title: Promoting continuity of care for people with long-term neurological conditions: the role of the neurology nurse specialist.
abstract: OBJECTIVE
  To identify service models that provided care co-ordination for people with long-term neurological conditions in the U.K.
  
  
  BACKGROUND
  The successful management of long-term neurological conditions needs sophisticated management across several health, social care and other service boundaries, as well as involvement of people with long-term neurological conditions and their support network. Yet, fragmentation of, and limited access to, support has been evident for over 20 years.
  
  
  METHODS
  This study employed a mixed-method approach, including a systematic review, qualitative case studies and a quantitative national survey. This paper reports findings from the qualitative case study element of the research.
  
  
  METHODS
  In-depth (qualitative) case studies were conducted in six neurology 'service systems' in the U.K. representing geographic and demographic diversity. The research took place between November 2007-May 2008. The concept of 'continuity of care' was used as a framework for our case studies. Qualitative methods, including telephone and face-to-face interviews, were used to explore people's experience of continuity of care. Data were managed and analyzed using the Framework technique.
  
  
  RESULTS
  Neurology nurse specialists were able to contribute to all elements of continuity of care for people with long-term neurological conditions.
  
  
  CONCLUSIONS
  Their specialist knowledge about the condition and local services, flexibility, co-ordinating role, and their holistic and collaborative approach to practice, are key factors in nurse specialists promoting continuity of care. Nurse specialists exist in many different clinical areas and in many countries. Findings about the importance of their role in promoting continuity of care have important implications for U.K. and international policy and practice.
authors.affiliation: Social Policy Research Unit University of York, Heslington, York, UK. fiona.aspinal@york.ac.uk
authors.forename: Fiona
authors.initials: F
authors.lastname: Aspinal
authors.forename: Kate
authors.initials: K
authors.lastname: Gridley
authors.forename: Sylvia
authors.initials: S
authors.lastname: Bernard
authors.forename: Gillian
authors.initials: G
authors.lastname: Parker
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003266:Continuity of Patient Care; D019468:Disease Management; D004739:England; D006801:Humans; D008134:Long-Term Care; D009422:Nervous System Diseases / Q000451:nursing*; D009720:Nurse Clinicians; D024802:Nurse's Role; D019982:Organizational Case Studies; D036301:Qualitative Research