Pathways and downloads for health professionals

 

DGH Guidance

Guidance on inpatient referral requests to visiting neurologists in DGHs

 

Rapid Access Neurology Assessment (RANA) service

The Rapid Access to Neurology Assessment (RANA) service, developed by clinicians at The Walton Centre, provides Emergency Department clinicians with direct access to expert neurologists when patients visit Emergency Departments with neurological signs and symptoms.

RANA was introduced in February 2021 to support the acute general hospital sites during the COVID-19 pandemic. The aim is to provide rapid and direct access for patients with acute neurological issues to specialist neurology service in consultant led clinics and reduce unnecessary hospitalisations and facilitate speedy diagnosis and management plans.

We have 36 slots in these clinics every week (Monday to Friday) with dedicated scan and neurophysiology slots and most patients can usually be seen within 24 hours (for referrals on Monday to Friday).

RANA is a model endorsed by Association of British Neurologists, aligned with GIRFT recommendations for acute neurological care and aligned with the requirements of the new specialist training curricular.

Service detail

• The RANA service is operational Monday to Friday, 9am – 5pm, and is available to Trusts across Cheshire and Merseyside

• Please note, RANA patients can only be referred by clinical teams – patients can not self-refer into the RANA service.

Who to refer

• Patient who has an undiagnosed neurological issue and is ambulant and stable enough to be seen within 24-48 hours (and willing to travel to The Walton Centre) should be referred
• Patients with life threatening neurological emergencies where there is an immediate risk to life or limb should not be referred and should be admitted locally and advice sought from on-call Neurology team as appropriate.
  • eg: repeated epileptic seizures impairing consciousness, acute stroke, cauda equina syndrome, suspected subarachnoid haemorrhage, rapidly progressive limb weakness where a differential diagnosis of Guillain-Barre syndrome or spinal cord/cauda equina compression is considered, any patients with bulbar weakness or alteration of consciousness should not be referred into RANA
• Patients presenting with first seizure can follow the first fit pathway and patients with chronic headaches can follow the headache pathway and guidelines but can be referred to RANA in the event of repeated admissions despite the above measures

How to refer

It can be done through this weblink or by scanning the QR code which will take you to a referral proforma and this can be used to refer patients.

Please note that this link is only for referral to RANA clinic and not for getting advice for inpatients and this should be done as usual by ringing on-call neurology team in urgent cases or by referring to the visiting neurologists in less urgent cases for getting advice for inpatients and this should be as before by ringing on-call neurology team.

Brain tumour pathway

The neuro-oncology team at The Walton Centre and the Acute Oncology Nursing Team at Whiston Hospital in Prescot have developed an improved pathway for patients at St Helens and Knowsley NHS Foundation Trust to receive the most appropriate treatment and/or support as quickly as possible.

For more information about this pathway, please watch this short film from Professor Andrew Brodbelt, Consultant Neurosurgeon and the lead for neuro-oncology at The Walton Centre.

Headache information and pathways

Acute headache pathway for A&E and acute medical units

(Please note: this PDF functions with Internet Explorer or Mozilla Firefox browsers only. Use the alternative Word Version if  the PDF fails to work).

Headache pathway (primary care) for GPs

Information for patients with primary headache disorders

 

Migraine information

Comprehensive guide to migraine

Suspected papilloedema / IIH

Suspected papilloedema and IIH pathway

Idiopathic Intracranial Hypertension - Patient information 

Parkinson's disease pathway 

Parkinson’s disease management pathway for emergency admissions into acute NHS Trusts

Seizure information and pathways

Seizure pathway for A&E and acute medical units

Poster for A&E and MAU departments regarding the seizure pathway

The Walton Centre ACUTE STATUS EPILEPTICUS guideline

Escalating Seizure Protocol

Information for patients after seizures

Management and prophylaxis of eclamptic seizures

  

Thrombectomy information and pathways

Thrombectomy in acute stroke - regional pathway and guidelines for referral