{"id":4286,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/parkinsons-moe\/"},"modified":"2025-12-16T11:29:22","modified_gmt":"2025-12-16T11:29:22","slug":"parkinsons-moe","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/medicineoftheelderlygeriatrics\/parkinsons-moe\/","title":{"rendered":"Parkinsons (MoE)"},"content":{"rendered":"\n<p><strong>Parkinson&#8217;s Disease \/ Movement disorder clinics for older people<\/strong><\/p>\n\n\n\n<p><strong>Parkinson\u2019s &amp; Movement disorders clinics for older people in NHS Lothian<\/strong><\/p>\n\n\n\n<p>Older people with suspected Parkinson\u2019s or similar movement disorders, may be assessed and managed by&nbsp;either <strong>Medicine of the Elderly or <\/strong>Neurology<strong> services<\/strong>&nbsp;depending upon their age at presentation and disease stage. <strong>The MOE and Neurology teams work together closely to ensure that people receive the care most appropriate to their needs. <\/strong>Please note, if a referral is felt to be more suitable for either MOE or Neurology the service will manage this. There is no expectation that the referrer will need to submit a further referral.<strong><\/strong><\/p>\n\n\n\n<p><strong>Helpful Referral Points<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>If a referral is received by MOE that would be best triaged to neurology or vice versa, then it will be redirected by the service receiving the referral accordingly with the referrer being informed.<\/li>\n\n\n\n<li>If a patient is being re referred to a service after being lost to follow up or for review of progressive symptoms, then please refer to the service the patient is previously known to (MOE or neurology).<\/li>\n\n\n\n<li>If a patient requires review or follow up due to being new to the area, then please refer to referral guidelines in determining whether neurology or MOE are most appropriate.<\/li>\n<\/ul>\n\n\n\n<p>The service provides multidisciplinary care for people with the following conditions:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Parkinson\u2019s disease<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Atypical Parkinsonian disorders such as: Progressive Supranuclear Palsy (PSP), Multiple System Atrophy (MSA), Corticobasal Degeneration (CBD) and Dementia with Lewy Bodies (DLB)<\/li>\n\n\n\n<li>Vascular parkinsonism<\/li>\n\n\n\n<li>Essential Tremor<\/li>\n\n\n\n<li>Drug-induced parkinsonism<\/li>\n<\/ul>\n\n\n\n<p>The typical motor (movement) features are:&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>bradykinesia, rigidity, rest tremor and postural instability.<\/strong><\/li>\n<\/ul>\n\n\n\n<p>Non-motor symptoms, which may also be present at diagnosis, include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>constipation, loss of sense of smell, sleep disturbance, anxiety and low mood<\/strong><\/li>\n<\/ul>\n\n\n\n<p>There is no definitive diagnostic test. Parkinson\u2019s Disease is a&nbsp;<strong>clinical diagnosis<\/strong>&nbsp;and for some patients establishing the diagnosis may take some time.<\/p>\n\n\n\n<p>For MOE patients can be referred to the following clinics:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>North West Edinburgh:<\/strong>&nbsp;Western General Hospital<\/li>\n\n\n\n<li><strong>North East Edinburgh:<\/strong>&nbsp;Leith CTC<\/li>\n\n\n\n<li><strong>South Edinburgh and Midlothian: <\/strong>Ellen&#8217;s Glen Hospital\/ MLCH \/ DCN, Anne Rowling<\/li>\n\n\n\n<li><strong>East Lothian:&nbsp;<\/strong>East Lothian Community Hospital<\/li>\n\n\n\n<li><strong>West Lothian:<\/strong>&nbsp;St John\u2019s Hospital<\/li>\n<\/ul>\n\n\n\n<p><strong>Parkinson\u2019s Disease Nurse Specialists&nbsp;within NHS Lothian<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Patient Telephone Advice Line<\/strong>: 0131 465 9156 (Opening times Mon &#8211; Fri, 08:30 to 10:30). The call will be answered by the secretaries who will book patients onto a telephone clinic where they will receive a call back from a specialist nurse. If the answerphone answers during these hours do NOT leave a message as it will not be responded to. The secretaries will be on another call, so please call back within the opening times. This is for Parkinson&#8217;s related issues only and not an emergency service.<\/li>\n\n\n\n<li>Email for professionals only:&nbsp;<a href=\"mailto:loth.parkinsonsnursespec@nhs.scot\" target=\"_blank\" rel=\"noreferrer noopener\">loth.parkinsonsnursespec@nhs.scot<\/a><\/li>\n\n\n\n<li>Intranet:&nbsp;<a href=\"https:\/\/eur01.safelinks.protection.outlook.com\/?url=http%3A%2F%2Fintranet.lothian.scot.nhs.uk%2FDirectory%2Fparkinsons%2FPages%2FDefault.aspx&amp;data=05%7C02%7Cjane.burnett%40nhs.scot%7Cfab1bb3a2d0c4205b80208dd6244d3ee%7C10efe0bda0304bca809cb5e6745e499a%7C0%7C0%7C638774769931396815%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&amp;sdata=WzVAMuUyExmAECIE%2FQ%2BEu5ijbqwuSSdub2Y4x9mOfJM%3D&amp;reserved=0\" target=\"_blank\" rel=\"noreferrer noopener\">&nbsp;Parkinson\u2019s&nbsp;Services Intranet page<\/a><\/li>\n\n\n\n<li>Internet:&nbsp;<a href=\"https:\/\/eur01.safelinks.protection.outlook.com\/?url=https%3A%2F%2Fservices.nhslothian.scot%2Fparkinsonsservices%2F&amp;data=05%7C02%7Cjane.burnett%40nhs.scot%7Cfab1bb3a2d0c4205b80208dd6244d3ee%7C10efe0bda0304bca809cb5e6745e499a%7C0%7C0%7C638774769931428436%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&amp;sdata=2%2FebUwhEOSfwnV3jBqh2aGqsxzSIYgOa4QhxUUi5oXI%3D&amp;reserved=0\" target=\"_blank\" rel=\"noreferrer noopener\">NHS Lothian PD and Movement Disorder Service<\/a><\/li>\n<\/ul>\n\n\n\n<p><strong>J.B. &amp; S.R.\/G.D. 25-04-25 <\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">Who to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Patients with suspected Parkinson&#8217;s Disease or a similar disorders&nbsp;(see above), aged&nbsp;<strong>over 65 years \/ or with markers of frailty please refer to the MOE Parkinson&#8217;s Specialist team \u2013 details on this page<\/strong><\/li>\n\n\n\n<li>Patients&nbsp;<strong>should be referred untreated<\/strong>.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Who not to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Patients with suspected Parkinson&#8217;s Disease or related movement&nbsp; disorders (see above),&nbsp;aged&nbsp;<strong>under 65 years \/ biologically young or those with atypical movement disorders please refer to <\/strong><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/neurology\/parkinsons\/\" target=\"_blank\" rel=\"noreferrer noopener\">Neurology<\/a><\/li>\n\n\n\n<li>Patients who are unable to attend an outpatient clinic and engage in clinical assessment and examination.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">How to refer <strong>to MOE Parkinson\u2019s services:<\/strong> <\/h4>\n\n\n\n<p>Patients aged over 65 years old with suspected Parkinson\u2019s Disease should be referred via SCI Gateway to the appropriate local service:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>North West Edinburgh:<\/strong>&nbsp;<\/li>\n<\/ul>\n\n\n\n<p>Western General Hospital &gt;&gt; Geriatric Medicine &gt;&gt; Basic Sign Referral<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>North East Edinburgh:<\/strong>&nbsp;<\/li>\n<\/ul>\n\n\n\n<p>Leith CTC &gt;&gt; Geriatric Medicine &gt;&gt; Basic Sign Referral<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>South Edinburgh and Mid Lothian:<\/strong>&nbsp;<\/li>\n<\/ul>\n\n\n\n<p>Ellen&#8217;s Glen Community Hospital &gt;&gt; Geriatric Medicine &gt;&gt; Basic Sign Referral<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>East Lothian:&nbsp;<\/strong><\/li>\n<\/ul>\n\n\n\n<p>East Lothian Community Hospital &gt;&gt; Geriatric Medicine &gt;&gt; Basic Sign Referral<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>West Lothian:<\/strong>&nbsp;<\/li>\n<\/ul>\n\n\n\n<p>St John\u2019s Hospital &gt;&gt; Geriatric Medicine &gt;&gt; WL Geriatric Medicine<\/p>\n\n\n\n<p>It is helpful if in the <strong>Referral Text tab <\/strong>the referrer indicates the referral is for the PD clinic by nothing either <strong>\u201c<em>Parkinson&#8217;s Disease<\/em>&#8221; <\/strong>or&nbsp;<strong><em>&#8220;Movement&nbsp;Disorder Clinic&#8221;<\/em>&nbsp;<\/strong>in the&nbsp;<strong>Reason for Referral&nbsp;<\/strong>box<strong>.<\/strong><\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\"><strong>For HCPs<\/strong><\/h4>\n\n\n\n<p><a href=\"https:\/\/www.nice.org.uk\/guidance\/ng71\" target=\"_blank\" rel=\"noreferrer noopener\">NICE Guidelines: Parkinson&#8217;s Disease in Adults<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/cks.nice.org.uk\/topics\/parkinsons-disease\/\" target=\"_blank\" rel=\"noreferrer noopener\">CKS: Parkinson&#8217;s Disease<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Information for patients<\/strong><\/h4>\n\n\n\n<p><strong>NHS Inform: <\/strong><a href=\"https:\/\/www.nhsinform.scot\/illnesses-and-conditions\/brain-nerves-and-spinal-cord\/parkinsons-disease\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.nhsinform.scot\/illnesses-and-conditions\/brain-nerves-and-spinal-cord\/parkinsons-disease\/<\/a><\/p>\n\n\n\n<p><strong>Parkinson\u2019s UK:<\/strong> <a href=\"https:\/\/www.parkinsons.org.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.parkinsons.org.uk\/<\/a><strong>Parkinson\u2019s UK Helpful information guides and booklets for patients<\/strong>: <a href=\"https:\/\/www.parkinsons.org.uk\/information-and-support\/parkinsons-symptoms\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.parkinsons.org.uk\/information-and-support\/parkinsons-symptoms<\/a><\/p>\n<\/div><\/div>\n<\/div>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Parkinson&rsquo;s Disease \/ Movement disorder clinics for older people Parkinson&rsquo;s &amp; Movement disorders clinics for older people in NHS Lothian Older people with suspected Parkinson&rsquo;s or similar movement disorders, may be assessed and managed by&nbsp;either Medicine of the Elderly or Neurology services&nbsp;depending upon their age at presentation and disease stage. The MOE and Neurology teams<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":4118,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[312],"class_list":["post-4286","page","type-page","status-publish","hentry","category-parkinsons-moe"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/medicineofelderlygeriatrics\/parkinsons-moe\/\" rel=\"tag\">Parkinson's (MoE)<\/a>","rttpg_excerpt":"Parkinson&rsquo;s Disease \/ Movement disorder clinics for older people Parkinson&rsquo;s &amp; Movement disorders clinics for older people in NHS Lothian Older people with suspected Parkinson&rsquo;s or similar movement disorders, may be assessed and managed by&nbsp;either Medicine of the Elderly or Neurology services&nbsp;depending upon their age at presentation and disease stage. The MOE and Neurology teams","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4286","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4286"}],"version-history":[{"count":11,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4286\/revisions"}],"predecessor-version":[{"id":25930,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4286\/revisions\/25930"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4118"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4286"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4286"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}