Service Overview

This service aims are:

• For all People with Multiple Sclerosis (MS) in Herefordshire to have access to the MS nurse service within a variety of settings
• To provide a responsive service to the changing needs of the person with Multiple Sclerosis (pwMS), their families and carers
• Provide health promotion for people newly diagnosed with MS
• Undertake the management of people with MS at and after diagnosis
• Provide education for carers of the person with MS and also health and social care staff
• Management and co-ordination of the disease modifying medication
• Palliative care and management of people throughout the whole of their disease trajectory leading to being severely affected by MS

Multiple sclerosis is the leading cause of disability in young adults. People are typically diagnosed at the age of 30 years. Over time, MS normally becomes progressive and can  cause complex disability in some patients. It is not life threatening and consequently the management of MS is a long-term team effort.

MS is a variable condition. However, the majority of patients will develop a range of fluctuating symptoms, both physical and cognitive, which take time to assess and manage. Additionally, significant levels of coexisting conditions such as depression are found in any MS patient population

Anticipated numbers of people with multiple sclerosis in the National population is: 100-120 cases per 100,000. Within Herefordshire, with its population of approx 180,000, the actual Multiple Sclerosis population in the county is 400, which is higher than other counties.

Accessibility / Acceptability

The service is not age specific, any person with MS can be reviewed.

The ratio of male to females with MS is 1:3, females being dominant, therefore the service is for any gender and adapts to the changing culture.

Referrals are accepted from any adult above the age of 18 years, going through or who has a diagnosis of MS, or an MS Mimic such as Devics disease and Hughes syndrome.

Where to find us and how to contact us

A telephone helpline operates Monday to Friday 9am - 5pm, and the MS service is available Monday to Friday 9am - 5pm apart from Bank Holidays.

Clinics are run in varying localities throughout the county:

• Hereford at Sarum House and the County Hospital
• Ledbury
• Ross-on-Wye
• Bromyard
• Leominster
• Kington

Other settings patients are seen in are: home visits, inpatients in the County Hospital (HHT), meetings within a mutual setting such as coffee shops or work environments, Community Hospitals and Nursing Homes

Population served

The MS Nurse Service responds to the whole county of Herefordshire. However, as people in the Powys area have access to the Neurologists in the County Hospital in Hereford, if any of these patients are diagnosed with Multiple Sclerosis then the Nurse Service reviews these patients.

Age: the pwMS need to be aged 18 years or above. If a child was diagnosed with MS the MS nurse would need to work with child health support services to support their needs.

The service is only for people within Herefordshire or for those people who have a Herefordshire Neurologist. The service will not accept anybody without a diagnosis of MS or who is not going through diagnostics for MS or an MS mimic.

Generally our criteria is as follows:

Anyone who is going through a diagnosis of Multiple Sclerosis, or anyone with a probable or clinically definite diagnosis. However there are a few diseases that mimic Multiple Sclerosis, and management of these is approached in the same way, therefore the MSSN also review people with Devic's Disease and also Hughes Syndrome. The service is also for family members of the person withMS as well as their carers.

The team

The MS Nurse, offers support, advice and training for the local MS population and health professionals.

Such as:

• Health promotion for people newly diagnosed with MS
• Management of people with MS at and after diagnosis
• Education of cares, health and social care staff
• Managing disease modifying medication
• Palliative care and management of people severely affected by MS

The MS Specialist Nurse is an expert in nursing and the specialist requirements of patients with complex health problems. Patients want specialist nurses to meet their special health needs and the MSnurse is able to provide regular and ongoing assessment and support that is not provided traditionally within the medical model. They promote a "wellness" approach and coach patients to live healthily throughout the disease trajectory.

The MS specialist nurse is pivotal in providing a greater understanding of the condition, and by adopting a holistic, collaborative and co-ordinated approach can help those individuals, where possible, reach their goals of self management. The role also involves acting as a consultant and educational resource for staff striving towards greater awareness and knowledge of MS in the health and social arena.