A new GP with special interest headache service: observational study.

BACKGROUND There is poor access to neurology services for patients in the community. AIM 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. DESIGN OF STUDY New service provision and evaluation by a questionnaire survey. SETTING General practice and hospital neurology service in inner-city London. METHOD 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. CONCLUSION GPwSI services can satisfy the needs of patients with similar headache impact at costs that are lower than those for secondary care services.