The development of a Scotland-wide neuroscience service is one of the key parts of Delivering for Health and followed from recommendations from the Neuroscience Action Team. On 16th May 2006, the Health Minister announced that John Glennie, the Chief Executive of NHS Borders, would chair the Neuroscience Implementation Group. Delivering for Health sets out a model for redesigning this service centred around three tiers of access - community based services, more specialised regional services, and a prime site for the most complex procedures.
Earlier attempts to reconfigure neurosurgery looked at that specialty alone, but it is clear that we need to look at all the disciplines that make up neuroscience in order to decide how neurosurgical services should be structured to best meet people's needs. The main specialties that are collectively referred to as neurosciences are neurosurgery, neurology, neuroradiology, neuropathology, neurophysiology, neurorehabilitation, neuroanaesthetics and critical care and neuropsychology.
Neurosurgery is currently delivered from four regional centres: Aberdeen Royal Infirmary and the Royal Aberdeen Children's Hospital; Ninewells Hospital, Dundee; the Western General and the Royal Hospital for Sick Children, Edinburgh; and the Southern General Hospital and the Royal Hospital for Sick Children, Glasgow. Each unit is an integral part of a multidisciplinary neuroscience service and is connected to a University Medical School.
The aim is to create a service which starts in the community, giving people the ready access they need to specialist neurological opinion, diagnostic tests, long-tern care and community-based rehabilitation. More specialised care would be hospital based, with onward referral if necessary to a prime site where the most complex adult, and all paediatric neurosurgery will be concentrated to make the best use of scarce specialist expertise.
The Implementation Group has representatives from the Scottish Neurological Alliance which represents the interests of people with a neurological condition, so that they and their carers have a strong voice. The Scottish Neurosciences Council is represented, and the group also includes neurologists, neurosurgeons, nurses, allied health professionals, members of the primary care team and a representative from the three Regional Planning Groups.
The Implementation Group will also take into account issues including emergency neurosurgery and the transport implications of the model for patients and their families and carers. In all of this work, the interests of patients and their safety is paramount.
The Group will report back to Ministers by the end of 2007.