The Neurological Alliance and The Migraine Trust have developed an interactive headache resource navigator tool that can assist NHS providers and health professionals to plan, design and improve local services by:

• Providing a framework to begin local service transformation
• Identifying local stakeholders and how to engage them in transformation
• Identifying evidence-based resources including optimum pathways, service specifications and data sources
• Informing local business cases
• Focusing on strengthening care in the community.

Box with link to download the tool

The tool has been developed by The Migraine Trust and the Neurological Alliance with support from a steering group of expert health professionals. Stakeholder interviews and a patient focus group were held to inform the content of the tool.

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Link to project report

Headache disorders represent one of the biggest untapped transformation opportunities in neurology. While most migraine does not require hospital care, poorly organised pathways are driving avoidable outpatient referrals and emergency attendances, creating pressure on services, poor value for the system and poor experiences for people affected.

Implementing evidence-based headache pathways directly supports the NHS 10-Year Health Plan by shifting care upstream, improving outcomes, and reducing unwarranted variation. These pathways offer a practical opportunity for commissioners and providers to manage demand, improve productivity, and deliver measurable cost and efficiency gains. However, identifying credible evidence and implementable resources can be challenging within the constraints of commissioning time and capacity.

The Headache Navigator Tool is designed to address this gap, providing commissioners and providers with a practical blueprint to redesign headache services now. It brings together trusted evidence, pathway models and implementation resources to support delivery at pace.

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Patient perspective on use of Advice and Guidance

As part of this project, The Migraine Trust explored patient perspectives on the use of Advice & Guidance (A&G) for headache and migraine. With A&G now being widely adopted across England, understanding how it is experienced by patients — and what good looks like in practice — is essential to effective pathway redesign.

A&G has the potential to support earlier specialist input, reduce unnecessary referrals and shift appropriate care into the community. If implemented well, it could help reduce avoidable demand on secondary care while improving access and outcomes.

In July 2025, an online focus group with adults with migraine highlighted strong support for access to clinicians with specialist headache expertise. Participants recognised potential benefits of A&G, including reduced travel and faster advice, but raised concerns about communication, limited patient involvement, misrepresentation of priorities, variable GP knowledge and lack of continuity of care.

These insights underline the importance of designing A&G pathways that improve efficiency and experience, with patient insight embedded throughout.

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Financial support for this project has been provided as a Quality Improvement Grant from Pfizer International LLC.  Editorial control rests with The Migraine Trust and the Neurological Alliance.