Specialist nurses for people with MS in the UK

MS is a complex diagnosis with an often fluctuating, variable and unpredictable pathway. This presents unique challenges to the health and social care professionals who work with people living MS. The impact of this complexity and uncertainty cannot be overstated.

MS specialist staff must keep up-to-date with the changing evidence-base, best practice, statutory guidance and therapies available to people living with MS. At present we are able to provide a limited number of study days and if more money were available, we would be in a stronger position to respond to new research findings. For example, research this year has shown that anxiety and depression are highly prevalent in people with MS, indicating that their mental health needs could be better addressed. The MS Trust would like to be able to develop an evidence-based master class in order to ensure that staff are better placed to address the mental health needs of people living with MS.

A relatively new factor that further complicates the support offered to people with MS is the creation of ‘neurological specialist’ services and posts. Where previously an MS specialist was available to people living with MS, they have in some instances been replaced with a ‘neurological specialist’ whose caseload is much wider than MS and incorporates other neurological conditions (Brain Injury, Parkinson’s Disease, Alzheimer’s, Epilepsy, Huntington’s Disease, MND, Spina Bifida, etc). The MS Trust already receives requests from some of these neurological specialists to attend some of the MS specialist master classes and study days but at present we are unable to meet this need.

Increased funding would allow us to develop and deliver a 3 day development module to ensure that neuro-specialist staff have the skills and knowledge required to support people living with MS and recognise their unique requirements amongst a wide and varied caseload.

We are grateful for your continued interest in our work to support MS specialist nurses and we look forward to updating you again soon.

Links:

• More about our MS Nurse Support Programme

In April 2012, the MS Trust launched the GEMSS project - Generating Evidence in Multiple Sclerosis Services - a year long project that will help to generate evidence about the tremendous value of MS specialist nurses.   Since the first MS nurses were appointed back in 1993, their role has grown and there are now some 270 MS specialist nurses around the UK.  The MS Trust has been at the forefront of developing the MS nurse workforce, providing specialist training as well as a competency framework which describes the range of skills and knowledge that they need to be effective.

People with MS consistently say how important MS nurses are in helping them to manage the complex range of issues with which they have to deal.  Neurologists and GPs also acknowledge how valuable they are in freeing up doctor time and in providing specialist expertise.  But despite this, MS specialist nursing in some areas is under threat.  There are still parts of the UK without a nurse, or where the travel distance to the nearest nurse is too far.  And more worryingly, in today's climate where NHS budgets are tight, some posts are not filled when people leave.

In 2010-11, the MS Trust commissioned a study to assess the evidence for the value of MS specialist nurses.  The result was a report, Defining the value of MS specialist nurses, which found that MS nurses are short on robust evidence to show that their services are cost-effective, and that more work is needed to prove this to those who fund NHS services.   The report also maps the nurse post around the country and shows how patchy coverage is.

The GEMSS project is the response to this work.  Four MS nurse teams, representing 13 MS specialist nurses, have been selected to take part.  They are based in Dorset (Poole Hospital and Dorset Disability Action), Sheffield Teaching Hospitals, Dudley Group of Hospitals and Northumbria Healthcare.   The teams reflect the broad range of different MS nurse teams around the UK: acute Trust and community based, urban and rural, large and small.

In May, the teams came together for the first time, outside Sheffield, for an initial training workshop.   The project will give the nurse teams involved the skills to measure the impact of what they do and demonstrate this clearly.  In addition, it aims to leave a lasting legacy for MS nurse services more generally by developing a set of common quality indicators and data collection for MS nursing services - including a new patient survey.

Vicki Matthews, an MS specialist nurse in Southampton for many years and nurse adviser to the MS Trust said, "This project is developing tools and information that I wish I'd had 20 years ago that would have helped me greatly in my job".  Tracy Dean, the newly appointed MS nurse in Dudley, said, "Even though we're from different places, we've all got the same passion, and same desired outcomes for our services".   And Cheryl King, MS nurse at Poole Hospital said "As a specialist service we can be quite isolated.  Coming together it's reassuring to see we share the same problems".

Amanda Cheesley, Long Term Conditions Advisor at the Royal College of Nursing and part of the GEMSS project steering group, said, "At a time when all NHS spending is in the spotlight, it is vital that the value of specialist nurses is clearly articulated, so that these roles which are so important to improving the lives of people living with long term conditions can be supported and built upon.  We welcome the launch of this innovative project by the MS Trust."