www.england.nhs.uk

MS service across the WMupdate on project

Bernie County

Acting Network Manager10 October 2014

www.england.nhs.uk

• Reducing variability in patient outcome and experience – West Midlands Multiple Sclerosis Pathway

What we are trying to do

www.england.nhs.uk

• To identify where and what services are provided across the West Midlands for MS patients

• To map the current MS pathway including information and data flows.

• To identify gaps or variation in provision and any impact this has

• To articulate the commissioning flows through the system• To understand the impact of new drugs and potential

changes to service provision in the future• To determine the validity of the specialist commissioning

service specification in light of the findings

Project Objectives

www.england.nhs.uk

• Bernie County WM Strategic Clinical Network • Brad White – CNS SWBH • Sam Colhoun – CNS UHB• Sylvia Lyons – CNS UHCW• Nikki Embrey – CNS UHNS• Nicky Ward-Able – Birmingham City University• Jo Scott - MS Society• Mahira Jabeen – Biogenidec

• Additional oversight and expertise is also provided by:• Dr David Nicholls MS Consultant City Hospital and member of CRG• Dr John Woolmore MS Consultant University Hospital Birmingham and Chair of MS EAG • Sarah Freeman – WM Specialist Commissioning Team• Mandy Matthews – Pharmacy Support to Specialised Commissioning Team

Project team

www.england.nhs.uk

• Mapped all acute pathways for all three neuroscience centres• We need to find a way of representing this

pictorially exceptionally large and confusing at the moment

• Looked at rehab pathway in the north• Rehab EAG have a work stream planned for

community rehab so looking to integrate in to that

What have we done so far with professionals?

www.england.nhs.uk

• Significant consistency across the WM• Utilising NICE, ABN, and NHS England guidance on

DMT• Wide variation in caseload for specialist nurses• May gain more by mapping patient flow so that we

can demonstrate the journey that patients have from different parts of the West Midlands

What have we learned from this part of the work

www.england.nhs.uk

• Arranged three ‘experience of care’ groups in partnership with MS Society and Neurological Alliance Champions

• No uptake for Birmingham event• Only one person at each of the Coventry and

Stoke events and both had a primary progressive diagnosis

• Need to explore ways of gaining information via a different format

What we have done so far with patients

www.england.nhs.uk

• A lot of correlation in the two responses• Very positive about the input of specialist nurse and ease of

access• Poor knowledge in primary care about MS and also the role

of the MS specialist nurse• Both had accessed physiotherapy services to manage fatigue• Both had received information about self management and

steps to take• Neither had been offered any form of counselling but said

that the MS nurses had provided good emotional care• No carers assessment had been undertaken

What we have learned from this part of the work

www.england.nhs.uk

• Gathering information about current numbers of patients and disease status

• Circulated questionnaire around DMT to gather information on consistency in application – response has been very poor (only 1)

Currently doing

www.england.nhs.uk

• Engage more patient to get their views• Get responses to the questionnaire about DMT• Validate information on patient numbers• Pull together all the information we have gathered in

to a format that will enable the reader to understand the system irrespective of there baseline knowledge

Need to

Simples

www.england.nhs.uk

Any