A to Z of MS
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A to Z of MS NICE MS Guideline
The National Institute for Clinical Excellence (NICE) published its clinical guideline Management of multiple sclerosis in primary and secondary care in November 2003.
The Guideline involved an extensive review and grading of the research evidence for the management of MS, from diagnosis to the treatment of symptoms.
The Guideline's six key recommendations were that people with MS should have:
- Access to specialist neurological and neurorehabilitation services.
- A rapid diagnosis (no longer than three months from referral to completion of investigations).
- A seamless service across health and social care, with all organisations in a local health area publishing protocols for sharing and transferring responsibility and information.
- A service which is responsive to people with MS, who should be actively involved in decisions about their care and treatment.
- Sensitive and thorough problem and symptom assessment, particularly focussing on "hidden" problems: fatigue, depression, cognition, sex, bladder.
- Self-referral back into specialist services after discharge.
In some areas, services envisioned by the Guideline will already be in place. In others, there will still be much work to be done. However, the Guideline gives a benchmark for services and every Primary Care Trust in England and Local Health Board in Wales will have a responsibility to "agree and publish information about how they will provide services".
The MS Trust in conjunction with the Royal College of Physicians conducts surveys periodically to monitor how health authorities are implementing the Guideline and how they are affecting people with MS. Surveys have taken place in 2006, 2008 and 2011.
Revision of the NICE MS guideline
NICE began the process of reviewing the Guideline in 2011. It is expected to take three years to complete.
The Guideline Development Group (GDG) consists of three neurologists, a GP, a physiotherapist, two occupational therapists, two MS specialist nurses, a neuropsychologist and three people who either have MS or have a family member with the condition. The scope for the Guideline review has been published on NICE's website.
NICE's recommendations apply only in England and Wales. NHS Quality Improvement Scotland published national standards of care for neurological conditions in October 2009.