1. www.england.nhs.uk MS service across the WM update on project Bernie County Acting Network Manager 10 October 2014

2. www.england.nhs.uk Reducing variability in patient outcome and experience – West Midlands Multiple Sclerosis Pathway Reducing variability in patient outcome and experience – West Midlands Multiple Sclerosis Pathway What we are trying to do

3. www.england.nhs.uk To identify where and what services are provided across the West Midlands for MS patients To map the current MS pathway including information and data flows. To identify gaps or variation in provision and any impact this has To articulate the commissioning flows through the system To understand the impact of new drugs and potential changes to service provision in the future To determine the validity of the specialist commissioning service specification in light of the findings Project Objectives

4. www.england.nhs.uk Bernie County WM Strategic Clinical Network Brad White – CNS SWBH Sam Colhoun – CNS UHB Sylvia Lyons – CNS UHCW Nikki Embrey – CNS UHNS Nicky Ward-Able – Birmingham City University Jo Scott - MS Society Mahira Jabeen – Biogenidec Additional oversight and expertise is also provided by: Dr David Nicholls MS Consultant City Hospital and member of CRG Dr John Woolmore MS Consultant University Hospital Birmingham and Chair of MS EAG Sarah Freeman – WM Specialist Commissioning Team Mandy Matthews – Pharmacy Support to Specialised Commissioning Team Project team

5. www.england.nhs.uk Mapped all acute pathways for all three neuroscience centres We need to find a way of representing this pictorially exceptionally large and confusing at the moment Looked at rehab pathway in the north Rehab EAG have a work stream planned for community rehab so looking to integrate in to that What have we done so far with professionals?

6. www.england.nhs.uk Significant consistency across the WM Utilising NICE, ABN, and NHS England guidance on DMT Wide variation in caseload for specialist nurses May gain more by mapping patient flow so that we can demonstrate the journey that patients have from different parts of the West Midlands What have we learned from this part of the work

7. www.england.nhs.uk Arranged three ‘experience of care’ groups in partnership with MS Society and Neurological Alliance Champions No uptake for Birmingham event Only one person at each of the Coventry and Stoke events and both had a primary progressive diagnosis Need to explore ways of gaining information via a different format What we have done so far with patients

8. www.england.nhs.uk A lot of correlation in the two responses Very positive about the input of specialist nurse and ease of access Poor knowledge in primary care about MS and also the role of the MS specialist nurse Both had accessed physiotherapy services to manage fatigue Both had received information about self management and steps to take Neither had been offered any form of counselling but said that the MS nurses had provided good emotional care No carers assessment had been undertaken What we have learned from this part of the work

9. www.england.nhs.uk Gathering information about current numbers of patients and disease status Circulated questionnaire around DMT to gather information on consistency in application – response has been very poor (only 1) Currently doing

10. www.england.nhs.uk Engage more patient to get their views Get responses to the questionnaire about DMT Validate information on patient numbers Pull together all the information we have gathered in to a format that will enable the reader to understand the system irrespective of there baseline knowledge Need to

11. www.england.nhs.uk Any