Service evaluation: the role of same day emergency care in managing acute neurological presentations

ABSTRACT

Background and aimDuring the COVID-19 pandemic, the neurology department at St Mary’s Hospital had to direct the bulk of its acute work to a newly expanded ‘hot clinic’ running Monday to Friday through Same Day Emergency Care (SDEC). Face to face clinic appointments were also halted and instead triaged to SDEC when examination of the patient was necessary. Patients were referred through a number of routes directly to the neurology consultants or on-call registrar, and subsequently seen on an urgent basis. We were interested in evaluating the types of referrals made to this service as well as their final outcomes.ResultsA total of 255 patients were seen between 3 March 2021 and 3 August 2021. Approximately a third were from the A&E department and just less than a third were from the Western Eye Hospital, our local ophthalmology A&E. Most referrals were for headache or visual change, and 61% of patients did not need to re-attend SDEC. Importantly, a quarter were discharged home after specialist review, and none required admission from clinic. Thus our emergency service was successful in avoiding admissions while ensuring patients received the care they required in a timely fashion.