Neurology

There are an estimated 14.7 million cases of neurological disorder in the UK, with one in six people living with a neurological condition.

Conditions impact on all levels of the nervous system – from the brain to nerve and muscle – and there are more 600 conditions. These can be broadly categorised into sudden-onset conditions (such as meningitis); intermittent and unpredictable conditions (such as epilepsy); progressive conditions (such as Parkinson’s disease), and stable conditions with changing need (such as spina bifida).

Neurology care is largely outpatient-based, with 1.3m patients seen in outpatients in 2018/19.

In the context of high demand, the GIRFT report looks to address known variation in equity of access, aiming to ensure access to dedicated/specialist neurological services wherever a patient lives.

Dr Niranjanan Nirmalananthan

Neurology joint clinical lead

Consultant neurologist and group clinical lead for specialised services at St George’s Epsom and St Helier Hospitals Group.

Dr Nirmalananthan is also NHS England’s National Clinical Director for neurology, in which role he chairs the NHS England Specialised Neurology clinical reference group (CRG) and co-chairs the National Neurosciences Transformation Board.

He is a consultant neurologist at St George’s Hospital, with subspecialty interests in neuromuscular disorders and headache disorders. He is also group clinical lead for specialised services at St George’s Epsom and St Helier Hospitals Group, part of Epsom and St Helier University Hospitals NHS Trust.

He was previously clinical director for neurosciences at St George’s Hospital from 2019-2023 and before that clinical lead for neurology and neurophysiology at St George’s from 2016-2019. He set up the South West London and Surrey Neurosciences Network in 2020, leading regional transformation in the sector. He co-chaired the network until 2025.

He is an honorary senior lecturer in neurology at City St George’s, University of London.

Dr Adrian Wills

Neurology joint clinical lead

Consultant neurologist and head of services for outpatients and therapies at Nottingham University Hospitals NHS Trust

Adrian is a former GIRFT clinical ambassador and advisor to the UEC programme.

He was appointed as consultant neurologist in Nottingham in 1998 and more recently he has branched out into acute medicine, maternal medicine and acute stroke. He is currently a consultant neurologist and head of services for outpatients and therapies at Nottingham University Hospitals NHS Trust.

He was previously a clinical lead for the ebrain online neuroscience e-learning resource and has produced a number of educational podcasts as well as recorded interviews with a number of leading neurologists, neuroscientists and neurosurgeons.

Dr Geraint Fuller

Former clinical lead and national report author

Consultant neurologist at the Gloucestershire Hospitals NHS Foundation Trust (Gloucester Royal Hospital)

Dr Fuller has worked as a consultant neurologist in Gloucester since 1994. He has an interest in general neurology and neurological education.

He has been Chair of the Specialty Advisory Committee for neurology that oversees neurological training in the UK, and was president of the Association of British Neurologists from 2013 to 2015.

He retired from his GIRFT role in 2025.

Useful information

Specialised neurology services (adults) (Aug 25)
This service specification covers the provision of specialised neurology services (adults) and outlines how they work alongside core neurology services to deliver care using a population health approach.
Neurology Service Transformation Programme – Futures
The Neurology Transformation Programme has developed a range of resources to support ICBs to develop an integrated neurology delivery model. These 7 resources are aimed at commissioners, clinicians and transformation leads in ICBs and NHS trusts. They can be found here, in the Neurology Service Transformation Programme workspace on Futures.
GIRFT neurology methodology and initial summary of regional data
The document describes the methodology used for the GIRFT regional presentations and the way services are provided to patients with neurological disorders across England. It also highlights some of the key findings from regional analysis.
Accompanying workbook to GIRFT neurology methodology (spreadsheet)
Background information upon which the methodology is based.

GIRFT national report aims to improve access to both inpatient and outpatient neurology services

The new national report for neurology from the Getting It Right First Time (GIRFT) programme focuses on improving access to care for patients with neurological disorders across England and ensuring services are available close to patients’ homes where feasible.

The GIRFT report highlights differences in how services are delivered and offers an unprecedented opportunity to share successful initiatives between trusts to improve patient services nationally.

Some of the historical mechanisms for funding and resourcing neurology services have contributed to these imbalances in neurology services and the introduction of integrated care boards (ICBs) will provide an opportunity to realign the neurology services to match the needs of their populations.