British Paediatric Neurology Association
Notes on building a business case for an additional Paediatric Neurologist

Things to include in argument:-

• Number of additional colleagues required to provide 24 hour on-call service/advice service to meet European working time directives.

• With secondary tier colleagues in general paediatrics identify a number of additional colleagues required to bring the number of outreach clinics to satisfactory level, to include the facility to review children with intractable epilepsy in those districts at least twice a year.

• To identify number of colleagues required to develop sub-specialty interest and responsibility within neurology (this may involve liaison and planning with a contiguous regional centre) – to include initially quaternary epilepsy, neuromuscular, neuro-oncology.

• Subsidiary arguments to include in a business case are: increased amount of supervision time required for trainees in assessment and appraisal, mentoring distance learning course, monitoring own CPD requirements along with time taken to go through the appraisal process.

• Inpatient activity per consultant. Elective, non-elective day cases.

• Outpatient activity, new and old.

• Waiting times.

• Any feedback from patient survey audit on quality.

The following documents are held by Deanery Advisers:

• BPNA document on activity authored by Mike Pike.

• BPNA Clinical Network document edited by Richard Newton.

• BPNA Manpower 2002/2003 authored by Colin Ferrie.

• A Guide for Purchasers of Tertiary Services for Children with Neurological Problems, January 1998, BPNA. Authored by Colin Kennedy.

• Specialist Service Commissioning document. 2000.

• Make an initial case (one side A4) to your Clinical Director and get his support to forward it through the Medical Director to your Trust's annual business planning process (usually runs April to April with submissions collated in the autumn).

• In parallel, start working with district paediatricians in your region to get their local data on unmet need. Recruit their help to make a submission to their local lead Primary Care Trust for children's services. This lead Trust will have a Director of Public Health. Arrange a meeting and seek advice on how best to present the case.

• Similarly for local strategic health authority, which has a specialist service commissioning role. SHAs and PCTs are relatively new in their inception, personnel are new and local processes are just being devised. The earlier they become aware of paediatric neurology services the better.