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Access to real choice in health services

'Choice' is a mantra within the NHS in England and has been fashionable for the past ten years. Scotland, Northern Ireland and Wales have been more hesitant about patient choice, but still acknowledge it's importance.

There are lots of arguments about whether choice is, in itself, a good idea. One side of the debate argues that choice helps individuals find convenient services that give them their best possible outcomes - not necessarily the outcomes that matter most to their doctors. The other side of the coin argues that very often, particularly when people are ill, choice is irrelevant: what we all want are good services that are close to home.

In practice, both arguments will apply to most of us at different stages of our lives. For example, when acutely ill, it's important that there is good, effective, emergency care close at hand. For longer-term problems, or to manage intractable symptoms, it may be very helpful to have a choice of treatments and places where this can be offered.

Still, to be able to choose adequate services and treatments people require:

Reliable information to decide what to choose

Good information can make the difference between a good experience of the NHS and a horror story.

The MS Trust is the definitive source of health information for people living and working with MS. We provide objective, evidence-based information to help people with MS make informed decisions about their healthcare. Informed decisions about healthcare are usually made with a health professional, but it helps to understand what the neurologist or specialist nurse might be suggesting, and the full implications of the options that are presented.

The MS Trust is proud of the quality of our information service. We are delighted to have received awards for some of our publications:

MS and me
MS Explained and Falls: managing the ups and downs of MS
Sexuality and MS: a guide for women Move it for MS DVD
Move it for MS DVD

We are also proud to have been accredited under the Information Standard. The Information Standard is a national scheme that aims to ensure all health information is accurate, impartial, well-written, evidence-based, accessible and balanced. In an ideal world we would like to see all providers of MS health information accredited under the Information Standard , particularly NHS information providers.

Equally good, properly funded local services

Too often 'choice' within the NHS means that local commissioners choose what is being offered to patients. Consequently the system is inequitable, a situation amply demonstrated by the MS Trust's three yearly audit of MS services. The national audit of services for people with multiple sclerosis 2011 commissioned by the MS Trust and the Royal College of Physicians.

No one charity can change the provision of services across the UK. But by funding audits like this one, by raising individuals' awareness of what they are entitled to and what services would best meet their needs, and by working with other organisations to raise the profile of MS, we continue to fight to secure the future of effective services for people with MS. We believe choice should mean just that: the right to receive the best possible care, not just the best available care in your locality.

Independence of action

Having the right information and working one's way round the system to achieve the best possible care is one element of choice. Exercising that choice is also dependent on being able to act independently.

Being able to continue to live independently means being able to do or get the right help to do lots of things: live in appropriate housing, have an adequate income, be capable of basic care (eating, washing, dressing) or getting appropriate help to do this, being able to get out and about, and being able to enjoy the work and leisure activities you like doing.

We don't pretend that the MS Trust can provide the answers to all these issues. We aren't a big enough charity to work in all these areas.

Still, where we can, we work to ensure that we can be a voice for people with MS in some of these areas, which really matter if everyone is to stay as independent as possible.

Also, the MS Trust has a great track record of helping people to help themselves: Stay Active for leisure activities; StayingSmart for help with memory and thinking; MS and Me are among our many tools to help.