NICE Guidelines – Referral for Suspected Neurological Conditions

What is NICE?

The National Institute for Health and Care Excellence (NICE) provides national guidance and advice to improve health and social care. It is used by medical professionals to ensure that they maintain a standard of care expected from a reasonably competent medical practitioner.

When was the new Neurological Guidance published?

1^st May 2019

What is it about?

Recommendations about which symptoms and signs should prompt a referral for further neurological assessment.

What is it for?

• GPs can recognise when symptoms could have a neurological cause
• GPs and doctors in emergency departments know when to refer people to a specialist straight away and when to do more tests first
• people who most need to see a specialist can see one sooner
• people are not referred to a specialist if they don’t need to be.

(Taken from the NICE website)

What to look out for – Under 16 Years of age

• 1.17 Attention, concentration and memory problems
• 1.18 Blackouts and other paroxysmal events
• 1.19 Confusion, acute
• 1.20 Dizziness and vertigo in children
• 1.21 Headaches in children
• 1.22 Head shape or size abnormalities
• 1.23 Hypotonia (‘floppiness’)
• 1.24 Limb or facial weakness in children
• 1.25 Motor development delay or regression, and unsteadiness
• 1.26 Posture distortion in children
• 1.27 Sensory symptoms such as tingling or numbness in children
• 1.28 Sleep disorders in children
• 1.29 Speech problems in children
• 1.30 Squint
• 1.31 Tics and involuntary movements in children
• 1.32 Tremor in children

Adults

• 1.1 Blackouts in adults
• 1.2 Dizziness and vertigo in adults
• 1.3 Facial pain, atraumatic
• 1.4 Gait unsteadiness
• 1.5 Handwriting difficulties
• 1.6 Headaches in adults
• 1.7 Limb or facial weakness in adults
• 1.8 Memory failure and cognitive deterioration
• 1.9 Posture distortion in adults
• 1.10 Sensory symptoms including tingling or numbness in adults
• 1.11 Sleep disorders in adults
• 1.12 Smell or taste problems
• 1.13 Speech, swallowing and language problems in adults
• 1.14 Tics and involuntary movements in adults
• 1.15 Tremor in adults
• 1.16 Information and support

What does NICE say?

Dr Paul Chrisp, director of the Centre for Guidelines at NICE, said: “People with suspected neurological conditions often need referral to a specialist to be diagnosed. However, we know that some people with neurological conditions are initially misdiagnosed or have a delayed referral to a specialist, and some referrals are unnecessary. These issues with referral can come from non-specialists not recognising neurological conditions.

“This new guideline should help improve outcomes for people with suspected neurological conditions by providing, for the first time, a comprehensive assessment of the key signs and symptoms across the range of possible neurological conditions that should trigger referral to a specialist.”

Richard Grunewald, Chair of the guideline committee: “A non-specialist cannot be expected to keep up with the rapid changes in knowledge and practice in clinical neurology. This new guideline will help non-specialists recognise patients with neurological symptoms, such as dizziness and sleep disturbance, to prompt their referral to specialist assessment and care.”

(Taken from the NICE website)

If you, or any of your family have been affected by a medical professional’s failure to ensure that an individual has been referred in a timely manner, please contact Williamsons Solicitors, on 01482 323697, for free advice.

If you prefer to email your experience, please email wayne.walker@williasons.co.uk

Wayne is a specialist Clinical Negligence Solicitor with over 14 years’ experience and would be happy to help determine whether there has been a failure to follow the new guidelines.