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GPs with Special Interest provide more satisfactory care for patients with headache at less cost

JULY 10, 2008

Dr Leone Ridsdale,  Senior Lecturer in Neurology and Reader in General Practice at the Institute of Psychiatry at King’s and colleagues found that compared to usual care in neurology clinics, patients with headaches are more satisfied with a GP with Special Interest in Headache (GPwSI) service, and the cost is lower.

A paper published in the British Journal of General Practice, entitled A new GP with special interest headache service: observational study reports in July 2008 on a headache clinic set up in a Southwark general practice (Vol 58, p 478-483).

Gaining access to diagnosis and management for common neurological problems is not easy in the UK. A major reason for this is that there are fewer neurologists than in other western countries. An additional consequence of fewer neurologists has been too few neurology teachers to train clinical medical students and junior doctors, with insufficient training in diagnosis and management. 

Headache is the commonest problem reported. Headache and migraine are in the top ten international causes of disability, and accounts for approximately 25% of new referrals to neurologists.

A project funded by Guy’s and St Thomas’ Charity trained five GPs with special interest in headache, and encouraged them to contribute headache teaching for:- GP tutors of medical students, to GPs in the locality, and to GP registrars. An intermediate headache service was set up at Princess Street Practice, and Southwark GPs were invited to refer patients with primary headache.

An evaluation of the service found that the group referred to GPs with Special Interest had similar levels of headache impact as the group referred to neurologists. The group referred to the GPwSI reported more satisfaction with the intermediate level service, and described it as more ‘the kind of service they wanted’. The new service was cheaper than the tariff charged by hospitals.

This approach, adapted to suit the context of other localities, could help patients with neurological problems get more services that are appropriate to their needs, satisfactory, and provided at lower cost.

For full details of the paper please refer to the British Journal of General Practice, July 2008. 

Br J Gen Pract. 2008 Jul;58(552):478-483. A new GP with special interest headache service: observational study. Ridsdale L, Doherty J, McCrone P, Seed P; the Headache Innovation and Evaluation Group. Unit of Neurology and General Practice, Department of Clinical Neuroscience, Institute of Psychiatry, King's College London, London.
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