Box 1.

Staffing change examples

  • All consultants with predominantly DGH sessions released from roles in neurosciences centres

  • Accordingly, stroke and neurology on-call rota revised – stroke and daytime neurology services staffed by neuroscience centre internally

  • Individual sub-specialties provide core and urgent services with, for example, daily multiple sclerosis consultant service to deal with any issues as they arise. Home delivery for immunotherapies where possible

  • Combined stroke and neurology wards, run by neurology to release stroke team; beds used flexibly

  • Increased community support to speed up discharge in stroke and rehabilitation

  • Roving physician colleagues to provide help and support to neurologists in general medicine roles

  • Daily consultant-led clinic focusing jointly on transient ischemic attack and hot neurology, including emergency department in-reach, inpatient referrals and urgent GP calls