Neurology model in north-west will increase risk of physician burnout

The hub-and-spoke model of delivering neurology services is “not working well” in the north-west due to insufficient staffing and resourcing, according to an internal review by the Saolta University Health Care Group.

Neurology services in the west are provided by Galway University Hospital (GUH). The north-west is covered by Sligo University Hospital (SUH), which also delivers outpatient clinics at Letterkenny University Hospital (LUH). The neurology review found both services are under-resourced.

“While the commitment of the Sligo consultants is recognised and commended, the model is not sustainable and will increase the risk of physician burnout in the coming years,” stated the review, which is dated October 2024.

It recommended two consultant neurologists be appointed to LUH which would lead to a total of five consultants covering the north-west.

Another recommendation is that Mayo University Hospital (MUH) develop its own neurology service on-site “as is warranted by the population numbers”.  This would include the appointment of two consultant posts, with the review noting the model of care requires that no unit has a single neurologist.

The resourcing of the neurology services would require adequate numbers of NCHDs, nurses, health and social care professionals, and administrators, it stated. Space for outpatient clinics and infrastructural deficits continued to pose “significant challenges for all the sites”.

A Saolta spokesperson said it welcomed the recent announcement of €2 million to expand national neurology services in 2025. A consultant neurologist and “clinical support member” have been approved for MUH and LUH.

Saolta’s neurology review “sets out our vision to provide state-of-the-art specialist neurology services across the region”.

“The services provided should be based on best practice and aligned to the national model of care and associated strategies. Specific to our region is the need for the model 4 neurology services to strengthen the access to consult and specialist services to the model 3 and model 2 hospitals in the region.

“Equally in the north-west, the two model 3 hospitals need to have neurology services on-site, which meets the needs of their catchment areas and which will provide the associated emergency care consults.”