Quality standard
Quality statement 5: Functional neurological disorders in adults
Quality statement 5: Functional neurological disorders in adults
Quality statement
Adults diagnosed with a functional neurological disorder are supported to manage symptoms that are a part of the disorder in non-specialist care.
Rationale
Adults with symptoms that occur as part of a functional neurological disorder can benefit from support and management in non-specialist care. These symptoms may include fatigue, difficulties with concentration, difficulties with movement, recurrent dizziness, recurrent limb or facial weakness, memory problems, and numbness and tingling. Non-specialist care can provide accessible reassurance and information on the nature of the symptoms and their fluctuation over time, advice on how to manage them, offers of psychological support when appropriate, and signposting to other sources of support. If new symptoms are identified, the person should be referred promptly for neurological assessment.
Quality measures
Structure
Evidence of written clinical protocols to ensure that adults with a functional neurological disorder have symptoms that are a part of their condition recognised and are supported to manage them in non-specialist care.
Data source: Local data collection, for example local audit of patient records.
Outcome
The proportion of adults diagnosed with a functional neurological disorder satisfied with symptom management support from non-specialist care.
Numerator – The number in the denominator who are satisfied with symptom management support from non-specialist care.
Denominator – The number of adults diagnosed with a functional neurological disorder.
Data source: Local data collection, for example patient surveys.
What the quality statement means for different audiences
Service providers (such as primary care services, secondary care services and neurology departments) ensure that adults with a functional neurological disorder are supported to manage their symptoms in non-specialist care, or are referred for neurological assessment if they present with new signs or symptoms.
Healthcare professionals (such as GPs, neurology specialists and nurses) are aware that adults with a functional neurological disorder can be supported to manage their symptoms in non-specialist care, with referral for neurological assessment if they present with new signs or symptoms. They are aware that people who experience dizziness, recurrent limb or facial weakness, memory problems, and numbness and tingling as part of their functional neurological disorder can be managed outside of specialist services.
Commissioners (such as clinical commissioning groups and NHS England) ensure that they commission services that support adults with functional neurological disorders to manage the symptoms associated with their disorder, and refer them for neurological assessment if they present with new signs or symptoms.
Adults with a functional neurological disorder are given support to manage the symptoms that are a part of their disorder by healthcare professionals in non‑specialist care settings. They are referred for assessment by a specialist if they develop new symptoms that are not a part of their diagnosed disorder.
Source guidance
Suspected neurological conditions: recognition and referral. NICE guideline NG127 (2019), recommendations 1.2.8, 1.7.7, 1.8.2 and 1.10.7
Definitions of terms used in this quality statement
Functional neurological disorder
A condition in which people experience neurological symptoms in the absence of any identifiable causative physical or structural abnormality. [NICE's guideline on suspected neurological conditions: recognition and referral]
Non-specialist care
Care delivered by a professional other than a neurology specialist. This may include GPs, occupational therapists, physiotherapists, social care and mental health professionals, and third-sector workers. [NICE's guideline on suspected neurological conditions: recognition and referral and expert opinion]