A specialist recruited to support people living with Parkinson's disease in the Vale of York has proved a huge success in the pioneering role.

Gill Clark took on the mantle of Parkinson's Nurse Specialist, working with patients registered with 14 GP practices in the South Hambleton and Ryedale, Tadcaster and Rural Selby and Selby Town Primary Care Networks, in July 2019.

NHS Vale of York Clinical Commissioning Group (CCG) had agreed to a proposal by Parkinson's UK for the charity to fund the role for two years – and now, following an evaluation of Gill's impact, the role has been made permanent by the CCG.

Gill offers expert care for people who have been diagnosed with Parkinson’s Disease as well as their families and carers. She has specialist experience, knowledge and skills and is able to support them in a variety of ways, including referring them to appropriate services and therapies, working with GPs and hospitals and advising on medication.

The post was designed to address inequalities faced by the communities served by these Primary Care Networks, including access to transport and distance to services. The average distance to hospital for patients in South Hambleton and Ryedale was found to be more than 18 miles, while these three areas were also found to have high numbers of people living with Parkinson's.

Parkinson's disease is a condition in which parts of the brain become progressively damaged over many years. Symptoms include body tremors, slow movement and stiff muscles, while those living with the condition can also experience depression and anxiety, balance problems, memory problems and various forms of dementia.

An engagement process with patients, their carers and stakeholders including GPs showed the CCG that the role provided an important source of support, and that many people find Gill friendly and approachable and her services easy to access. She can provide care in a variety of locations including patients' homes, care homes and nurse-led clinics.

Gill said: "I've got 30-plus years' experience in community nursing. I've looked after quite a few Parkinson's patients – it's one of those conditions that's very complex and I felt I wanted to specialise in something. I felt with all my experience I could help the patients.

"I can get referrals from GPs, from consultants. I work very closely with the consultants at all the different hospitals – Scarborough, York, some of the Leeds ones and as far as Newcastle. I've got access to York Hospital's systems and all 14 GP surgeries, and I can look on the systems to see who the Parkinson's patients are, ring round, make sure they're alright, see if there's anything I can do to help.

"From there I can refer them on to people like speech therapists, physios, occupational therapists. I work very closely with the mental health team because mental health can be a big problem with Parkinson's."

Feedback

Feedback from stakeholders, as recorded in the CCG's evaluation report summary, includes:

"An excellent resource that helps when we need it and we always appreciate her knowledge and experience."

"Very advantageous. Easy to contact. Very knowledgeable. She is a very good link to my Parkinson’s Consultant."

"She can be accessed very quickly over the phone, she is available when I need to talk to her, sometimes I will leave a message and she will call back."

"She is very easy to contact, if I start to worry about my symptoms I would get in touch."

Dr Paula Evans, Clinical Director of South Hambleton and Ryedale PCN, said: "Parkinson’s disease care has historically been patchy and hasn’t adequately holistically identified or met patients' and their carers’ needs. The model of care required these needs to coincide with scheduled reviews.

"Gill’s work has in a short period of time turned this around. Her accessibility, responsiveness and ability to consider the whole person has been key. She is empowered to refer directly to other healthcare professionals, with the link to mental health and dementia services being particularly important. Her work has had such an impact and we’re delighted she is now able to further develop within our communities."

Dr Helena Ebbs, a GP at Pickering Medical Practice and a member of NHS Vale of York CCG's Governing Body, said: "Having a community-based Parkinson’s Nurse working with us has been a fabulous improvement in the way we deliver care to our patients with Parkinson’s, particularly for those who are frail or living with multiple health conditions.

"Changing the way we work has meant that our patients receive care when they need it, close to home and coordinated with their GP practice. This has joined up care, helped care be more responsive and allowed us to support the non-medical aspects of chronic ill health much more effectively."

The NHS Vale of York evaluation report summary can be found here.

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