Improved NHS migraine care to save thousands of hospital stays

Headache and migraine sufferers will benefit from better diagnosis and care as part of the NHS Long Term Plan to improve local health services, avoiding up to 16,500 emergency hospital admissions every year.

Health chiefs and other experts believe that the greater use of ‘headache diaries’ and fast access to specialist advice for family doctors will improve the quality of life of millions and reduce pressure on frontline services.

Around 10 million people aged 15-69 in the UK suffer from migraines, which are classified as a disabling illness, while headaches are amongst the most common neurological reasons for attending A&E.

The number of admissions to hospitals in England for headaches and migraines has increased by 14% over the last five years, NHS Digital data shows, from 95,548 emergency admissions in 2014/15 to 108,711 emergency admissions in 2018/19.

At the same time, around 2.5 million primary care appointments are linked to headaches and migraines, around 100,000 of which are referred to hospital for further assessment.

In total, it is estimated that the NHS spends around £150 million per year on treating migraines and £250 million on care for headache sufferers.

The cost to the wider economy is even higher, with around £4.4 billion a year lost to three million migraine-related sick days.

In response, the NHS is rolling out a new toolkit to help local health groups understand the scale of the problem in their area and roll out tried and tested solutions which improve services for patients, and free up money and staff time which can be reinvested in better care.

Hugh McCaughey, NHS National Director for Improvement, said: “Headaches and migraines can place a heavy burden on sufferers, the NHS and the wider economy, but we know that there are local health services which are doing really well in meeting people’s needs early in the community, and therefore reducing the need for hospital care.

“As they work with staff, patients and local partners to implement the NHS Long Term Plan, this initiative will provide all local NHS leaders with the information and proven ideas they need to deliver high-quality headache and migraine services to every communities.”

Developed by clinical experts in the NHS and the Neurological Alliance, the NHS RightCare Headache and Migraine Toolkit could help prevent 16,500 emergency hospital admissions every year if every local health group matches the performance of the best-performing areas with similar populations to their own.

This will be achieved through:

  • Improving the identification and diagnosis of headache disorders in primary care;
  • Supporting better decision making on referring people to hospital;
  • Providing patients with the guidance they need to self-manage their condition after diagnosis, and;
  • Planning long-term care and treatment, including medication, in a more personalised way.

Practical steps in use in some areas of the country which should now be rolled out include using headache diaries for patients to help them record the frequency and pattern of their attack, and developing support hotlines for GPs and their teams to access specialist advice.

Those who need long-term care should also be given expert advice on avoiding attacks, including the risks and signs of medication overuse, as well as the chance to develop a personalised care plan that accounts for their work and lifestyle factors, as well as any additional health conditions and risks which may be playing a part.

NHS England expects the benefit to patients of improving the delivery of local headache and migraine services to include:

  • fewer unnecessary visits to both primary and secondary care
  • improved quality of life due to better control of headaches and migraines
  • better sleep, less restriction on daily activities and attendance at work

The rollout of the NHS RightCare toolkit is the latest action by the NHS to improve headache and migraine care, following the commitment last year to fund access to a hi-tech device that can ‘zap’ away ‘cluster’ headaches.

The handheld GammaCore gadget is being made available on prescription for the one in 20 people who do not respond to traditional treatments such as painkillers, oxygen or anticonvulsants.

The NHS-funded device can be carried around and, when someone feels like an attack is on its way, placed on the neck where it stimulates the vagus nerve, which can lead to a reduction of pain.

It is one of a number of new medical devices which are being made available as part of the NHS Long Term Plan to put cutting-edge treatments at the heart of people’s care, introducing proven and affordable innovations into the health service as quickly as possible.