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Introduction The MSAA is utilised by various specialties for assessment of direct urgent referrals from the community or emergency department. Referral criteria exist to regulate this pathway. This service evaluation is aimed at assessing whether Neurology referrals made to MSAA were appropriate and if other more appropriate pathways exist.Method 1 month of prospective data collection of all neurology referrals to the MSAA. Data was collected on patient demographics, reason for referral, proposed urgency, if accepted for review prior to transfer, diagnosis and outcome. Cases were further reviewed for their appropriateness and if alternative pathways could have been utilised.Results 27 referrals were identified. 26 were referred as urgent, the most common referral reason was headache (9), followed by limb weakness (6). Only one third were formally accepted prior to sending to MSAA. Other more appropriate pathways existed in 24 of the patients and only 7 were considered truly urgent/emergency reason for referral.Conclusion The majority of Neurology referrals to MSAA were inappropriate and better pathways already existed that could have been utilised. The need to develop comprehensive criteria for utilisation of the service was highlighted. Patients should be discussed with the on-call neurology team to allow better utilisation of alternative available services.a.emam@nhs.net