Parkinson's Disease

Overview

See the CKS Parkinson's Disease guidelines for advice on management of suspected and confirmed Parkinson's Disease.

Consider reviewing the Tremor page on Remedy if appropriate.

The Parkinson's UK website also has information and support for patients and a professional resources section includes links to useful information and learning hub.

Bristol Health Partners have set up a Movement Disorders Health Integration Team (HIT) who are working together to improve treatment and support for people with Parkinson's and other movement disorders in the Bristol area and further afield. 

Referral

Suspected Parkinson's Disease

If Parkinson's Disease is suspected the following options for referral are available: 

Care of the Elderly Movement Disorder Clinics available via eRS - see Movement Disorders page:

• UHBW Care of the Elderly Parkinson's and Movement Disorder Clinics accept referrals for patients aged 40 and over with suspected Parkinson's Disease.
• NBT Care of the Elderly Parkinson's Disease and Movement Disorder Clinics accept referrals for patients aged 70 and over with suspected Parkinson's Disease.

Neurology via eRS

• Parkinson's Disease and Movement Disorders - Neurology - Southmead - see their Movement Disorder Service page.

The BNSSG Referral Service suggest that most referrals can be sent via eRS to the Care of the Elderly Teams at either UHBW and NBT. This is often a quicker route to diagnosis and treatment than the neurology service which usually has longer waits. Onward referral to a neurology service can be made by these teams if necessary.

If a neurology service is specifically required then please state clearly in the referral.

Confirmed Parkinson's Disease

Patients with a known diagnosis of Parkinson's Disease who need support or advice can be referred to the Community Parkinson's Service - see details of the service below:

Community Parkinson's Service

Who is the service for?

• For individuals with a diagnosis of Parkinson’s, or any associated condition (parkinsonism type illness ie MSA, PSP, CBD); diagnosed by a specialist consultant
• Patients who are registered with a GP in the Bristol, North Somerset, South Glos (BNSSG) area (incl Weston & Worle)

 Exclusion criteria

• Dystonia as the primary diagnosis
• Where dementia symptoms are the primary concern; please refer to Dementia Wellbeing Service on 0117 904 5151 (bristoldementiawellbeing.org)
• Medically unwell patients (ie infection); if acutely unwell, please refer to the patients GP. Urgent Care Services may be able to assist via SPA on 0300 125 6789. If deterioration remains following end of medical treatment, consider referral to Parkinson’s Service at that point
• Where the primary need is a social issue – refer to local council (Bristol, North Somerset or South Glos)

What will the Parkinson’s Specialist Service provide?

• A comprehensive assessment of needs (including physical health, mental health and social care needs)
• Review PD medications and management of PD symptoms
• Information, advice and support for the person with Parkinson’s living in the community, including their carers, families and healthcare professionals involved in their care.

Current Services offered

• Telephone and e-mail access to the Parkinsons Specialist Service.
• Specialist patient assessment to look at the needs of each person with Parkinson’s their family and carers.
• Provision of Specialist Parkinsons Practitioner clinics in the community (across all areas)
• Partnership working with other healthcare professionals and voluntary services, involved in caring for a person with Parkinson’s.
• Support to monitor and review the effectiveness of Parkinson’s medication.
• Education to individuals, groups and multidisciplinary health and social care professionals to promote a greater understanding and awareness of Parkinson’s.

How can a person with Parkinson’s access the service?

• Initially by asking their GP or Consultant to refer them to the service
• Once referred into the service, the person with Parkinsons can self-refer into the service at any time using the contact details below:

Tel: 0300 125 5550

Email: sirona.parkinsons@nhs.net

 How can professionals refer to the service?

• Please complete the Parkinson’s Service Referral form and email to parkinsons@nhs.net

Neurophysiotherapy

Please see Physiotherapy section of Remedy for further details.

Complications of Parkinson's Disease

Difficulty swallowing medication can be an issue in these patients and local clinicians have produced Community guidelines for management of Parkinson's Disease pts with swallowing difficulties 2022

End-Stage Parkinson's Disease

CKS has some guideline on recognising and managing End-Stage Parksinson's Disease .

Hospice services may also be appropriate for support with end of life care.

Supporting patients deteriorating with Parkinson's disease (PD)

‘Framework for professionals supporting patients deteriorating with Parkinson’s Disease (PD)’. Co-produced by Consultants from NBT, UHBW and St Peter’s Hospice. Found on the Hospice website  Clinical Guidelines - St Peter's Hospice (stpetershospice.org).

For any queries, please use the St Peter’s Hospice 24/7 clinical advice line 0117 9159 430.

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.