3176 Disparities in Parkinson's service provision for those living in a rural area of North West England

Abstract

Introduction As part of an Idiopathic Parkinson’s disease (IPD) prevalence study, electronic records were identified for 721 individuals living in North Cumbria under the care of the local specialist service. This study aimed to understand how individuals access services, with a view to identifying trends and barriers. Methods An electronic record search was performed to identify frequency of contact with a doctor and Parkinson’s nurse specialist (PDNS). Contact within the last three, six or 12 months, and whether this was via telephone or face-to-face was detailed. We recorded contact with tertiary referral services for consideration of advanced therapies. Rural areas were defined as living in a settlement of less than 10,000 people, and most and least deprived areas, defined as the lowest five and highest five deciles of deprivation retrospectively. Results In total 93.1% had contact with a specialist within the last 12 months. The number receiving contact from a PDNS within the last six months was 194 (26.9%), lower than seen nationally. Only 23 (3.2%) of this population were receiving/considered for advanced therapies. There was no difference seen in service contact between rural and urban areas. Numbers in the most deprived areas were statistically significantly more likely to not have had service contact in the last 12 months compared to the least deprived areas, 37 (74.0%) (95% CI 61.8–86.2) compared to 13 (26.0%) (95% CI 13.8–38.2). There were statistically significantly fewer numbers with face-to-face PDNS contact in the most, compared to the least deprived areas, 48 (38.4%) (95% CI 29.9–46.90) compared to 77 (61.6%) (95% CI 53.1–77.1). Conclusion Greater disparities in service contact were seen between the most and least deprived areas, rather than living in the most remote or rural areas. It is hoped results will inform quality improvement work to improve equitable service provision throughout North Cumbria.