Quality standard

Quality statement 5: Follow-up in secondary care

Quality statement 5: Follow-up in secondary care

Quality statement

People who have had bacterial meningitis or meningococcal disease have a follow-up appointment in secondary care within 6 weeks of discharge from hospital. [2012, updated 2024]

Rationale

People who have had bacterial meningitis or meningococcal disease should have a follow-up appointment in secondary care within 6 weeks of discharge. This is so that short-term effects of the illness can be reviewed and long-term issues can be identified early, ensuring prompt referrals.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Process

Proportion of people who have had bacterial meningitis or meningococcal disease who have a follow-up appointment in secondary care within 6 weeks of discharge from hospital.

Numerator – the number in the denominator who have a follow-up appointment in secondary care within 6 weeks of discharge from hospital.

Denominator – the number of people who have had bacterial meningitis or meningococcal disease and have been discharged from hospital.

Data source: NHS Digital Hospital Episode Statistics contain the data necessary for the monitoring of outpatient follow-up, including those people who have had bacterial meningitis or meningococcal disease.

What the quality statement means for different audiences

Service providers (secondary care services) ensure that systems are in place for people who have had bacterial meningitis or meningococcal disease to have a follow-up appointment in secondary care within 6 weeks of discharge from hospital. This appointment should be carried out by a paediatrician for children and by a hospital doctor for adults. Because these conditions are associated with a wide range of potential complications, the appointment can be with a general physician who can refer the person to the relevant specialities.

Healthcare professionals (secondary care nurses and doctors, including paediatricians) ensure that people who have had bacterial meningitis or meningococcal disease have a follow-up appointment within 6 weeks of discharge from hospital. During this appointment, current symptoms can be reviewed, ongoing needs can be reviewed and assessed, and any further follow up can be agreed. This includes the arrangement of an additional review of babies under 12 months who have had bacterial meningitis or meningococcal disease, which should take place with a paediatrician 1 year after discharge from hospital.

Commissioners ensure that they commission services in which people who have had bacterial meningitis or meningococcal disease have a follow-up appointment in secondary care within 6 weeks of discharge from hospital.

People who have had bacterial meningitis or meningococcal disease are seen in hospital for a follow-up appointment within 6 weeks of their discharge from hospital. At this appointment, their current symptoms can be reviewed and ongoing needs can be reviewed and assessed. Adults are seen by a hospital doctor, and children and young people are seen by a paediatrician.

Definitions of terms used in this quality statement

Follow-up appointment in secondary care

This is a follow-up with a secondary care doctor for adults, or a paediatrician for babies, children and young people, within 6 weeks of discharge from hospital. This review should cover:

  • the results of their audiological assessment and whether cochlear implants are needed

  • damage to bones and joints

  • skin complications (including scarring from necrosis)

  • psychosocial problems

  • neurological problems

  • care needs (for adults)

  • developmental problems (in children and young people), in liaison with community child development services.

To ensure a full review of any possible complications, this appointment should take place in person and not virtually. [Adapted from NICE's guideline on meningitis (bacterial) and meningococcal disease: recognition, diagnosis and management, recommendations 1.13.1 and 1.13.2 and expert opinion]

Equality and diversity considerations

People who have had bacterial meningitis or meningococcal disease, and their family and carers, should be given information at the follow-up appointment that they can easily read and understand themselves, or with support, so they can communicate effectively with healthcare professionals. Information should be in a format that suits their needs and preferences. It should be accessible to people who do not speak or read English, and it should be culturally appropriate and age appropriate. People should have access to an interpreter or advocate if needed.

For people with additional needs related to a disability, impairment or sensory loss, information should be provided as set out in NHS England's Accessible Information Standard or the equivalent standards for the devolved nations.