Over 800,000 people in Ireland are living with neurological conditions, however neurological services in Ireland are seriously understaffed and under-resourced, a new report has shown.

The report by the Neurological Alliance of Ireland (NAI) is based on the results of a survey of clinicians working in the country's 12 neurology centres. The survey was carried out between November 2020 and January 2021 and is a follow-up to a similar survey carried out in 2015.

It revealed that every neurology centre in the country reported "critical understaffing across all specialties". The number of consultant neurologists continues to fall "far short" of recommendations in the Model of Care for Neurology Services in Ireland.

Furthermore, the number of neurological clinical nurse specialists represents just 44% of what is required. The number of clinical nurse specialists working in the areas of multiple sclerosis, epilepsy, Parkinson's disease and migraine are significantly below recommended levels for the Irish population. For example, 30 nurse specialists are recommended to work in the area of Parkinson's disease, but there are currently just six, while 35 are recommended for multiple sclerosis, but there are just 22.

"We know that expanding and developing the role of clinical nurse specialists is the future of neurology services in Ireland. They streamline patient care and play a vital part in educating patients and families about specific neurological disorders. In many cases, they prevent unnecessary hospital admissions. We have 44% of what is required," commented NAI executive director, Magdalen Rogers.

Meanwhile, physiotherapy, occupational therapy, and speech and language therapy dedicated to neurology services stayed the same or declined across most centres over the last five years, despite increased demand for these. Furthermore, most neurology centres do not have access to a specialist dietitian.

When it came to dedicated neurology beds (excluding stroke), a majority of the 12 centres said they had an insufficient number of inpatient beds or a lack of ring-fenced beds for the neurology service.

"The Association of British Neurologists recommends 10-15 dedicated neurology (excluding stroke) beds per 500,000 population. Extrapolated to an Irish context that equates to a minimum of approximately 100 dedicated neurology beds for our population. The 2020 survey findings indicate less than half of this number is in place, with a lack of dedicated ring-fenced beds reported as a significant problem across centres," the report noted.

Waiting times for MRI scans is another key issue for neurology patients, with at least half of the neurology centres stating that patients must wait more than 12 months for an MRI.

When it comes to neuro-rehabilitation, there has been an increase since 2015 in the number of centres reporting no access to community neuro-rehabilitation services. Most reported no access or very limited access and this "continues to be a critical issue for neurology services".

Ms Rogers pointed out that the lack of investment in neuro-rehabilitation impacts significantly on long-term outcomes for patients.

The report also highlighted the importance of the not-for-profit neurological sector, which helps to deliver important services to people with neurological conditions and their families, such as neuro-rehabilitation services, respite, day services and residential care.

Successive funding cuts and the collapse of fundraising due to the COVID19 pandemic means that this sector is seriously struggling.

"The vital importance of not-for-profit organisations in the delivery of everyday care for neurological illness in this country cannot be overstated. They contribute millions each year from fundraised income, without which neurological care in this country could not be sustained, commented Prof Orla Hardiman, the national clinical lead for neurology.

The report was published as part of Brain Awareness Week, which runs from March 15-21. For more information on this awareness event, click here. To read the NAI report, Resourcing of Neurology Services in Ireland Five Years On: 2015-2020, click here.