PT  - JOURNAL ARTICLE
AU  - Kuven K Moodley
AU  - Valerie Jones
AU  - Mahinda Yogarajah
AU  - Bhavini Patel
AU  - Umesh Vivekananda
AU  - Pablo Garcia-Reitboeck
AU  - Kiran Samra
AU  - Gillian Cluckie
AU  - Oliver Foster
AU  - Anthony C Pereira
AU  - Niranjanan Nirmalananthan
TI  - Hyperacute neurology at a regional neurosciences centre: a 1-year experience of an innovative service model
AID  - 10.7861/clinmedicine.19-2-119
DP  - 2019 Mar 01
TA  - Clinical Medicine
PG  - 119--126
VI  - 19
IP  - 2
4099  - http://www.rcpjournals.org/content/19/2/119.short
4100  - http://www.rcpjournals.org/content/19/2/119.full
SO  - Clin Med2019 Mar 01; 19
AB  - St George’s Hospital hyperacute neurology service (HANS) is a comprehensive, consultant-delivered service set in a teaching hospital regional neuroscience centre. The service addresses deficiencies in acute neurological care previously highlighted by the Royal College of Physicians and the Association of British Neurologists. HANS adopts a disease-agnostic approach to acute neurology, prioritising the emergency department (ED) management of both stroke and stroke mimics alike alongside proactive daily support to the acute medical unit and acute medical take. Rapid access clinics provide a means to assess ambulatory patients, providing an outlet to reduce the burden of referral from primary care to acute medicine. This paper reports the results from the first year of the service. Admission was avoided in 25% of the cases reviewed in the ED. Compared to historic data, there was a significant improvement in the length of stay for non-stroke disorders while the occupancy of stroke beds by non-stroke cases reduced by 50%. The configuration of this service is replicable in other neuroscience centres and provides a framework to reduce the barriers facing patients who present with acute neurological symptoms.