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Last Updated: Wednesday, 26 November, 2003, 00:23 GMT
Guidance to improve MS care
Nurse consultation
All patients must have access to specialist services
Guidelines designed to ensure all multiple sclerosis patients receive high quality care have been issued.

The National Institute for Clinical Excellence (NICE) says all MS patients must have access to specialist neurological and rehab services.

Suspected cases should also be seen quickly by specialists who can give a prompt diagnosis, it says.

Around 63,000 people in England and Wales have MS - the most common neurological disability in the young.

The new guideline is the most far-reaching step ever taken towards better management of one of the most common neurological conditions.

Mike O'Donovan
Multiple sclerosis attacks the nerves, stripping them of their protective coating.

Initially it causes loss of balance, reduced vision and bouts of localised paralysis.

Eventually, patients may become totally paralysed and wheelchair-bound.

There are different forms of the disease. Some cause a gradual deterioration, while others lead to bouts of illness, followed by partial recovery.

Symptoms can vary greatly between individual patients.

The new guidelines - a collaboration between NICE and the National Collaborating Centre for Chronic Conditions - stress the need for flexible services to properly address the whole range of needs that a person with MS may encounter.

They also gave cautious support for the possible benefits for complementary therapies such as fish oil, reflexology and t'ai chi for treating MS.

But while they state there is "some evidence" to suggest that these therapies might be of benefit, they also stress there is insufficient evidence to give more firm recommendations".

The main recommendations are:

  • Making specialist neurological and neurological rehabilitation services available to all MS patients
  • Ensuring all suspected cases are referred swiftly to a specialist neurology service, and given a prompt diagnosis
  • Local health organisations should publish protocols on MS treatment to ensure a seamless service
  • MS patients should be actively involved in decisions about their care
  • Health workers must systematically consider how the disease may impact on each patient
  • Patients must be told how to access services even when they are not receiving regular treatment
Andrew Dillon, NICE chief executive, said: "This guideline represents a catalyst for change and will inform a more joined-up approach to service delivery."

Health care lottery

Mike O'Donovan, chief executive of the Multiple Sclerosis Society, said: "Tens of thousands of people with multiple sclerosis currently face a lottery of health care.

"Long waits for diagnosis are frequently followed by repeated struggles to access the treatments they need at the time they need them.

"The new guideline is the most far-reaching step ever taken towards better management of one of the most common, complex and unpredictable neurological conditions.

"It provides a stimulus for action which can make a real difference to the quality of life of people affected by this dreadful disease."

Christine Jones, chief executive of the MS Trust said the guidance reflected a much better understanding of the needs of people with MS.

"From now on, local service providers will be monitored and measured against the new standards.

"It's up to all of us to ensure that the standards of good practice which the guidelines advocate are really met."

Judy Mead, of the Chartered Society of Physiotherapy, said: "This guideline will mean that people with MS can expect a more consistent provision of services."


The Department of Health has released figures showing that thousands of MS sufferers were now benefiting from drug therapies as a result of a "risk-sharing scheme" launched last year.

Under the scheme the NHS pays for the drugs if they were shown to benefit a patient, but if they do not, then the drugs company foots the bill.

More than 3,000 people have been enrolled on the scheme since May 2002.

Health Minister Lord Warner said: "This scheme has gone a long way towards ending the uncertainty that affected thousands of people with MS around their treatment with these therapies."

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