11 Sep 2024 Nisren Abdul-Karim · Prevention of Future Deaths report Manchester South
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Concerns raised 1
Absence of a face-to-face neurology service at some sites View source
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
NHS Greater Manchester Integrated Care Board
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AI-generated summary
Nisren Abdul-Karim · Prevention of Future Deaths report
This summary was generated using AI from the published report. Please read the original report for the complete account.
Report summary
Nisren Abdul-Karim had underlying health conditions and developed hallucinations before being admitted to Wythenshawe Hospital, where she sustained a fractured hip in an unsupervised fall. She was transferred to Trafford General Hospital for rehabilitation, continued to deteriorate, and died there on 5 January 2024. The principal concern was that neurology notes recorded on patient pass were difficult to access and contained limited detail, resulting in disjointed neurology care and an unclear overview, particularly at sites without face-to-face neurology services.
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How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation Absence of a face-to-face neurology service at some sites
Wider context from the report “The evidence before the inquest was that the neurology service based at Salford Royal Hospital provided a service across Greater Manchester. However the notes kept by the neurology team were not stored on the patient’s notes but recorded on patient pass. This meant accessing the notes required recognising that patient pass needed to be accessed.
In addition the evidence was that the detail within the neurology notes on patient pass was very limited and meant that it was difficult to fully understand the neurology advice given or the contact that there had been with neurology. As a consequence delivery of neurology care was disjointed and meant there was no clear neurology overview held by neurology. This impacted on the care that could be provided to patients and the provision of advice to other clinicians. Illustrative of this one neurologist was unaware that it was one of their neurology colleagues had diagnosed a neuro degenerative disease. This is exacerbated in relation to sites such as Trafford Hospital where all contact with neurology is telephone or patient pass as there is no face to face neurology service .
” Source location Nisren Abdul-Karim · Prevention of Future Deaths report
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Source evidence
How this respondent position was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Rochdale does not require inpatient neurology ward reviews because it is non-acute and has no demand; 24/7 on-call neurology advice remains available.
Verbatim wording from the response “The neurology team provide ward reviews to all GM hospital sites. This is with the exception of Rochdale. As Rochdale is not an acute site, there has never been the demand for neurology inpatient reviews. Any site can always access Neurology opinion via the on-call service 24/7, and advice will be provided. Requests for ward reviews come through Patient Pass. There is currently variation in process in terms of on-going documentation after that initial request via the system. In some cases, on-going clinical advice is continued on Patient Pass (akin to how this works for on-going neurosurgical or spinal advice through the same system). This requires local hospital-based clinicians to access Patient Pass to see the documentation. In other cases, on-going clinical advice is written in the local hospital site’s notes, on whatever system exists on that site for this.” Source location Response from GMIC
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28 Feb 2024 Chloe Anne Tapp · Prevention of Future Deaths report Essex
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Concerns raised 3
Chronic staffing shortages across neurology doctors, nurses and administrative staff View source Unsafe backlogs for neurology first and follow-up appointments View source Insufficient national neurologist capacity relative to demand View source
This report raised 12 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked responses
Mid and South Essex NHS Foundation Trust NHS England
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised. 5
Mid and South Essex NHS Foundation Trust
Establish neurology medical staffing with four consultants and three specialty doctors, with annual staffing-needs review.
View source
Mid and South Essex NHS Foundation Trust
Appoint two nursing posts within the neurology team.
View source
Mid and South Essex NHS Foundation Trust
Increase neurology administrative support and obtain additional funding for administrative staff in the Multiple Sclerosis service.
View source
NHS England
Conduct a GIRFT review visit to Mid and South Essex NHS Foundation Trust’s neurology department.
View source
NHS England
Deliver the Long Term Workforce Plan, expanding domestic education, training and recruitment while improving culture, leadership and staff wellbeing.
View source See 2 more actions
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AI-generated summary
Chloe Anne Tapp · Prevention of Future Deaths report
This summary was generated using AI from the published report. Please read the original report for the complete account.
Report summary
Chloe Anne Tapp, a 20-year-old with epilepsy and other medical conditions, suffered seizures and respiratory and cardiac arrest on 7 October 2021 and died in hospital on 8 October 2021. The principal concerns included delays transferring her to adult neurology, a telephone consultation despite her being non-verbal, an incorrect and inadequately documented medication tapering regime, and unanswered attempts to obtain clarification. Broader concerns were raised about staffing shortages, unsafe backlogs and difficulties responding to patients and carers within the neurology department.
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How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation Chronic staffing shortages across neurology doctors, nurses and administrative staff
Wider context from the report “The consultant in question gave evidence of a very bleak picture of ongoing practice in the neurology department; a letter from all four consultants in that department had been sent to the Trust in July 2023, where patient care was described as ‘sub-optimal’, and numerous concerns were set out including:
o Chronic staff shortages in respect of doctors, nurses and administrative staff within the neurology department
o Substantial and unsafe backlogs for first and follow up appointments
o Inability to answer, in a timely manner, the volume of phone calls, phone messages and emails from patients/carers raising queries.
o The delays / ways in which investigations are carried out and reported, and the way in which clinical staff can access results.
” Source location Chloe Anne Tapp · Prevention of Future Deaths report
Open source report × Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation Unsafe backlogs for neurology first and follow-up appointments
Wider context from the report “The consultant in question gave evidence of a very bleak picture of ongoing practice in the neurology department; a letter from all four consultants in that department had been sent to the Trust in July 2023, where patient care was described as ‘sub-optimal’, and numerous concerns were set out including:
o Chronic staff shortages in respect of doctors, nurses and administrative staff within the neurology department
o Substantial and unsafe backlogs for first and follow up appointments
o Inability to answer, in a timely manner, the volume of phone calls, phone messages and emails from patients/carers raising queries.
o The delays / ways in which investigations are carried out and reported, and the way in which clinical staff can access results.
” Source location Chloe Anne Tapp · Prevention of Future Deaths report
Open source report × Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation Insufficient national neurologist capacity relative to demand
Wider context from the report “The independent consultant neurologist in giving evidence expressed that this was not an unfamiliar picture across a number of different Trusts and that there was a recognised shortage of neurologists and increase in demand for that speciality nationally .
” Source location Chloe Anne Tapp · Prevention of Future Deaths report
Open source report
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Establish neurology medical staffing with four consultants and three specialty doctors, with annual staffing-needs review.
Verbatim wording from the response “In addition to this, we have invested in staffing within the neurology service. Our medical staffing is now fully established which includes four consultants and three specialty doctors. Our medical staffing is reviewed annually to check the needs of the service are properly met.” Source location Response from Mid and South Essex NHS
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Appoint two nursing posts within the neurology team.
Verbatim wording from the response “We now have two nursing posts within the team, both roles have recently been appointed to. Our overall administrative support has also increased and additional funding for administrative staff has been obtained for our Multiple Sclerosis service that sits under the Neurology umbrella.” Source location Response from Mid and South Essex NHS
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Increase neurology administrative support and obtain additional funding for administrative staff in the Multiple Sclerosis service.
Verbatim wording from the response “We now have two nursing posts within the team, both roles have recently been appointed to. Our overall administrative support has also increased and additional funding for administrative staff has been obtained for our Multiple Sclerosis service that sits under the Neurology umbrella.” Source location Response from Mid and South Essex NHS
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Conduct a GIRFT review visit to Mid and South Essex NHS Foundation Trust’s neurology department.
Verbatim wording from the response “Having considered your Report and the concerns raised, a GIRFT visit to Mid and South Essex NHS Foundation Trust has been arranged to review the specific situation within their Neurology department.” Source location Response from NHS England
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Deliver the Long Term Workforce Plan, expanding domestic education, training and recruitment while improving culture, leadership and staff wellbeing.
Verbatim wording from the response “NHS England is also working at a national level to deliver the Long Term Workforce Plan which was published in June 2023. This is a robust and effective strategy to ensure we have the right number of people, with the right skills and support in place to be able to deliver the kind of care people need. It heralds the start of the biggest recruitment drive in health service history, but also of an ongoing programme of strategic workforce planning. It includes ambitious commitments to grow the workforce by significantly expanding domestic education, training and recruitment, as well as actions aimed at improving culture, leadership and wellbeing so that more staff are retained in NHS employment over the next 15 years.” Source location Response from NHS England
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Source evidence
How this respondent position was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation The Trust considers its neurology staffing establishment appropriate to meet service needs after staffing increases and annual review arrangements.
Verbatim wording from the response “In addition to this, we have invested in staffing within the neurology service. Our medical staffing is now fully established which includes four consultants and three specialty doctors. Our medical staffing is reviewed annually to check the needs of the service are properly met.” Source location Response from Mid and South Essex NHS
Open published response
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Source evidence
How this respondent position was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation National guidance cannot directly address funding shortfalls or recruitment and retention challenges in individual neurology services.
Verbatim wording from the response “NHS England’s Neurology Programme is in the process of developing guidance and specifications to support Systems and NHS Trusts to develop integrated care for neurology services, including epilepsy. However, this cannot directly impact issues arising from funding shortfalls in individual services or challenges with recruitment and retention of appropriately qualified medical and nursing staff in some parts of the country, as raised in your Report.” Source location Response from NHS England
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Source evidence
How this respondent position was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Trusts are responsible for ensuring safe staffing levels during the day-to-day operation of their hospitals.
Verbatim wording from the response “These actions will aim to close anticipated staffing shortfalls in the NHS in the long term, however Trusts have a responsibility to ensure safe staffing levels in the current day to day operation of their hospitals. This is in line with Care Quality Commission (CQC) Regulation 18 which states that providers must deploy enough suitably qualified, competent, and experienced staff to enable them to meet all other regulatory requirements.” Source location Response from NHS England
Open published response
Concerns raised 3
Long-term vacancy of a substantive neurology consultant post View source Delays in neurology outpatient appointments View source Gaps in neurology service provision View source
Linked responses
NHS England University Hospitals Sussex NHS Foundation Trust
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised. 11
University Hospitals Sussex NHS Foundation Trust
Advertise substantive consultant neurologist posts.
View source
NHS England
Publish the NHS Long Term Workforce Plan to grow, retain and reform the NHS workforce.
View source
University Hospitals Sussex NHS Foundation Trust
Provide three weekly consultant neurologist sessions for GP advice and guidance before or instead of outpatient referral.
View source
University Hospitals Sussex NHS Foundation Trust
Update outpatient referral triage criteria and introduce a pre-screen for previously known patients.
View source
University Hospitals Sussex NHS Foundation Trust
Monitor the waiting list and review urgent patients awaiting appointments to support prioritisation.
View source
University Hospitals Sussex NHS Foundation Trust
Employ a locum consultant neurologist to provide additional outpatient clinics and consultant triage.
View source
University Hospitals Sussex NHS Foundation Trust
Provide more than 600 additional outpatient appointments through Elective Services over 12 weeks.
View source
University Hospitals Sussex NHS Foundation Trust
Implement cross-site management changes offering alternative-site appointments to reduce maximum outpatient waiting times.
View source
University Hospitals Sussex NHS Foundation Trust
Continue developing the advanced clinical practice model in neurology with clinical nurse specialists across general and specialist services.
View source
University Hospitals Sussex NHS Foundation Trust
Increase advanced clinical practitioner service capacity under the developed proposal.
View source
University Hospitals Sussex NHS Foundation Trust
Maintain a weekday standard operating plan for emergency consultants to obtain consultant neurologist advice.
View source See 8 more actions
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AI-generated summary
Nicholas John PENNICOTT · Prevention of Future Deaths report
This summary was generated using AI from the published report. Please read the original report for the complete account.
Report summary
Nicholas John PENNICOTT’s health deteriorated from March 2021, and he suffered a cardiac arrest at home on 19 August 2021 while awaiting an urgent neurology appointment. The report identified persistent neurology capacity problems, including a long-term consultant vacancy and long waiting times, which led to a missed opportunity for earlier specialist assessment.
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× Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation Long-term vacancy of a substantive neurology consultant post
Wider context from the report “During the course of the evidence the Hospital explained that long waiting times for neurology outpatient appointments was a persistent challenge for the Trust due to capacity issues within the neurology service.
There had been a long-term vacancy, of three years, within the neurology service for a substantive neurology consultant at the hospital . The Inquest was told that there was a national shortage of neurologists. The Trust had relied on long term locum consultants, leading to some short-term gaps in provision.
The shortage of Neurologists nationally and the capacity issues within the neurology service at the Hospital led to a missed opportunity for Mr PENNICOTT to receive earlier specialist assessment.
” Source location Nicholas John PENNICOTT · Prevention of Future Deaths report
Open source report × Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation Delays in neurology outpatient appointments
Wider context from the report “During the course of the evidence the Hospital explained that long waiting times for neurology outpatient appointments was a persistent challenge for the Trust due to capacity issues within the neurology service .
There had been a long-term vacancy, of three years, within the neurology service for a substantive neurology consultant at the hospital. The Inquest was told that there was a national shortage of neurologists. The Trust had relied on long term locum consultants, leading to some short-term gaps in provision.
The shortage of Neurologists nationally and the capacity issues within the neurology service at the Hospital led to a missed opportunity for Mr PENNICOTT to receive earlier specialist assessment.
” Source location Nicholas John PENNICOTT · Prevention of Future Deaths report
Open source report × Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation Gaps in neurology service provision
Wider context from the report “During the course of the evidence the Hospital explained that long waiting times for neurology outpatient appointments was a persistent challenge for the Trust due to capacity issues within the neurology service.
There had been a long-term vacancy, of three years, within the neurology service for a substantive neurology consultant at the hospital. The Inquest was told that there was a national shortage of neurologists. The Trust had relied on long term locum consultants, leading to some short-term gaps in provision .
The shortage of Neurologists nationally and the capacity issues within the neurology service at the Hospital led to a missed opportunity for Mr PENNICOTT to receive earlier specialist assessment.
” Source location Nicholas John PENNICOTT · Prevention of Future Deaths report
Open source report
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Advertise substantive consultant neurologist posts.
Verbatim wording from the response “• We have advertised for substantive consultant neurologists. The advert closes on 26th July and we look forward to shortlisting any applicants” Source location Response from Universityt Hospitals Sussex NHS Foundation Trust
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Publish the NHS Long Term Workforce Plan to grow, retain and reform the NHS workforce.
Verbatim wording from the response “Last month, NHS England published the NHS Long Term Workforce Plan, setting out our plans to grow, retain and reform our workforce across the next fifteen years. This plan looks to reduce the national shortages we see across the NHS, helping to provide safe and timely access to urgent care that will reduce the delays currently being faced by patients such as Nicholas.” Source location Response from NHS England
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Provide three weekly consultant neurologist sessions for GP advice and guidance before or instead of outpatient referral.
Verbatim wording from the response “Advice and Guidance service for GPs” Source location Response from Universityt Hospitals Sussex NHS Foundation Trust
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Update outpatient referral triage criteria and introduce a pre-screen for previously known patients.
Verbatim wording from the response “• Patients referred for outpatient clinic are triaged by a consultant neurologist and categorised by clinical urgency based on the information provided by the GP” Source location Response from Universityt Hospitals Sussex NHS Foundation Trust
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Monitor the waiting list and review urgent patients awaiting appointments to support prioritisation.
Verbatim wording from the response “• We have introduced regular monitoring of the waiting list, with reviews of urgent patients waiting to be seen to allow appropriate prioritisation within available clinic capacity” Source location Response from Universityt Hospitals Sussex NHS Foundation Trust
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Employ a locum consultant neurologist to provide additional outpatient clinics and consultant triage.
Verbatim wording from the response “• We have now employed a locum consultant neurologist to support the service and provide additional outpatient clinics and consultant triage. This arrangement is ongoing” Source location Response from Universityt Hospitals Sussex NHS Foundation Trust
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Provide more than 600 additional outpatient appointments through Elective Services over 12 weeks.
Verbatim wording from the response “• We have engaged Elective Services to provide additional outpatient capacity to address waiting times for new patients and anticipate that these measures will reduce waiting times for all patients. Elective Services are providing in excess of 600 outpatient appointments over a 12-week period” Source location Response from Universityt Hospitals Sussex NHS Foundation Trust
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Implement cross-site management changes offering alternative-site appointments to reduce maximum outpatient waiting times.
Verbatim wording from the response “• We are implementing changes to manage the demand for new outpatient appointments across the 3 sites within the Trust to reduce the maximum waiting time for patients across Sussex, offering patients appointments at alternative sites to reduce waiting time” Source location Response from Universityt Hospitals Sussex NHS Foundation Trust
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Continue developing the advanced clinical practice model in neurology with clinical nurse specialists across general and specialist services.
Verbatim wording from the response “• We continue to develop our model of advanced clinical practice in neurology with a team of clinical nurse specialists working in general neurology as well as in specialist areas, including headache, epilepsy and Parkinson’s disease. We have developed a proposal to increase the capacity of the services that ACPs are providing and expect to deliver this in the second half of this financial year” Source location Response from Universityt Hospitals Sussex NHS Foundation Trust
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Increase advanced clinical practitioner service capacity under the developed proposal.
Verbatim wording from the response “• We continue to develop our model of advanced clinical practice in neurology with a team of clinical nurse specialists working in general neurology as well as in specialist areas, including headache, epilepsy and Parkinson’s disease. We have developed a proposal to increase the capacity of the services that ACPs are providing and expect to deliver this in the second half of this financial year” Source location Response from Universityt Hospitals Sussex NHS Foundation Trust
Open published response
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Maintain a weekday standard operating plan for emergency consultants to obtain consultant neurologist advice.
Verbatim wording from the response “Advice and guidance for hospital consultants” Source location Response from Universityt Hospitals Sussex NHS Foundation Trust
Open published response
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Source evidence
How this respondent position was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Implementing recommended acute neurology outpatient clinics is constrained by workforce shortages.
Verbatim wording from the response “Your Report also raises a concern that there is a shortage of neurologists at a national level. This is a well-recognised issue within the NHS and there is currently significant variation in neurologist numbers across England. The Getting It Right First Time (GIRFT) programme for neurology (GIRFT is a national NHS England programme designed to improve the treatment and care of patients through clinically led reviews) recommends that all acute hospitals have acute neurology liaison services in place, and, ideally, acute neurology outpatient clinics to urgently see rapidly deteriorating patients. However, this is dependent on workforce constraints.” Source location Response from NHS England
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17 Aug 2022 Philip Jones · Prevention of Future Deaths report Manchester South
View report summary
Concerns raised 1
Significant backlogs in appointments for neurology assessment View source
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
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AI-generated summary
Philip Jones · Prevention of Future Deaths report
This summary was generated using AI from the published report. Please read the original report for the complete account.
Report summary
Philip Jones developed difficulty swallowing in February 2021, lost significant weight, and was diagnosed with Motor Neurone Disease after hospital admission in September 2021. He developed bronchopneumonia, deteriorated, was discharged home, and died there on 9 October 2021. Concerns included backlogs for neurology appointments, incompatible IT systems affecting information sharing, and delays in communications from consultants to other clinicians and patients.
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How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation Significant backlogs in appointments for neurology assessment
Wider context from the report “1. The Inquest heard evidence that there were significant backlogs in appointments to see a neurologist due to a national shortage of clinicians and appointments. In Mr Jones’ case this had not impacted the overall outcome but the Inquest heard evidence that this would not necessarily be the case in all patients. The Inquest heard that pre-pandemic, there was a backlog in existence at 3,500 patients waiting for a neurology appointment . The figure at the time of the Inquest was approx. 7,000 ;
” Source location Philip Jones · Prevention of Future Deaths report
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Increase NHS workforce capacity to address rising demand for health and care services.
Verbatim wording from the response “I also note your concern about the shortage of neurological clinicians. We have increased the size of the NHS workforce over the last decade and this growth continues to be a key focus to ensure we meet the rise in demand for health and care services. Looking at the workforce of the future, the Department has commissioned Health Education England to work with system partners and review long term strategic trends for the health and regulated social care workforce, and have commissioned NHS England to develop a long-term workforce plan.” Source location Response from Department of Health and Social Care
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Commission NHS England to develop a long-term workforce plan.
Verbatim wording from the response “I also note your concern about the shortage of neurological clinicians. We have increased the size of the NHS workforce over the last decade and this growth continues to be a key focus to ensure we meet the rise in demand for health and care services. Looking at the workforce of the future, the Department has commissioned Health Education England to work with system partners and review long term strategic trends for the health and regulated social care workforce, and have commissioned NHS England to develop a long-term workforce plan.” Source location Response from Department of Health and Social Care
Open published response
22 Apr 2016 Marina Fagan · Prevention of Future Deaths report Inner North London
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Concerns raised 1
Insufficient availability of specialist neurological care View source
Linked response
Department of Health and Social Care
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AI-generated summary
Marina Fagan · Prevention of Future Deaths report
This summary was generated using AI from the published report. Please read the original report for the complete account.
Report summary
Marina Fagan was admitted to hospital with headaches, later developed confusion, visual loss and eye movement palsy, and was diagnosed with PRES before dying on 6 October 2015. The report raised concerns about the availability of specialist neurological care, including delays in neurology input and limited out-of-hours neurologist provision, and noted that future deaths could occur in similar circumstances.
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How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation Insufficient availability of specialist neurological care
Wider context from the report “This witness set out his concern that, nationwide, there are insufficient neurologists to provide necessary specialist care . He noted that in the out of hours setting, although there were neurologists available the nearby tertiary care hospital, none were on-call in the hospital to which Ms Fagan was initially admitted .
Ms Fagan's general practitioner set out that the current waiting time to see a neurologist in the outpatient setting, is 72 days .
Given the issues regarding availability of specialist neurological care, I am concerned that future deaths will occur in similar circumstances.
” Source location Marina Fagan · Prevention of Future Deaths report
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Source evidence
How this respondent position was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Barts Health NHS Trust is responsible for addressing local neurologist availability and staffing levels.
Verbatim wording from the response “It is the responsibility of providers to ensure that they have appropriate staffing levels to meet the needs of their patients. The availability of neurologists locally is therefore for Barts Health NHS Trust to address.” Source location 2016-0162-Response-by-Department-of-Health
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Source evidence
How this respondent position was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Health Education England is responsible for planning the national neurology workforce and commissioning training places.
Verbatim wording from the response “On a national basis, Health Education England (HEE) plans the future workforce. HEE has consistently invested in the commissioning of training places in neurology and intends to commission 219 training places in 2016/17, a small rise from 217 in both 2014/15 and 2015/16.” Source location 2016-0162-Response-by-Department-of-Health
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Source evidence
How this respondent position was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation National neurology waiting times meet the operational NHS waiting-time standard, so existing arrangements address the national concern.
Verbatim wording from the response “Where this is not possible, the NHS should take all reasonable steps to offer a range of suitable alternative providers able to see or treat the patient more quickly than the original provider, if this is what the patient wants and it is clinically appropriate. Commissioners are not obliged to take all reasonable steps to find an alternative provider if the patient does not ask for this. Some patients will wait longer than 18 weeks by choice, for personal or social reasons, or because this is clinically appropriate.” Source location 2016-0162-Response-by-Department-of-Health
Open published response
Actions and positions describe what organisations say in published responses. Implementation is not independently verified.