NHS neurologist makes case for effectively prioritising different inpatient services
In an interview with The Parliamentary Review, Dr Ashwin Pinto, one of the UK’s leading neurologists, discusses his specialist plasma exchange clinic at the University of Southampton Hospital NHS Foundation Trust. This clinic, Dr Pinto believes, can teach the NHS something about prioritisation best practice when it comes to inpatient services; a lesson that becomes even more important to learn when one considers the impact of Covid-19.
The unprecedented outbreak of COVID-19 – the most devastating pandemic in the last hundred years – brings into sharp focus the limited capacity of the NHS to deliver high dependency and intensive care to critically ill patients.
Plasma exchange is a highly effective treatment for a range of neurological conditions including antibody-mediated neurological diseases such as myasthenia gravis.
At the Wessex Neurological Centre (University of Southampton Hospital Trust), we have established a plasma exchange service in response to a global shortage of intravenous immunoglobulin (IVIG), a common alternative treatment, and to recent evidence supporting plasma exchange in the treatment of devastating antibody-mediated central nervous system disorders such as neuromyelitis optica (NMO) and autoimmune encephalitis.
In many centres in the UK, plasma exchange is delivered in high dependency and intensive care units (ICU) through a catheter inserted into a large central vein, often requiring a lengthy in-patient admission. Advances in technology now allow patients to receive plasma exchange via peripheral veins and enable day-case (outpatient) treatment.
We have established a therapeutic plasma exchange service based on this day-case model where patients do not have to stay in hospital. The evidence from the Wessex Unit shows that this is a safe, effective treatment for patients and has resulted in saved neuroscience ICU bed days that are now available to treat other critically ill neurology and neurosurgery patients.
The UK will pull through this crisis, and, as we do, we must collaborate and learn from best practices to ensure the NHS is futureproofed with the most efficient solutions so that patients receive the vital care and support they need.
Dr Ashwin Pinto is one of the UK’s leading neurologists who has pioneered a specialist plasma exchange service at the University of Southampton Hospital NHS Foundation Trust.