October 14, 2003
Multiple Sclerosis Society
Specialist nurses have made a far-reaching impact on multiple sclerosis care provision and are at their most effective when part of a multi-disciplinary professional team influencing the long-term development of a wide range of services.
This is a key finding of research released today (14 October 2003) by the Multiple Sclerosis Society. A team from King's College London has completed a commissioned evaluation of the Society's nurse funded programme, which was launched in 1999 to expand the number of specialist professionals working in health and social care for people with MS across the UK.
Comparisons were made between 206 people who had seen an MS nurse working in the programme and 146 at two control sites who had not seen a nurse.
The researchers found "dramatic" improvements had been achieved and maintained in standards of care provided where a specialist nurse was in post. There was a significant reduction in the incidence of pressure sores and their costly complications. The nurses also help patients with fatigue management and can help maintain psychological stability.
The evaluation used the Society's standards of healthcare, developed with the National Hospital for Neurology, and measured significant improvements in care among sites in the nurse funded programme.
Standard attainment increased by 27% in the diagnostic phase, 41% in minimal impairment, 25% in moderate disability and 13% in severe disability.
But the team says the level of co-ordination across types of service such as neurology and rehabilitation is generally low. None of the 24 sites which took part offered a fully integrated service providing clinical management across the disease trajectory.
Sharon Haffenden, the MS Society's director of research and services, said, "It is encouraging to see the real impact our initiative in funding nurses and other health professional posts is making. The evaluation has provided us with a wealth of information which has already informed the development of a model of potential integrated structures of MS care.
"It has shown a clear need for attention to be focused on building up multi-disciplinary teams. It has also highlighted the importance patients attach to the role of their GPs in providing information and support.
"A disappointing finding is the much lower rating given to services and professionals by 257 carers of people with MS who were contacted and frequently reported physical and psychological problems," she said.
"The NICE guidelines being published shortly will be highly influential in helping us move forward and the Society will be working closely with health professionals to see that they are implemented to the fullest possible extent."
The sites taking part in the evaluation included nine community rehabilitation, eight specialist neurology, three palliative care, two specialist MS, one general medical and one social work. There were differences in sizes of team, geographical area and numbers of patients seen, level of development and philosophy and focus of care.
The evaluation research team was from the Florence Nightingale School of Nursing & Midwifery at King's College London, led by research fellow Angus Forbes and professor of community nursing Alison While.
A summary of the evaluation is available. It includes baseline data
from 927 patients with MS, providing insights into current health and healthcare
experiences. The full report is also available on CD-Rom. Copies from Anna
Roberts, MS Society, MS National Centre, 372 Edgware Road, Cricklewood,
London NW2 6ND.
Copyright © 2003, Multiple Sclerosis Society