Heartbeat: Handling headaches – Clinical Nurse Specialist leads the way

March 28, 2020

A mild ache, thumping headache to debilitating migraine, we have all had them and the impact they have on your life can be anything from slightly irritating to life changing, however the work of a clinical nurse specialist (CNS) is changing the way we manage this common condition.

It’s not often you hear of a clinical nurse specialist who focusses on headaches, however the headache service had been offering headache clinics for the last 15 years and remains the only nurse led diagnostic service in the UK.

A significant proportion of neurology referrals at our Trust are headache related with upwards of 39 per cent of patients presenting with the condition. Likewise, it is the most common neurological problem presented at the emergency department.

The latest review in 2018 by the Work Foundation put the economic cost to the UK of migraine at 6.6 to 8.8 billion pounds per year, with 75 per cent of sufferers unable to work or function during an attack. 86 million working days are lost every year due to this condition and yet remains the most poorly funded of all the neurological conditions.

And if making waves in headache care at our Trust wasn’t enough, Julie has also been involved in providing expert knowledge to the ‘All-Party Parliamentary Group on Primary Headache Disorders’ taking her influence from a local and regional level to the national stage. On 25 March, Julie will be attending the launch of the next phase of the Work Foundation project in The House of Commons to raise awareness of good working practises for employers to support migraine sufferers. This will recommend self-management by patients, but also flexibility by employers to enable people to reduce the disability their migraine causes. Julie says “It is always rewarding and a privilege to attend these meetings, the building is fantastic to see but it also raises awareness of this much maligned condition.” NHS Right Care for England are also looking at developing pathways in which to improve patient care and have recently developed a headache tool kit to help with managing headaches better.

Currently Julie conducts six clinics and sees in the region of 2000 patients per year. In the downtime between clinics, Julie has not only completed Master’s in Chronic Pain Management but also works at UHB in the complex headache clinic one day per week. This has led to joint treatment protocols across the two trusts to ensure continuity of care across the region.

Headache nurses remain a rare commodity, when she started this role there were only 12. The current UK headache nurse group has 60 members, and is growing slowly but surely. Our second headache nurse here at SWBH has just been recruited and should be in post in the next few months. This will increase our capacity to see patients and shorten waiting times for treatments such as botulinum toxin injections for chronic migraine. Headache is such a common problem that staff in any area may be required to assist a patient with a headache, there is plenty of help available to both patients and staff to improve knowledge. There are many resources to choose from.