Neurology team finalistsBMJ 2016; 353 doi: https://doi.org/10.1136/bmj.i2085 (Published 15 April 2016) Cite this as: BMJ 2016;353:i2085
- Nigel Hawkes, freelance journalist
- London, UK
Aiming high—a new multidisciplinary team service
Children born with cerebral palsy in Northern Ireland faced a fragmented pattern of care when Claire Lundy was appointed consultant in paediatric neurodisability at Belfast Health and Social Care Trust in 2011. “Individually they were probably being treated pretty well, though they were ricocheting between services,” she says. “But there was a real challenge for the more able children. They were seen when quite young but then forgotten about, with their needs unmet.”
The best approach, and the one approved by the National Institute for Health and Care Excellence (NICE), is multidisciplinary care by teams incorporating clinicians, occupational therapists, and others. No such service then existed for the 1000 people below the age of 20 years in Northern Ireland recorded as having cerebral palsy. She had worked at the Evelina London Children’s Hospital and had the skills and experience to set up such a service. “They told me, ‘There you go, get on with it.’”
Pilot funding was provided for a clinic designed to provide assessment and initial treatment in one appointment. Within six months 139 children had been seen, with strongly positive feedback from doctors and families. A separate pilot clinic for children with upper limb disorders led to the creation of a network of occupational therapists and standardised pathway for children having treatment with botulinum toxin.
What may seem like small changes can transform lives for the better. Lundy remembers a boy of 14 who desperately wanted to be able to tie his own shoelaces and open a packet of crisps like his friends. “With help, he achieved it—it sounds really simple but it transformed that boy’s life,” she says.
Neurology liaison service
Forth Valley Royal Hospital, opened in 2011, is a new hospital that has adapted …