Setting Up A Headache Clinic
This project has developed strategies for the creation of specialist headache clinics in primary care. For the successful management of headaches (chronic and acute), a partnership needs to be developed between the GP and the specialist physician. A new form of intermediate specialist care is now in development in the UK (and is encouraged by the new GP contract), the General Practitioner with Special Interest (GPwSI) service. GPs are encouraged to develop specialist services in certain disease areas and run their own clinics based in individual PCTs. The GP who is a member of MIPCA and has experience in headache management forms the ideal candidate to become a GPwSI in headache. MIPCA has worked with the Royal College of General Practitioners to develop a framework document for the GPwSI in headache service:
RCGP_headacheMIPCA, in concert with the lobbying group Headache UK has developed a framework for UK headache services:
- GPs and the new walk-in clinics deal with TTH and uncomplicated migraine using their own practice teams.
- Patients with chronic headaches, more complicated migraine and those with facial pain syndromes are dealt with by the GPwSI in headache, also located in primary care.
- Patients with more specialist, or more urgent medical needs may need to be referred immediately to a neurologist or headache specialist by the GP or GPwSIin headache. Such patients include those with suspected sinister headache, those refractory to repeated treatments and those with rare headache subtypes (e.g. the rare migraine and chronic headache variants). Some refractory patients benefit from referral to specialist pain management clinics, where group sessions and counselling can be made available, where necessary.
References
- Sender J, Bradford S, Watson D, Lipscombe S, Rees T, Manley R, Dowson AJ. General Practitioners with a Special Interest (GPwSI) in headache: setting up a specialist headache clinic in primary care. Headache Care 2004;1: 165–71.
- Department of Health. Guidelines for the appointment of General Practitioners with special interests in the delivery of clinical services: Headache. April 2003, www.doh.gov.uk/pricare/gp-special interests/headache.pdf
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