MS audit finds little improvement in care
pharmafile | October 12, 2011 | News story | | MS, multiple sclerosis
There has been “little or no improvement” in the care of multiple sclerosis patients over the past five years, according to new research.
The damning audit by the Royal College of Physicians and the MS Trust also found that NICE’s recommendations for the management of patients with the neurological condition “are no closer to being met today than when they were first launched in 2003”.
NICE issued six main points on the care of this incurable disease – but the report found that not one has been implemented “widely or fully”. As a result, NHS trusts are being urged to look again at the guidelines.
“All organisations in the NHS should be required to initiate a five-year project with protected staff with the responsibility to reorganise services to achieve compliance,” the report said.
But the audit identified a number of failings, such as not offering a rapid diagnosis once patients have MS symptoms and not ensuring that specialist services are in place.
Basic symptoms such as pain, fatigue and problems with cognition are not being treated correctly, while a third of trusts have no plans to improve neurological services in the next year.
Most trusts are giving “insufficient management attention” to joining up services across the NHS or with social care, and most MS sufferers do not have access to specialist rehabilitation, the report said.
The original NICE guidance acknowledged that there may be local variations in the way care was implemented and admitted there was “little evidence upon which to base recommendations” in many areas of MS.
But its guidelines made clear that some of the most significant recommendations – while not evidence-based – were what experts “would recommend for their patients or relatives”.
At the time NICE said the main aims “ought to be common across England and Wales, and if adopted should lead to better standards of care and thus better outcomes from this often distressing condition”.
However, the MS Trust warned that increasing financial pressure on the NHS does not give much hope for any significant improvement in this area.
“With huge changes in commissioning and squeezed budgets there is no evidence that things are going to improve and we are extremely worried about the future for the services that people with MS depend upon,” said chief executive Pam Macfarlane.
Derick Wade, professor in neurological rehabilitation and associate director of the audit, was more upbeat, saying that future changes to the way health services are commissioned provides a “unique opportunity” for reorganising services for MS patients.
But he warned: “We must not repeat the mistakes and inertia of the past eight years. We must move forward, identifying where services are deficient and making them better.”
MS affects around 100,000 people in the UK, and is a life-long condition whose effects, while unpredictable, can lead to loss of work and independence. Pharma markets several drugs for the condition – notably Teva’s Copaxone, Novartis’ Gilenya and Biogen’s Avonex and Tysabri – and others are expected to be filed soon.
Adam Hill
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