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722 Prince of Wales Road
S9 4EU
Telehone: 0114 305 1104
20 February 2015
Dear colleague
Re: Decommissioning of headache and migraine intermediate service
Thank you to those of you who replied to our recent communications seeking comments
about the headache and migraine intermediate service.
The headache and migraine clinic was set up a number of years ago to help manage a
huge waiting list for patients referred directly to neurology, most of whom could be
assessed and managed by a GPSI run service. They had access to CT scanning before
this was available to all GPs.
The specification for this service has not changed during this period. During this time
excellent resources for GPs have become available to investigate and manage patients
with headache and migraine, such as the BASH guidelines (British Association for the
Study of Headache, direct access imaging and irefer
guidelines ( as well as familiarisation with triptans and
newer prophylactic agents.
The neurologists in Sheffield have made clear that they welcome referrals for patients
who fulfil NICE recommendations ( We have a highly specialised resource for complex patients in Sheffield
As you may know from recent communications in the CCG e-bulletin, the NHS Sheffield
CCG Clinical Executive Team has decided the headache and migraine intermediate
service will no longer be commissioned from 31 March 2015 and that the service is no
longer accepting new referrals.
Alternative services, exclusion details and contact information for Neurology are
provided on the Choose & Book system and replicated on the reverse of this letter for
your reference.
This guidance, including further information developed by the CCG, is also available on
the PRESS portal:
Information for patients: The CCG is also providing a leaflet to share with patients
containing useful information including types of headache, support available including a
range of national organisations. A copy of the leaflet is enclosed for your information
and more will be made available to your practice.
If you require further information on any of the above from NHS Sheffield CCG please
Yours sincerely
Dr Charles Heatley
Chair: Dr Tim Moorhead
Accountable Officer: Ian Atkinson
“Neurology - General Neurology - Royal Hallamshire – RHQHH. Choose & Book
Service ID 143530
Service Contact Name Neurosciences Appointments Team
Age Range Treated 16 years and over
Indicative Wait Times Urgent / Routine: 40 Days
Telephone Number 0114 271 1598
Conditions Treated
NB: We are happy to see all aspects of general neurology listed below, but please be
aware that we do offer a number of specialist clinics where patients may be better
placed if the diagnosis is known or clear. e.g. Parkinson's Disease book with Movement
Additionally we run Neurology Services in the surrounding District Generals Hospitals. It
often makes more clinical sense for patients to be booked into these clinics where our
Neurologists have access to their full history and investigations.
NB: we will not see primary headache (migraine, tension type headache, medication
overuse headache) unless evidence is provided in the referral letter that NICE guidance
CG150 has been followed.
Central Nervous System disorders, Peripheral Nervous System disorders, Neurological
disease, Trigeminal neuralgia, Facial pain, Loss of consciousness, Transient
confusional states, Dizziness, Vertigo, Collapse, Double vision, Visual loss, Ptosis,
Dysarthria, Dysphasia, Swallowing difficulties, Cranial nerve disorders, Movement
disorders, Tremor, Dystonia, Torticollis, Writer's cramp, Tic disorder, Chorea,
Myoclonus, Parkinson's disease, Parkinsonism, Early onset memory disorder, Ataxia,
Limb weakness, Sensory loss, Tingling, Numbness, Peripheral neuropathy,
Mononeuropathy, Muscle disease, Myositis, Myopathy, Myasthenia gravis,
Mitochondrial disease, neurological disorders associated with systemic disease,
Neurological vasculitis, Motor neurone disease, Papiloedema.
Specialist clinics are available for Epilepsy, Movement Disorder, Multiple Sclerosis and
Neuromuscular problems.
Myalgic Encephalitis, Chronic Fatigue Syndrome, Patients under 16 years old, Insomnia,
Acute brain injury.
Chair: Dr Tim Moorhead
Accountable Officer: Ian Atkinson
Administrative Requirements
If transport or interpreter services are required please indicate when making the referral.
Alternative Services
Specialist Clinics at the Royal Hallamshire Hospital in Epilepsy, Movement Disorder,
Multiple Sclerosis and Neuromuscular disorders.
Neurology clinics in Doncaster Royal Infirmary
Neurology clinics in Rotherham District General Hospital
Neurology clinics in Barnsley District General Hospital
Neurology clinics in North Derbyshire and Chesterfield Royal Hospital
Neurology clinics in Bassetlaw Hospital
Elderly Falls Clinic in Elderly Care- Sheffield Teaching Hospitals
Myalgic Encephelitis Clinic in Infectious Diseases - Sheffield Teaching Hospitals
TIA/Minor Stoke Clinic - Sheffield Teaching Hospitals”
Chair: Dr Tim Moorhead
Accountable Officer: Ian Atkinson