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Clinical neurophysiology departments are present in all regional neuroscience centres and in many large district general hospitals, but the requirement for dedicated recording rooms, expensive recording equipment and the logistics of service provision precludes delivery of high-quality services in primary care.

Commissioning varies throughout the UK but most departments receive significant numbers of referrals from primary care for nerve conduction studies (NCS), and in some parts of the UK (such as East Kent), neurophysiology is the first step in the primary care clinical pathway for managing carpal tunnel syndrome.

NICE recommends that ‘an EEG should be performed only to support a diagnosis of epilepsy’, and that the diagnosis of epilepsy be made by a medical practitioner with specialist training. Consequently, most electroencephalogram (EEG) requests come from secondary or tertiary care. 

The Department of Health has published specific advice on achieving waiting times (opens PDF, 813.34KB) in clinical neurophysiology.