1. Neurophysiology in a Nissen Hut Dr Adrian J Fowle & Elaine Crighton West Surrey Clinical Neurophysiology

2. Clinical Neurophysiology? (1)  We run a diagnostic service  EEG / EMG / EP  Used by all disciplines  Orthopaedics, GP, Rheum (Carpal tunnel etc)  Paediatrics (Epilepsy, N-ICU)  Neurology (MND, Epilepsy, Neuropathy etc)  Medicine / Elderly Care  Psychiatry  ITU

3. Clinical Neurophysiology? (2)  Provided by physiologists and doctors  Shortage of both nationally.  Made worse by MSC – no training places  Patient facing  Neonate -> Elderly  Autism / Schizophrenia / Seizures / Apnoea  Wheelchairs  OPD, but also NICU / ITU / outlying hospitals

4. The Team  Deliberately built  Based on  Good social life  Creature comforts  Shared values  Low hierarchy  Mutual respect  CPD  Training

5. Patients  Patient Information Leaflets  Meet and Greet  Explain tests  Humour, compassion, distraction  Explain results  Give patients copy of report  Change pathway sometimes

6. Other Colleagues  Referrers  Management  Commissioners  Trainees  Medical  Physiological  Other  Regional group  National group  Be Nice  Meet their needs  Coffee  Newsletter  Engage  Be Tough  Say No!  Ask again

7. You have just seen 3 Slides About being nice to people

8. IT  Spread sheet  In house network, server, admin database  Trust IT  Commercial admin database  Very tight integration  Type own reports

9. Queue management (1)  NHS Modernisation Agency  Single queues, post office not supermarket  No carve out  Be tough  “Demand Capacity matching”  DNAs are important  18ww – Reduced interdepartmental wait  Fax then letter  Report to patient when possible

10. Queue Management (2)  Microbooking by experienced staff  Travel times for elderly  Travel times for transport  Staff resources  You can have too short a queue

11. Clinic Management  Physiologist clinics  1 stop shop  Extended hours  Blitzing (only goodwill)  Skill mix & across 2 sites  Need higher grades in small department  Microbooking

12. Single site / multi site  Single site  Economies of scale  Cover for leave  Sufficient expertise in rare tests  Mutual aid of staff  Multi site  Near patients  Use of IT to bridge gap

13. Finance and Activity Data  Keep an eye on it  Question possible errors  Time consuming

14. Quality  Care about people  Be flexible  Accreditation - IQIPS