National Headache Working Group

From the 1st April 2013, twelve Strategic Clinical Networks (SCNs) were introduced to the new NHS structures for England in April 2013. As part of the four new networks, the SCNs were tasked to improve services for people with neurological conditions.

In April 2014, it was agreed nationally that SCNs would initially focus on three work streams, including headache.

A national headache working group was established with the following objectives:

  • To identify the current headache pathways
  • To share best practice
  • To develop and agree a common integrated care pathways adaptable for local service provision

Some facts:

  • Headache is common, costly and disabling (World Health Report, WHO 2001).
  • 4% of adults consult a GP each year for headache (Latinovic et al. 2006).
  • Whilst tension-type headache is the most common form in the community, the most frequent headache seen in general practice is migraine.
  • 6.7 million people are living with migraine in England (Neurological Alliance, 2014),
  • 80% have disabling attack interfering with work, home or socialisation (Steiner 2005).
  • The direct cost to the NHS is estimated at £1 billion per year (Ridsdale 2007), with GP consults and medications of £468 per patient per year.
  • The cost of headache to the economy in terms of lost productivity was estimated at £5 billion.
  • Ninety seven per cent of headache is managed in primary care (Latinovic et al: 2005)
  • 70% of GP consulters for headache receive no specific diagnosis (Kernick el al: 2008).

Across Thames Valley the total hospital admissions and costs for headache have increased over the past four years. In 2012/13 total costs for those with a primary diagnosis of headache across the SCN area were £2,016,691 and for those with a secondary diagnosis were £5,008.805. The total cost burden to the Thames Valley SCN area was just over £7 million.

Decision to review headache:

  1. service provision is variable;
  2. headache patient pathways are frequently not well delineated;
  3. patient experience is poor
  4. costs for headache services are high

 Priority areas for change

  • Developing integrated care pathways and models of care (quality outcome 1)
  • Improving diagnosis (quality outcome 2)
  • Improving on-going care for those with a diagnosis of headaches to prevent presentation to Emergency Departments (EDs) (quality outcome 3)
  • Reviewing the use of drugs (quality outcome 3)
  • Improving self-care / self-management (quality outcome 4)

 Useful links:

SCN Headache Report Draft V1 25-7-14 (PDF)