020 The headache hub: a multidisciplinary diagnosis and management resource for GPs

The need to improve care of patients with headache prompted development of a new model in South West London. The Headache Hub, piloted at St George’s University Hospitals NHS Foundation Trust, consisted of a multidisciplinary team; Consultant Neurologists, GP with Extended Role and Allied Health Professionals. The Hub triages new GP referrals and offers an online migraine group clinic (engaging patients through shared medical appointments in a group setting).

Between April-December 2021, 171 GP referred patients were seen, of which 96 (48%) had Chronic Migraine (CM), 36 (18%) High Frequency Episodic Migraine and 23 (12%) Low Frequency Episodic Migraine patients. CM patients reported 31 ED attendances in the prior year and 53% had the highest unmet needs, HURT 8 (Headache Under Response to Treatment) score 17-24. Real-time data on waiting times enabled clini- cians to make informed follow up choices.

Triage to "consultant only" occurred in 56% of referrals, enabling a subsequent reduction in consultant caseload to address tertiary headache waiting lists. Patient satisfaction was high (80%) and group clinic feedback highlighted beneficial shared experiences; "super productive and made me feel not so alone in a challenging time".

This model is being considered at other secondary care hospitals in the region.