Table 1

Barriers identified by professionals

Neurology professionals
Resources	“Workload volume”
	“Increasing number of referrals will put the service to the same problem as in other healthcare foci - waiting times and availability may fall behind which happens to all services sooner or later. Sadly, the better services the sooner you will use your resources”
	“Resources and how best to communicate with varied services/provision”
	“Social care funding. Pent up demand”
	“Cost”
Clinician awareness and acceptance	“Knowing what services are available in localities”
	“Awareness, especially in primary care”
	“Clinician awareness”
	“Senior medics previous practices”
	“Getting themselves trusted by the consultants”
Continuing collaborations and communication	“Creating good links between the MS team and the palliative care team”
	“Communication issues between different care providers”
	“Ongoing joined-up work to ensure care continuity and no repetition of service provision”
	“Establishing a robust and efficient process for communicating with all disciplines involved in the patient's care …”
Geography	“Geographical limitations - a lot of our patients are not local”
	“Geographic's”
	“Many of our patients live a long way from the centre to allow active engagement”
Patient perceptions and acceptance	“Patient resistance”
Patient perceptions and acceptance	“The term hospice which often patients and families feel has a strong association with immanency of dying. People often express fear of contact with a hospice if they do not feel that they are close to death”