Table 3.

A Summary of our Findings and Recommendations

Key points and recommendations for primary care clinicians:

- Tics are common in school children and can persist into adulthood - The impact of tics should be explored in all patients, even if tics are new-onset, as this informs the need for a secondary care referral - Information about tics should be provided to patients (and parents/carers if appropriate), to include general tic prognosis and a brief overview of potential treatment options - Tics are unlikely to completely remit in most people but typically prognosis is good. With time, tics often become less severe and have a smaller impact on quality of life and a minority experience worsening of their tics; manage patient and parental expectations accordingly

Key points and recommendations for secondary care services:

- Patients and family members raised the following concerns of secondary care: o Long waitlist times, particularly for adults o Being referred to multiple secondary care services (neurology, paediatrics, psychiatry) sequentially as each said they do not offer support for people with tics o Being discharged from secondary care after diagnosis with no support provided - There appears to be a paucity of NHS clinicians with a specific interest in tic management across the UK - Greater clarity is needed on which secondary care services can receive referrals for tics and manage these patients appropriately – consider formation of dedicated NHS tic services