Lessons learnt from the COVID-19 pandemic.


NNAG Report published: 14th April 2021

Lessons learnt from the COVID-19 pandemic. Priorities in care for people with neurological conditions after the pandemic

Our report outlines the far reaching impacts of the COVID-19 pandemic on people with neurological conditions and key services on which they rely. 

The report, which was developed using evidence collected from patient groups, NHS England and NHS Improvement key datasets, professional bodies and services, highlights:

  • an estimated backlog of more than 225,000 neurology appointments and 58,000 neurosurgery appointments at the end of 2020 – the winter surge of COVID cases is likely to have increased these figures further

  • a growing number of long-covid patients who now require neurological, neurorehabilitation and neuro-psychiatric and/or neuro-psychological care to manage their symptoms and functioning – this will too increase demand for neuroscience services

  • a slow down in referrals more generally. For example, specialist centres for MND have experienced an estimated 30-50% drop in referrals, leading to delays in diagnosis and support

  • there was already a significant shortage of specialist neuroscience professionals across the country prior to the pandemic. Redeployment to COVID-19 wards and increased pressure to reduce waiting lists are having a significant impact on the mental health of health and care professionals, and without the right support and planning, we risk losing much needed specialist expertise after COVID-19

  • the COVID-19 pandemic has magnified the challenges facing rehabilitation services in particular. NHS Data shows there were 20,000 fewer outpatient appointments with a rehab consultant across all neurological conditions between March and June 2020 compared with the same period last year

  • new models of care, particularly remote consultations, must be rolled out carefully – evidence received from across the neurological sector suggests mixed patient experience with remote consultations, and clear concerns about the possible exacerbation of health inequalities should they become common place.

The report urges NHS England and NHS Improvement to urgently provide the necessary support to restore services for people with neurological conditions to at least pre-pandemic levels.  We also make a series of longer term recommendations to address the risks to the resilience of the system, including recommendations related to the neurological workforce, social care, outpatient coding and neurological research.

With demand for services set to increase, and health and care professionals likely to leave the profession, we face a perfect storm with regards to services for people with neurological conditions. Waiting lists, in many areas, have soared, meaning long waits to access the right specialist and, possibly, the right treatment to help slow progression, manage painful symptoms, and live as independently as possible. As the only national multidisciplinary group for neuroscience in England, the NNAG has a unique and important role to play in articulating the impact of this crisis and recommendations for change. In this context, it is absolutely critical that we work together, through and with the NNAG, to support services to learn from key innovations during the pandemic, and ensure commissioning is geared towards to meeting the best outcomes for people with neurological conditions as possible.
— Professor Adrian Williams, Co-Chair of NNAG
With life-changing treatment and therapies delayed or cancelled across the country, long periods of isolation due to the need to shield and wider support restricted, people with neurological conditions have undoubtedly been hit hard during the pandemic. Care for people with neurological conditions has, for too long, been in the shadow of other medical speciality areas. People living with long COVID will also require support from neuroscience services, and so it is absolutely critical neurological services get the support and investment they need to meet present and the future demands. In particular, we urge NHS England and NHS Improvement to work with people with neurological conditions, healthcare professionals, professional bodies and patient groups to ensure that services are restored to their pre-pandemic levels as soon as possible after the COVID-19 threat level is lowered.
— Georgina Carr, Chief Executive of the Neurological Alliance and Co-Chair of NNAG