Every patient who is suspected of having multiple sclerosis should be seen by a neurologist within six weeks of referral, and investigations should be completed within another six weeks. These are recommendations in the new guidelines of the National Institute for Clinical Excellence (NICE) that were issued this week.
The aim of the guidelines is to provide easier and faster access to specialised services for the 50 000 to 60 000 people with the condition. The guidelines were welcomed by patient groups.
The institute laid down six key priorities, including reducing delays in diagnosis and producing a responsive and seamless service from the viewpoint of the patient.
Specialist services should be available to everyone when they needed them, which was usually when they developed any new symptom or sign. Patients should be able to refer themselves to a specialist in such circumstances.
Every health commissioning organisation, primarily primary care trusts, should ensure that all organisations in a local heath area agree and publish protocols and procedures for sharing and transferring clinical and resource responsibility for people with multiple sclerosis.
In addition, health professionals should consider in a systematic way whether the person with multiple sclerosis had any sensitive and hidden problems that could worsen their condition, including depression, fatigue, and sexual dysfunction.
The institute recommended that the number of UK neurologists be tripled, from the current 360, and the number of nurse specialists doubled, from the current 150. It also made evidence based suggestions for the treatment of acute episodes with steroids and described the possible benefit of some complementary therapies such as fish oils and reflexology.
Andrew Dillon, the institute's chief executive, who described the guidelines as “aspirational but also achievable,” admitted that they had not been costed.
The recommendations were welcomed by several patient groups. Mike O'Donovan, chief executive of the Multiple Sclerosis Society, said: “This is a very big day for people with multiple sclerosis.”
A spokesman for the charity MS Trust said: “The introduction of a clinical guideline for the management of MS, which provides a benchmark for good practice in the NHS, will undoubtedly bring further benefits to people with MS.”
Copies of the guidelines (including a version for patients and families) are available from the NHS Response Line (tel 0870 1555 455) or from the NICE website (www.nice.org.uk).