The soaring number of people on waiting lists for neurological services is due to “ongoing critical understaffing” in the area and general under-resourcing, according to a new report.Research by the Neurological Alliance of Ireland (NAI) has found that over a five-year period, the number of people on out-patient department waiting lists for a first-time appointment to see a neurologist increased by 40%, meaning that by last year, 22,649 people were waiting for an appointment.At the same time, multidisciplinary teams are understaffed in all 12 neurology centres and are entirely unavailable in some regions, while the report found that neurological clinical nurse specialists represent only 44% of what is required.
Referring to what the report describes as critical understaffing, Magdalen Rogers, NAI executive director, said: There are 800,000 people living in Ireland with a neurological condition. 
The lack of commitment to address serious gaps in staffing continues to impact significantly on outcomes for neurology patients.
The report also found that neurorehabilitation services have deteriorated further since poor levels of access were reported in 2015. 
Ireland has less than half the number of inpatient rehabilitation beds required for the population and a dearth of long-term community supports at every level, from community multidisciplinary teams to day services, vocational supports and transitional and long-term residential facilities.
A lack of adequate resources also extends to the not-for-profit neurological sector, which the NAI said plays an important role in the delivery of neurological care services such as specialist nurses, neurorehabilitation services, respite care, day services, and residential care, and counselling support for people with a neurological condition and their families.
The NAI said successive funding cuts and the collapse of fundraising due to the Covid-19 pandemic has badly impacted those services.
The report is launched to mark the start of Brain Awareness Week and also found that MRI access is very poor, with waiting times in years for non-emergency cases not uncommon. Cork, Galway, and most of the hospitals in Dublin reported waiting times of more than ina year in 2020.
One of the people interviewed for the report said: “We really need a dedicated rehabilitation facility for patients with severe brain and spinal injuries in Munster. Only a very small percentage gain access to the National Rehabilitation Hospital for rehabilitation.
Access to post acute inpatient neurorehabilitation services was also described as “very limited” for most facilities around the country.
Increased investment and capacity in the system are among the recommendations made in the report, which states: “There is a need to address critical gaps in multidisciplinary staffing across neurology services through continued year on year investment in staffing to increase the numbers of clinical nurse specialists, neuropsychologists and other multidisciplinary staff which continues to fall far below what is required.”
Ms Rogers said: Two years on from publication of the implementation framework and a decade since the neurorehabilitation strategy was first launched in December 2011, only two additional community neurorehabilitation teams have been partially funded and there has been no new investment to develop community neurorehabilitation supports. 
“Despite the redevelopment of the National Rehabilitation Hospital, fewer than 30 new neurorehabilitation beds have been brought into the system. All of this is worsened by curtailment of existing services due to Covid-19 restrictions.”

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