1. Neurosciences National Framework for Service Change Criteria Options Neurological Alliance Sub group 7 th December 2004 Agenda Item 4.1

2. The Context National Framework for Service Change National Framework for Service Change –Independent Advisory Group to lead development of a new national framework for the future shape of NHS Scotland –Number of Action teams set up to examine specific issues One of which is Highly Specialised Care Neurosciences One of which is Highly Specialised Care Neurosciences

3. Action Team issues Self Assessment Audit Self Assessment Audit Consultant Workforce Consultant Workforce Information and Data Information and Data Unscheduled Care Unscheduled Care European Working Time Regulations European Working Time Regulations Assessment Criteria for future model of neurosurgical services Assessment Criteria for future model of neurosurgical services Patient Perspective Patient Perspective

4. The Neurological Alliance Levelling Up – Standards of Care Independence and quality of life Independence and quality of life Speedy Access Speedy Access Comprehensive Assessment Comprehensive Assessment High Quality Information High Quality Information Well trained interdisciplinary professionals Well trained interdisciplinary professionals Prevention Prevention On-going access On-going access Equity of service provision Equity of service provision

5. Standards – cont’d Co-ordinated care across sectors Co-ordinated care across sectors Access to voluntary organisations Access to voluntary organisations User Involvement User Involvement Holistic rehabilitation Holistic rehabilitation Established care pathways Established care pathways Good record keeping Good record keeping Addressing the needs of carers Addressing the needs of carers

6. The Scottish Model Learning from the past Learning from the past Assessing the present Assessing the present Planning for the future Planning for the future –Key patient priorities An integrated Scotland wide service An integrated Scotland wide service Specialist vs generalist Specialist vs generalist Paediatric and adult Paediatric and adult Critical mass issues Critical mass issues Workforce issues Workforce issues Funding issues Funding issues Political influence to make it happen for patients Political influence to make it happen for patients

7. Neurological Alliance Sub Group Group Discussion Outcomes

8. Criteria for Model of Delivering Neurosurgery in Scotland General Comments Group not happy with model which looked at site(s) rather than service Group not happy with model which looked at site(s) rather than service Essential to use outcome of options appraisal as part of the decision making process rather than being led by it Essential to use outcome of options appraisal as part of the decision making process rather than being led by it

9. Suggested criteria may be enhanced by taking into account –24hr care, safe neuro catchment of 1m+ and Min 6 WTE consultants all interrelated. May be better detailed as a single criteria (Safe Neurosurgery) –Equity of Access to be expanded to include Diagnosis, Assessment and Treatment provided as locally as possible – a high priority for patients, family and carers

10. The Vision of a Scotland wide service Group felt that irrespective of site model adopted, a National Managed Clinical Network approach was essential. Group felt that irrespective of site model adopted, a National Managed Clinical Network approach was essential. –This would develop a model of working which relied on clinicians throughout Scotland, (irrespective of their future location(s)) being part of a “virtual” organisation that actively involves patients in service design and focus. It would also promote interdisciplinary working not just at primary, secondary and tertiary levels but with all relevant agencies and key stakeholders (patients, carers and the voluntary sector)

11. Summary The NA “Levelling Up” Report should be commended as an exemplar of Patient Priorities with regard to minimum standards of Care and service delivery The NA “Levelling Up” Report should be commended as an exemplar of Patient Priorities with regard to minimum standards of Care and service delivery A National Managed Clinical Network should be developed as an urgent priority A National Managed Clinical Network should be developed as an urgent priority Appropriate balance needs to be struck between centralisation, critical mass issues, the needs of local and rural communities and expectations of patients families and carers Appropriate balance needs to be struck between centralisation, critical mass issues, the needs of local and rural communities and expectations of patients families and carers