Improving management of headache, migraine and chronic pain

The Elective Care Transformation Programme’s wave 5 100 Day Challenge ran from October 2018 to the end of January 2019, with neurology as one of the focus specialities. The programme used a structured innovation method that unlocks the knowledge and skills of frontline staff and service users to accelerate the pace of change across complex systems. Teams were challenged by their senior leaders to design and test interventions within 100 days to improve neurology services. Interventions were themed across the pathway to look at rethinking referrals, shared decision making and self-management support, and transforming outpatients.

Teams in North East Essex, Salford and South West Hampshire focused on improving the management of headaches and migraine. Improved referral pathways, provision of Advice and Guidance services for GPs and better access to community headache services contributed to reducing referrals to secondary care and waiting times for treatment. Liverpool chose to address chronic pain. The team trialled a community multidisciplinary team (MDT) and found the majority of referred patients could either be discharged to the GP with advice or were suitable for a community MDT appointment.

Learning from the neurology 100 Day Challenge has been collated in the neurology specialty handbook which covers an overview of tested interventions. The handbook, supporting webinars, case studies from pilot sites, further resources and useful information can all be found on the Elective Care Community of Practice online collaboration platform. You can become a member of the Community of Practice by emailing: