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Current services in relation to need

Adults :: Long term neurological conditions :: Current services in relation to need

Community services

Community neuro—physiotherapy: a neuro-phyiotherapist holds outpatient clinics at St Barts, MFT and the Walter Brice Centre for 130–150 patients.

Specialist neurology services

• PD and MS specialist nurses: MFT has two full time nurses for each condition, providing home visits, clinics, education and training.
• Epilepsy specialist nurses: One clinic a week is held in Lordswood by the ESN who also covers Dartford and Gravesham. MFT has submitted a business plan to recruit an ESN to increase provision and improve links with consultants.
• Tysabri clinic for MS: MS patients who stop responding to disease modifying therapies can be screened for suitability for Tysabri treatment, which takes place at Kings (London). Tysabri appointments occur every 4 weeks, with each one lasting a minimum of 90 minutes.
• Huntingdon's disease specialist care in nursing homes: There are two nursing homes in Medway specialising in providing care for people with advanced HD, including many patients from outside of Medway.
• Emotional support and psychological therapies: The CCG is providing training for staff to recognise anxiety and to ensure appropriate support pathways are in place.

Social services

Support from social services for people with LTNC comes mainly for people with associated physical disabilities that are severe enough to qualify for social care. People will often enter the system once their condition is quite far advanced. The exception to this is the large number of people receiving support from the learning disabilities team who also happen to have epilepsy.

Social services at Medway Council is also diverting more resources into support for carers. They have started to implement a strategy for increasing the number of carer's assessments completed and increasing the amount of support available, with a dedicated care manager and care manager's assistant based at the council.

Palliative and end of life care

• MCH specialist palliative care service: MCH provides a specialist palliative care service, including Wisdom Hospice (15 beds), a day hospice and a home care team of nurses that care for about 350 patients in their homes at any one time. Outpatient clinics are provided at the Disablement Service Centre.
• Multi–disciplinary team for MND: A multi–disciplinary team provides a service for patients with MND which is unfunded and reliant on the goodwill of its members to function. The team comprises a palliative care consultant, Wisdom Hospice, home care nurse, social worker, MND association rep, Occupational Therapist (OT) from MCH and speech and language therapists. The team is usually involved from diagnosis of the condition, since the prognosis is usually 2–3 years. Joint clinics are held for people requiring non–invasive ventilation. These clinics are also due to start with a nutrition nurse for people who may need percutaneous endoscopic gastrostomy (PEG) feeding.

Third sector services

• The Huntington's Disease Association: This is a small charity with one person working across Kent & Sussex and Bromley, Bexley and Dartford as a non-medical advisor, providing advice for individuals with HD, signposting them to services and also supporting professionals. The representative's support extends to families and she makes home visits in Medway as well as visiting nursing homes and clinics.
• Parkinson's UK: A large charity which has had active involvement in Medway, notably through pump–priming of the two PD specialist nurse posts. It has a local branch which meets monthly in Chatham, offering information and support to individuals, families and carers.
• MS Society: The MS Society has a local development support officer who works with branches as a volunteer. The Medway branch is quite active, organising social meetings and signposting people if they need support for advocacy. It also runs a drop in centre, has a helpline number and an active website. It organises speakers at its events such as the MS specialist nurse, who is also the charity's main interface with the health service. Support for carers is provided from support volunteers and the national centre, and in 2014 a big push in this area is planned, including a appointing strategic national lead for carers.
• Carers First: Support to carers is available primarily through Carers First in Gillingham, although each of the condition-specific charities offer support to carers too.