Neurologists put to the test: sustainability amid governance, data and needs

The Italian healthcare system — understood as the integrated set of services provided to patients by accredited public and private organisations — is undergoing a significant period of transformation, characterised by rising demand for services and resources that are not expanding at the same rate. An ageing population, the rise in chronic and neurodegenerative conditions, the introduction of therapeutic innovations with significant organisational and economic implications, and the reorganisation of healthcare providers are profoundly altering the scope of needs and the structure of service provision.

In this context, neurology is a paradigmatic discipline. Given its epidemiological scope, the cross-cutting nature of its settings (hospitals, the community, rehabilitation), the structure of clinical networks and growing therapeutic innovation, it serves as a testing ground for the system’s ability to realign the planning of professional resources, organisational models and sustainability.

In recent years, the Italian Society of Neurology (SIN) has embarked on a process of strategic reflection, aimed not at examining the clinical and scientific role of the discipline, but rather at assessing its position within the healthcare system. It is within this context that NeuroNetwork, an initiative promoted by SIN in partnership with Biogen and Cergas SDA Bocconi, is situated.

The 2025 edition of NeuroNetwork provided an opportunity to consolidate the debate within the neurological community on the issue of the number of neurologists in different Italian regions. The discussion focused on the alignment between staffing levels, the structure of accredited public and private healthcare provision, and emerging healthcare needs in certain regions. Indeed, the analysis carried out in Veneto, Liguria, Puglia and Abruzzo made it possible to test a method for assessing the numbers and distribution of neurologists across different geographical areas.

The study has highlighted that the issue cannot be reduced solely to the number of professionals. Regional differences relate to the structure of the networks, the proportion of accredited private sector provision, the distribution of services between hospital and community settings, the average complexity of cases, and organisational structure. In a system comprising 21 regional models, there is no such thing as ‘Italian neurology’, but rather 21 configurations consistent with different structural and organisational choices.