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Improving Functional Neurological Disorder pathways

Why hold a Functional Neurological Disorder Masterclass? Dr Paul Shotbolt, Consultant Neuropsychiatrist, South London and Maudsley NHS Foundation Trust and Clinical Senior Lecturer, King’s College London blogs.

Paul Shotbolt 3You’ll have heard of headache or migraine, the most common reason for a neurological outpatient visit, but you’re unlikely to have heard of the second most common reason.

Functional Neurological Disorder, FND for short, covers symptoms in the body which appear to be caused by problems in the nervous system but which are not caused by a physical neurological disease or disorder. These symptoms can be as debilitating as Parkinson’s Disease and Multiple Sclerosis.

The economic impact of functional disorders is estimated to be even higher than that of dementia, with many working-age adults affected and resulting in extensive use of healthcare resources.

However, FND services and pathways are currently extremely variable.

[Image: Dr Paul Shotbolt, Consultant Neuropsychiatrist, South London and Maudsley NHS Foundation Trust and Clinical Senior Lecturer, King’s College London.]

So earlier this year the King’s Health Partners Institute of Neurosciences took up the challenge. We created our first dedicated workstream to review the FND services currently provided across our trusts, understand our patients’ unmet needs, and make recommendations to sustainably improve services across the whole partnership. Focusing on these strands has the potential to make meaningful and impactful changes that improve patient experience and outcomes.

Early on we recognised while our small multi-disciplinary group contained a high-level of knowledge, experience, and expertise - other healthcare professionals across a wide range of clinics and settings will come into contact with FND patients in their day-to-day work.

Clearly education on diagnosis and management of these patients is key – meaning sharing our experiences beyond our specialism and across King’s Health Partners.

And so was born the half-day ‘masterclass’ to add value to a much wider network of healthcare professionals, including therapists, doctors, and nurses, from both acute and community care across the partnership.

It provided us an opportunity to talk big picture - the vision for and patient benefits of King’s Health Partners Neurosciences. A range of speakers from across all services provided talks on making an effective diagnosis and role of different professionals in the treatment of patients.

One of our patients gave a talk sharing their personal experiences on never hearing about FND until being diagnosed, how they manage their condition, and the specialist services they receive. The attendees found this very powerful and told us hearing the experiences of a service user first hand will them improve the services that they provide.

To our very great delight, 90% of attendees rated excellent or very good the overall assessment of the masterclass and 88% of attendees rated that the masterclass extremely or considerably met their training needs.

Even more positively, many delegates reported that they would take learning back to their workplace as a result of attending the masterclass, such as how to communicate and discuss diagnosis effectively. In addition, delegates reported an improved understanding of treatment pathways – meeting our goals for the event.

Clearly collaboration is crucial and King’s Health Partners is in a unique position to bring people together and drive change. The Functional Neurological Disorder Workstream will continue to meet regularly with a focus on joint working across clinical services, teaching and research developments achieving the tripartite mission of King’s Health Partners Neurosciences.

But for collaboration to work most effectively, it needs to extend beyond specialisms and individual settings. It will only be when we broaden out to staff at all levels across our partners that we can make real improvements to the care and the outcomes of our patients living with functional neurological disorders.

King’s Health Partners Neurosciences has an ambitious vision to use our collective clinical, research, and educational expertise to deliver world-class patient care and research. 

Access free neurosciences elearning for King’s Health Partners staff.