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722 Prince of Wales Road Sheffield S9 4EU Email: [email protected] 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, http://www.bash.org.uk/) direct access imaging and irefer guidelines (http://nww.irefer.nhs.uk/adult/) 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 (http://www.nice.org.uk/guidance/cg150/chapter/1guidance). 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: http://www.sheffieldccgportal.co.uk/pressv2/index.php/clinicalguidance/item/interim-headache-guidance 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 email [email protected]. 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 Address GLOSSOP ROAD, SHEFFIELD, SOUTH YORKSHIRE S10 2JF 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 Disorder. 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. http://www.nice.org.uk/guidance/CG150 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. Exclusions 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