Parkinson’s Advanced Symptom Unit (PASU) South Tees Hospitals NHS Trust

Parkinson’s disease (PD) affects one in 100 people over the age of 65. In an ageing society, the number of people with the disease is expected to rise. The disease is characterised by motor fluctuations, postural instability, gait freezing and falls, in addition to mood disturbance, psychosis and dementia. All of these are key determinants of disability, quality of life and mortality.

Hospital outpatient clinics can struggle to meet the often complex needs of these patients. In Teesside, the Parkinson’s team has 1,000 patients under its care. They wanted to improve care for these patients and so introduced a novel outpatient service – the Parkinson’s Advanced Symptoms Unit (PASU). Run by South Tees Hospitals NHS Foundation Trust, it is staffed by a neurologist, a Parkinson’s disease nurse specialist, a community psychiatric nurse, a pharmacist, a physiotherapist, an occupational therapist and a therapy assistant.

PASU is a rapid access, community based, self-referral service for patients with advanced PD, and addresses both physical and mental wellbeing – the first of its kind in the country.

It offers flexible scheduling of patient slots, depending on clinical need. Detailed assessments are carried out by the team, without the time pressures of a normal clinic environment.  

Data from the first six months have demonstrated that PASU delivers a high quality service, that there have been improvements in patient quality of life, and an increase in patient engagement with health care. There has also been a reduction in unscheduled admissions to hospital for patients with PD, when comparing hospital admission data before the initiative and after six months.

Staffing of the unit has been the main challenge for the project, as well as turnover of staff. Close working with the mental health trust, and physiotherapy and occupational therapy leads, has been key to the success of the project. A service model for PASU has been agreed for a second year of the initiative.

This Innovating for Improvement project ran from the beginning of May 2015 until the end of July 2016.

Contact information

For more information about this project, please contact Dr Neil Archibald, Consultant Neurologist, South Tees Hospitals NHS Trust.