Neurophysiology in a Nissen Hut

Dr Adrian J Fowle & Elaine CrightonWest Surrey Clinical Neurophysiology

Clinical Neurophysiology? (1)

We run a diagnostic service EEG / EMG / EP Used by all disciplines

Orthopaedics, GP, Rheum (Carpal tunnel etc) Paediatrics (Epilepsy, N-ICU) Neurology (MND, Epilepsy, Neuropathy etc) Medicine / Elderly Care Psychiatry ITU

Clinical Neurophysiology? (2)

Provided by physiologists and doctors Shortage of both nationally. Made worse by MSC – no training places

Patient facing Neonate -> Elderly Autism / Schizophrenia / Seizures / Apnoea Wheelchairs OPD, but also NICU / ITU / outlying hospitals

The Team

Deliberately built Based on

Good social life Creature comforts Shared values Low hierarchy Mutual respect

CPD Training

Patients

Patient Information Leaflets Meet and Greet Explain tests Humour, compassion, distraction Explain results Give patients copy of report Change pathway sometimes

Other Colleagues

Referrers Management Commissioners Trainees

Medical Physiological Other

Regional group National group

Be Nice Meet their needs Coffee Newsletter Engage

Be Tough Say No! Ask again

You have just seen

3 Slides

About being nice

to people

IT

Spread sheet In house network, server, admin database Trust IT Commercial admin database Very tight integration Type own reports

Queue management (1)

NHS Modernisation Agency Single queues, post office not supermarket No carve out Be tough “Demand Capacity matching” DNAs are important

18ww – Reduced interdepartmental wait Fax then letter Report to patient when possible

Queue Management (2)

Microbooking by experienced staff Travel times for elderly Travel times for transport Staff resources

You can have too short a queue

Clinic Management

Physiologist clinics 1 stop shop Extended hours Blitzing (only goodwill) Skill mix & across 2 sites

Need higher grades in small department

Microbooking

Single site / multi site

Single site Economies of scale Cover for leave Sufficient expertise in rare tests Mutual aid of staff

Multi site Near patients Use of IT to bridge gap

Finance and Activity Data

Keep an eye on it Question possible errors Time consuming

Quality

Care about people Be flexible Accreditation - IQIPS