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Migraine: A Burden on Patients, And a Strain on the NHS

09/02/2015 13:55 GMT | Updated 06/04/2015 10:59 BST

2015-02-05-Headache_opt.jpg If like me, you suffer from migraine you are not alone - a huge 6.7 million people in England suffer from them. According to the World Health Organization migraine is the leading cause of neurological disability, yet many people don't realise what a debilitating condition it can be, and one that puts a big strain on our health economy too.

Four percent of adults will visit their GP each year for headache or migraine and the cost to the NHS is over £1 billion a year. This excludes related costs for conditions like anxiety and depression, and the estimated £5 billion cost to our economy. No small problem.

During my first attack my left side went numb and left me thinking I had had a stroke; with no headache I had no clue that the culprit was migraine. An out-of-hours GP sent me straight to accident and emergency.

Visits to A&E are not unusual for people with migraine or headache - in fact it is the most common neurological reason for A&E attendance, normally because they can't get the help they need elsewhere.

My migraines began to affect my balance, speech and cognition every day: I staggered about the house in a confused haze, walking into door frames and worrying about how I would do the simplest things. The emotional strain was enormous and eventually I had to stop full-time work. While such frequent and severe migraines are unusual, 80% of migraineurs have disabling attacks that interfere with work, home and social life to some degree.

After seven years my migraines are now thankfully under control. An excellent neurologist keeps tabs on me, and while the treatment is first class, appointments are frequently postponed, clinics are strained by overbooking, and patients can wait hours for their turn.

On one particularly stressful occasion a postponed appointment meant I couldn't get my regular medication, and I was directed by healthcare staff to present at A&E to access it. Such a totally avoidable crisis situation is ludicrous - stress is the last thing a patient needs, and expensive A&E visits are the last thing the NHS needs either particularly when A&E is under unprecedented strain. Aware of a buckling system, I felt loathed to become a needless statistic in A&E when my problem could and should have been dealt with effectively elsewhere.

Services simply aren't working efficiently: neurology clinics are overloaded, GPs are struggling, and A&E is bearing the brunt.

Some areas have solved the problem by implementing dedicated headache clinics headed up by GPs with a special interest in headache, who do a great job at reducing referrals to the neurology clinic. These types of services have adopted specially designed local headache pathways, supported by the neurology clinic when needs be, and show just what is possible when other health professionals like GPs, specialist headache nurses and opticians get involved in managing patients effectively away from the neurology clinic.

I was lucky enough to access one of these types of clinics and it was an absolute pleasure to get the expert help I needed so easily. If the whole of England operated on this model the gains would be enormous: patients like me would all have an accessible local 'headache' GP they could call on for reassurance and a smoother ride through the system, and the NHS would save considerable amounts of money which could be reinvested elsewhere.

This article originally featured on the author's blog, The Mehta Analysis