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Planned Care Innovation Exemplars

Improving Triage and Diagnosis for those with Neurological Symptoms

Michelle Price, AHP Lead, Person Centred Care
Rhiannon Edwards, Neurological & Rare Disease Implementation Group Coordinator

Neurological Implementations Group, Supported by Powys Teaching Health Board


The Neurological Conditions Implementation Group (NCIG) has recognised that there are significant delays in getting a diagnosis for people in Wales who experience neurological symptoms. This has been exacerbated by the Covid-19 pandemic and the difficulty recruiting to consultant neurologist posts. This can result in significant distress to those who are awaiting a diagnosis, increases in unplanned admissions and emergency department attendances, delays in treatment and potentially worse outcomes for patients. Service users across Wales have highlighted their frustration at the time it takes to get a diagnosis of a neurological condition and the impact this has on their lives. Focusing on improving this first element of the patient journey has the potential to improve outcomes for people with neurological conditions and release capacity in the system to enable further service improvements.


  • Improve the patient experience to neurological diagnosis at primary care
  • Map the referral processes and pathways from primary care and identify any gaps
  • Collate data on current waiting times from primary care to diagnosis
  • Produce an all Wales resource for GPs and patients to provide better support and outcomes



– Collate data on current waiting time and pathways from primary care referral to diagnosis

– Explore patient experience of journey to diagnosis to inform gaps in service provision

– Investigate opportunities to impact on the delays and quality of care provided to the patient

– Develop resources to support the improved outcomes for patients


Outcomes / Benefits

  • Roll out of an all Wales Headache Pathway and Toolkit for the diagnosis and management of headaches (scaling an existing pathway delivered by SBUHB, shown to reduce referrals to neurology by 40%)
  • Headache Toolkit tested and coproduced with patients
  • Development of a national referral database to inform/ support future specific neurological pathways
  • Development of resources and access to specialist information for GPs to aid decision making and referrals into neurology
  • Development of resources for patients

What next?

– Continue to evaluate the headache toolkit usage, and monitor neurology referral data to assess impact.

– Work with service managers to develop a mechanism to record specific referrals into neurology to support workplan management.

– Utilise learning from engagement and coproduction activities to translate into future workstreams

View project posters and slides from the PCIP National Showcase Event