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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".

NICE's recommendations apply only in England and Wales. NHS Quality Improvement Scotland began looking at possible national standards of care for neurological conditions in May 2005. They will taking into account initiatives such as the NICE Guideline. It is not clear how the NICE guidelines will impact on services for people with MS in Northern Ireland.

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. The latest survey was conducted in January and early February 2008.

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