Increased activity/waiting times FYFV - New models of Care Community Headache pathway - Case for Change Strategic context The Vision The Benefits ‘To develop a headache pathway that allows patients with headache who need to be seen in secondary care to do so quickly, while keeping in the community those patients with headache who can be better managed there, through supporting GPs in their independent practice and providing community headache services that are cost-efficient, easier to access and care is delivered closer to home. This improves patient care and also releases capacity in over-stretched neurology outpatient clinics’. Dr Richard Wood, Oxfordshire CCG Improved patient experience as seen in a timely manner closer to home Improved patient outcomes as patients who need to see a specialist have quicker access Increased capacity in outpatient clinics reducing waiting times Reduced health system costs and pressures on the acute sector Increased communication between primary and secondary care supporting learning Increased consistency of care Improved knowledge and skills in primary care Closer links with third sector support in the community Improved patient education and self management Reduction in number of referrals to acute which can be managed in primary care Reduction in A and E attendances due to easier access to support Care closer to home Increased activity/waiting times Cost pressures RightCare Approach STP priorities FYFV - New models of Care

Community Headache pathway – 3 key elements Referral Triage Set up of Community Health Clinic Improvement in primary care recognition of primary headaches Including migraine and medication overuse headache Programme on self care management Triage undertaken by neurology consultant who will also provide advice to referrers, interpret imaging reports and provide clinical oversight and support to the community clinicians. Run by headache specialist nurse or GP with special interest in headache Management of those with migraine, medication overuse headache, tension-type headache, cluster headache, chronic post-concussion headache Education and Support for GP management of headache Triage options Back to referrer Community Based Headache clinic Imaging without appt General neurology clinic Specialist headache clinic Care close to home Faster access to the right support Clear guidelines and proformas for diagnosis Improved patient experience

Headache consultant triage MRI without outpatient appointment Emergency referrals including symptoms of brain tumours have their own dedicated 2 week pathway Headache pathway Neurology outpatient clinic Community Headache Clinic Patient education and advice from Pharmacy Referral Headache consultant triage GP GP management Advice Specialist Headache clinic A and E MRI without outpatient appointment