title: A new GP with special interest headache service: observational study.
abstract: BACKGROUND
  There is poor access to neurology services for patients in the community.
  
  
  OBJECTIVE
  To describe the training of GPs with special interest (GPwSI) in headache and the setting up of a GPwSI clinic in general practice, and report on a comparison with the existing neurology service in terms of case severity, patient satisfaction, and cost.
  
  
  METHODS
  New service provision and evaluation by a questionnaire survey.
  
  
  METHODS
  General practice and hospital neurology service in inner-city London.
  
  
  METHODS
  The intervention involved training GPs as GPwSIs and setting up a GP headache service. A questionnaire survey was conducted, measuring headache impact, satisfaction, and cost estimates.
  
  
  RESULTS
  Headache impact was not significantly different between the two groups of patients, referred to hospital and to a GPwSI. Patients were significantly more satisfied with the GPwSI service, particularly that the service was effective in helping to relieve their symptoms (89% versus 76%; adjusted odds ratio=7.7; 95% confidence interval=2.7 to 22.4). The cost per first appointment was estimated to be pound sterling 136, with pound sterling 68 for subsequent contacts. These are lower than costs for neurologist contacts.
  
  
  CONCLUSIONS
  GPwSI services can satisfy the needs of patients with similar headache impact at costs that are lower than those for secondary care services.
authors.affiliation: Unit of Neurology and General Practice, Department of Clinical Neuroscience, Institute of Psychiatry, King's College London, London. L.Ridsdale@iop.kcl.ac.uk
authors.forename: Leone
authors.initials: L
authors.lastname: Ridsdale
authors.forename: Jane
authors.initials: J
authors.lastname: Doherty
authors.forename: Paul
authors.initials: P
authors.lastname: McCrone
authors.forename: Paul
authors.initials: P
authors.lastname: Seed
mesh_terms: D000328:Adult; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D004739:England; D005194:Family Practice / Q000191:economics / Q000193:education* / Q000458:organization & administration; D005260:Female; D020773:Headache Disorders / Q000175:diagnosis / Q000191:economics / Q000628:therapy*; D006297:Health Services Accessibility / Q000191:economics / Q000458:organization & administration / Q000592:standards; D006801:Humans; D008297:Male; D009462:Neurology / Q000191:economics / Q000193:education* / Q000458:organization & administration; D017060:Patient Satisfaction; D015397:Program Evaluation; D012017:Referral and Consultation / Q000191:economics; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires