not be an easy task."

The Department of Health estimates that approximately 10 million people across the UK have a neurological condition, which account for 20% of acute hospital admissions and are the third most common reason for seeing a GP.

Over one million people attend accident and emergency departments each year with a head injury, potentially leading to long-term neurological damage.

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