Table 3.

Key Output (Activity) themes and sub-themes with supporting data.

Theme	Sub-theme (Context)	Sample of coded text
Training packages	Screening & Triaging How to support pwMS to complete screening and interpret the results	1. I'm not sure our OTs, even our specialist rehab OTs would have used the digit symbol and some of these, so it's kind of, you know, are introducing something new to people that then will need to interpret that, but I don't think with training, I think that's feasible isn't it. Neuropsychologist PS05
	Cognitive management programme How to deliver and set goals	2. Not all nurses have been through rehabilitation unit or rehabilitation training to kind of be aware of the notion of goalsetting and monitoring and motivational – you know. Neurologist N03
Supervision Ongoing monitoring and support	3. So if this is just an MS nurse working on their own then they might find it harder to make some of those decisions unless they've had some solid training and some supervision, ongoing supervision just to, you know, flush it out a bit. Neuropsychologist PS05
	4. I think it does definitely need to have a review and monitoring built into that. Neuropsychologist PS03
Screening tool	Administration How to enable completion of screening ahead of routine appointment	5. That would be an ideal, digitalising the assessment pre-appointment. That would be wonderful…so when they come into clinic we have got everything there. MS Nurse MS05
		6. Interviewer So you wouldn't have any problems filling that in and accessing the link. Carer C20 No, no, not at all, I'd be alright.
		7. Which is obviously brilliant because the whole thing about a paper link is that someone then has to type it in. And as much as possible, isn't it, you want someone to have the link on their device so they just have to click on it. Neurologist N03
	Cognitive measures Include short, sharp assessments that avoid mathematics	8. Interviewer Did those tests seem relevant? PwMS P20 Yeah, very much so, yeah.  Especially the one with the colours and the - Interviewer The Stroop test. PwMS P20 Yeah, you know, it's quite profound how your brain works because, you know, somebody without MS you still kind of have to really think one thing but you're having to override it.  I think that's a really good test
		9. Because I've got to think of too many numbers so I can't focus on the number that I need to focus on because I've just done the total. So I will have forgotten that number.  I just couldn't do that. Focus Group Female F1
10. Your balances a bit, isn't it, it's finding something which is quick but MS nurses will be able to do with everybody quickly as part of their clinical interview while still being meaningful enough. Neuropsychologist PS03
Screening results	Transfer Electronic transfer to clinical team	11. So probably for us it would be emailing to the MS coordinator, who would upload it onto the patient's EPR so that it was there as an electronic document and then it would remain so, as opposed to lost in someone's email and never available again. Neurologist N03
	Feedback report What should this include	12. I think if we could categorise them really in a binary way or in these three categories, I think that would be excellent. That's very practical and I think we all know pretty well who we're thinking of when we're thinking of these categories. Neurologist N02
		13. I mean, it might be useful to know in roughly what sort of domain we're talking about the deficit as being, you know, so whether it's a memory problem or whether it's – I don't know – been a processing problem or maybe something roughly categorising it a little bit further rather than just severity. Neurologist N04
Communication How to communicate screening results to pwMS	14. I think face to face is probably better than an email. Carer C20
	15. Well it depends what the result is. If it's very severe, you're going to need a consultant I think. Focus Group Male M2
Triage	Concurrent symptoms Interpret cognitive performance considering concurrent symptoms	16. You will need somebody who's quite skilled at interpreting the different components you've discussed, so the mood and the cognitive, to think about how best to manage their difficulties. Neuropsychologist PS03
	Perspective of person with MS Allow pwMS to indicate how they are feeling	17. Everything's all right, or you might be having a bad day but you picked up this. How do you feel about how this goes for you every day? Is this actually a problem or was it just, you know, that answer on the test? PwMS P27
Functional impact How do cognitive problems affect pwMS	18. I think as long as it's then not prescriptive and it's not taken at that value of it being the person in front of them is sitting there saying ‘I'm struggling at work’ and we turn round and go ‘but the screens don't show us anything’ and then that's taken as part of I suppose a triangulated discussion which you'd hope any clinical team would facilitate. Neuropsychologist PS05
Cognitive management programme	Content What should the programme cover	19. And it could also provide a bit of information, you mentioned fatigue earlier and that having an impact sometimes. Charity Volunteer CV01
		20. Skills, different techniques, to help us and then you perhaps try and test it. Focus Group Male M2
		21. The way that people are making decisions, and in the way that they're managing their condition or not managing their condition effectively. Occupational Therapist OT02
		22. If it's abstract it's very difficult for them to take, say reading something, or being given a handout to applying it. Neuropsychologist PS03

Note: Alpha-numerical codes represent participant ID numbers.