Systematic evidence and policy review of how education and training best equips the care workforce for people with chronic neurological disorders

Objectives: To systematically review policies and research on condition-specific education and training for the health and care workforce, across chronic neurological disorders. Methods: We searched electronic databases for primary research studies (2015-2025), evaluating condition-specific training for professionals and students supporting people with neurological disorders selected based on prevalence in England and diversity of aetiology and course: Stroke, Multiple Sclerosis (MS), Traumatic Brain Injury (TBI) and Motor Neuron Disease (MND). We assessed study validity using the Cochrane risk-of-bias tool, prioritised low risk of bias studies, and evaluated evidence using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. We reviewed English policies (January 2015- July 2025), identifying relevant policy contexts. Results: 7/22 included studies were rated ‘low risk of bias’. Most (n=17) related to stroke. We found some evidence that: simulation learning on acute stroke screening and clinical pathways improved treatment timeline and patient functioning; a train-the-trainer (TTT) programme with performance monitoring, improved guideline adherence, and reduced vascular event recurrence and stroke disability; a speech and language therapy students’ lecture improved communication with stroke patients with aphasia; and e-learning knowledge of stroke assessment. From MS-related literature (n=3), we identified some evidence that scenario-based online learning supported MS neurologists’ decision-making regarding escalation therapy; and in TBI-related studies (n=2), a TTT case-based, guideline-focused intervention improved initial management and discharge safety. The quality of the evidence for both stroke and MS was weak. No controlled studies evaluated training for MND, the social care workforce or training effects beyond two-years. Most studies focused on training for doctors and nurses, though our condition-specific focus may have excluded social care training, which is usually needs-based. Policies prioritised addressing workforce gaps through greater undergraduate neurological specialties exposure, developing credentials, training to support interdisciplinary working around optimal clinical pathways, and digitalising training. Conclusions: Evidence-based interventions were brief, used technology to facilitate communication and/or performance feedback, TTT models and audits to promote optimal care pathways, and case-based and simulation methods to develop skills. English government policy plans implementation of digital training programmes; embedding research evaluations could increase understanding of how skills are acquired, retained and used, potentially transforming workforce education. PROSPERO Registration: CRD420251004555 - For Stroke, MND and TBI; CRD42025632254 - For MS