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 system further as part of The Walton Centre’s mutual aid offer during the COVID-19 pandemic.

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.

RANA provides:

• Direct, rapid access to a dedicated RANA Neurological Registrar at The Walton Centre to discuss patients presenting to local EDs with an acute Neurological sign or symptom
• Daily ambulatory assessment capacity, both onsite at The Walton Centre and at satellite sites for patients that have been discussed with, and accepted by, the identified RANA Consultant / Registrar
• Ring-fenced diagnostic capacity at The Walton Centre to support a rapid diagnosis and management plan

Service detail

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

• Patients who meet the defined clinical criteria for RANA support, should be referred by an Emergency Department clinician to the RANA clinician (Registrar or Consultant) via the dedicated phone line – 07977 022703
• The RANA clinician will discuss with the ED clinician and make the decision to accept to RANA or reject based on clinical criteria

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

If a patient is accepted to RANA:

• The RANA clinician will provide an appointment slot time for the patient review on the next working day to the ED clinician, to be passed onto the patient.
• The ED clinician should provide patient with the completed RANA attendance booking slip 
• Patients presenting to RANA will be seen by senior registrar or Consultant from The Walton Centre and receive on-the-day access to radiology diagnostics
• If a patient is felt to be inappropriate for the RANA service will be transferred back to their original hospital
• Patients who are seen in a RANA clinic and require admission or further follow-up will be managed under the care of the RANA (on call) consultant

Why refer through RANA?

The benefits of RANA are across a range of health care key performance indicators, such as quality, patient experience, reduction in patient delays, operational performance and use of resources.

Some key benefits are listed below:

• Provides local hospitals with rapid, specialist neurology access and support
• Supports the appropriate use of bed capacity
• Appropriate use of diagnostics
• Appropriate care, by appropriate person in the most appropriate setting
• Avoidance of longer than necessary hospital stays
• Increased bed availability in acute hospitals by avoiding unnecessary admissions
• Patients presenting as a neurological emergency are assessed, diagnosed with a management plan in place on the same day
• Increased inpatient flow and throughput in acute hospitals

 

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

 

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