Greater Glasgow Movement Disorder Clinics; Primary Care Awareness Newsletter
A network of Movement Disorder Clinics (MDC’s) has been established in Greater Glasgow, run by a physician or neurologist with Parkinson’s disease nurse support staff. Patients with the following conditions should be referred to one of the clinics described below with contact numbers:
- Parkinson’s Disease or Parkinsonism
- Essential Tremor where there are management difficulties
- Tremor of uncertain cause
- Patients with dystonia (e.g. torticollis) should be referred to Dr Donald Grosset, Department of Neurology, Southern General Hospital. Patients with other movement disorders should be referred as at present.
We suggest the following:
- Early referral of new patients
- Referral before starting treatment (this helps assessment and improves diagnostic accuracy)
- Review of present caseload in your practice
- Satisfactory ongoing clinic attendance, no change required, option of transfer to movement disorder clinic decided by those involved
- Patients not attending any clinic, refer to a movement disorder clinic
Implications for Primary Care Practitioners *
There is rarely any urgency to prescribe at initial presentation. It is usually better to delay until the diagnosis and care plan have been agreed with the specialist.
Primary Care team priorities:
- Watch out for complications
- Establish access and relationships with specialist nurse and clinic
- Define follow up arrangement with patient
- Patient Concerns:
- Work
- Finance
- Signposting to benefits
- Sexual relationships
- Patients and carers need appropriate support:
- Palliative care services may be needed
- Social services to address needs resulting from increased disability and dependency
- Care may be needed at home, nursing home or hospice
On suspicion of diagnosis:
- Tell the patient of your suspicion of ‘parkinsonism’ and the need for confirmation by referral
- Check repeat prescriptions for StemetilTM and other drugs that can cause parkinsonism.
*Extracted from Parkinson’s Aware in Primary Care, A guide for primary care teams developed by The Primary Care Task Force for PDS (UK).
What to expect from the clinics
- Standardised treatment plans will be applied across clinics. These will follow best practice, (Ref. MacMahon flow chart, Macphee & Needleman, Prescriber, Jan 2003, p24-36 www.escriber.com).
- Referral to allied health professionals as clinically indicated.
- Clinic attendance for most patients. Some patients e.g. in nursing homes will have liaison conducted by the Parkinson’s nurse instead.
North Glasgow Service
Stobhill has a weekly clinic on a Wednesday afternoon. This is a multidisciplinary clinic were patients are able to see a doctor, the nurse, the physiotherapist, the occupational therapist and the speech and language therapist as appropriate.
Personnel
The clinic is held in the Assessment and Rehabilitation day hospital at Stobhill. Personnel involved are:
- Dr Jim Davie, Consultant
- Kay Hood, Specialist Parkinson’s Nurse
- Lesley White, Specialist Parkinson’s Nurse
- Roberta Dickie, Physiotherapist
- Hazel Whitby, Occupational Therapist
- Carol Nelson, Speech and Language Therapist
Clinic Details and Contacts
For further information please contact Dr J W Davie at 201 3217 or Sr Kay Hood on 201 3851.
Waiting times to be seen at the clinic is three weeks approximately.
North West Glasgow Service
The Parkinson’s Disease Service is based at Drumchapel Hospital and is dedicated to the interdisciplinary management of patients with Parkinson’s Disease and related disorders. Its purpose is that patients have access to comprehensive facilities within Greater Glasgow to ensure:
- Accurate diagnosis and interdisciplinary assessment
- Individualised treatment planning, advice and monitoring
- Rehabilitation
- Ongoing maintenance of drug and other therapies
- Education for patients and carers
- Training and support for local Healthcare Professionals
Referrals are currently welcomed for patients over 65 years of age. Referring practitioners are encouraged to refrain from pre-treating patients.
Personnel
- Dr William Gilchrist, Consultant Physician
- Paul Lochrin, PD Nurse Specialist
Clinic Details and Contacts
Clinics are held at the Day Hospital at Drumchapel Hospital on Wednesday afternoons. A monthly pilot clinic at Clydebank Health Centre is held on Tuesday morning.
Referrals should be made to the clinic secretary. Target waiting time for new patients is 6 weeks from referral.
Paul Lochrin can be contacted for information and ad hoc advice regarding aspects of PD.
Paul Lochrin - Telephone: 0141 211 6012 - E-mail: paul.lochrin@northglasgow.scot.nhs.uk
Clinic Secretary - Telephone: 0141 211 6177
Dr William Gilchrist - Tel: 0141 211 6021
North-East Glasgow Service
Parkinson’s Disease clinic opened in May 2003, based at Lightburn Hospital Out Patient clinic.
Personnel
A PD Nurse Specialist is being recruited.
Clinic Details and Contacts
Referrals to the clinic should be made to Dr Jennifer Burns / Prof David Stott: department of Medicine for the Elderly, 5th Floor, Centre Block, Glasgow Royal Infirmary: Tel: 0141 211 4908 - Fax: 0141 211 1121 - Email: burns.jennifer@northglasgow.scot.nhs.uk / d.j.stott@clinmed.gla.ac.uk
The clinic runs every two weeks and it is anticipated that there will be a wait of no more than 4-6 weeks for new appointments.
South-East Glasgow Service
The Parkinson’s Disease service is based at Mansionhouse Unit, Victoria Infirmary. The focus is on multidisciplinary and patient-centred care. The service was awarded a Chartermark in 2000.
Referrals are taken for patients of all ages. The aims of the service are:
- Accurate diagnosis and assessment
- Treatment planning and monitoring
- Rehabilitation and maintenance
- Education and information for patients, carers and health professionals
Referrals are welcomed for patients of all ages, preferably prior to any treatment being commenced.
Personnel
- Dr.David Stewart, Consultant Physician
- Sister Elizabeth Craig, PD Nurse Specialist
- Glynis Anderson, Occupational Therapy
- Anne Currie, Physiotherapy
- Gillian Wilson, Speech Therapy
- Jacqui Duffin, Clinic Nurse
Clinic Details and Contacts
Clinics run at the Day Hospital at Mansionhouse Unit on Tuesday mornings (Medical) and Wednesday mornings (Nurse led).
Referrals to the clinic should be made to the Clinic secretary. New patients will be seen within six weeks of referral. Sister Craig should be contacted for information and advice on any aspect of PD.
Sister Elizabeth Craig: Tel: 0141 201 6319 - Page: 4076 - Email: Elizabeth.Craig@gvic.scot.nhs.uk
Clinic Secretary: Tel: 0141201 6108 - Fax: 0141 201 6305
Dr. David Stewart : Tel: 0141 201 6126 - Email:David.Stewart@gvic.scot.nhs.uk
South-West Glasgow Service
Aims of this service are:
- To provide a local diagnostic, therapeutic and interdisciplinary service to patients with tremor and Parkinsonian Disorders.
- To provide support and education for parents, carers and other health care professionals.
Personnel
- Dr. Graeme J.A. Macphee, Consultant Physician
- Carol Vennard, SRN, Parkinson’s Disease Nurse Specialist
- Anne Currie, Senior Physiotherapist
- Carol Hopkins, Senior Occupational Therapist
- Nicola Woodside, Senior Speech Therapist
- Catherine Wham, Dietician
- Access to other disciplines as required.
Clinic Details and Contacts
This is a weekly clinic and / or day hospital sessions. Waiting times for appointment are approximately 3-4 weeks. Referrals to the clinic should be made to Dr Macphee’s Secretary or Carol Vennard, Parkinson’s Disease Nurse Specialist. Tel: 0141 201 2453.
Department of Neurology - Southern General Hospital
This is a joint clinic for Glasgow and West of Scotland Patients with Parkinson’s disease and tremor disorders.
Emphasis is placed on:
- Younger patients (treatment strategies varies according to age)
- Structural and functional brain imaging (to improve diagnostic accuracy)
- Use of new drug treatments in development
- Patient therapy compliance / concordance (to ensure optimum therapy response)
- Assessment and follow-up of neurosurgical intervention (for advanced patients with severe tremor or dyskinesia).
Personnel
- Dr. Donald Grosset, Consultant Neurologist
- Dr Graeme Macphee, Consultant Physician
- Tracy Jones, Parkinson’s Disease Nurse Specialist
- Carol Vennard, Parkinson’s Disease Nurse Specialist
Clinic Details and Contacts
Current waiting time for new patients is 6 weeks.
Referrals to the clinic should be made to Dr Grosset's secretary, Rosemary Tracey: Tel: 0141 201 2478 Fax: 0141 201 2510 Email: rosemary.tracey@sgh.scot.nhs.uk
Proposed Service Developments
- Completion and roll out of clinical information system; establishing reporting system.
- Completion of ‘database’, incorporating epidemiological data for patients with Parkinson’s Disease, epilepsy and multiple sclerosis.
- Development of patient information systems, including provision of copy letters.
- Development of a rehabilitation service for people with Parkinson’s Disease.
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