Quality requirement 2:
Early recognition, prompt diagnosis and treatment.

People suspected of having a neurological condition are to have prompt access to specialist neurological expertise for an accurate diagnosis and treatment as close to home as possible.

Prompt referral to specialist (within 18 weeks)


Prompt diagnosis (within 36 weeks)



Indicators of progress

In Fitzpatrick et al’s study (2010), 65% of respondents reported a period of a year or less before they received a definite diagnosis and 35% reported a period of at least a year. However for the majority of respondents the experiences surrounding diagnosis related to more than five years prior to the survey. It is also noted that there are difficulties in saying to what extent these waiting times were because of the ways that symptoms may occur and GPs’ low levels of experience in dealing with them (because of the typically small numbers of people with LTNCs per practice).

Inhibitors of progress

Hoppitt et al (2011) report that, across the board, it can take up to two years to diagnose a rare neurological condition, but “mean levels vary across conditions and standard deviations are large” (p138). Making a diagnosis can be a lengthy process, as many rare LTNCs rely on the process of elimination (as illustrated by the fact that the mean time to diagnosis in Huntington’s Disease was 6 months, where it can be done via a genetic test, compared to 3 years in Multiple System Atrophy, where symptoms can be initially mis-diagnosed as Parkinson’s Disease).




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