New national guidelines on the diagnosis and treatment of multiple sclerosis have been criticised by a charity for failing to emphasise the role of specialist nurses.
The guidance was published today by the National Institute for Health and Care Excellence, which described it as a “paradigm-shift” in MS care. The document updates a previous version from 2003.
“There is clearly a crucial role for a critical nurse specialist in the provision of care”
It recommends that MS patients should be appointed an “appropriate single point of contact to coordinate care and help them access services”.
It also states that MS patients should undergo a review of all aspects of their care at last once year by “healthcare professionals with expertise in specific areas of the review if needed”.
However, the guidance does not specifically mention MS specialist nurses for providing either of these functions.
The MS Trust claimed that NICE’s failure to do so demonstrated a lack of recognition of the “pivotal role” that specialist nursing staff played in delivering and signposting services for the long-term condition.
Amy Bowen, director of service development at the MS Trust, said specialist nurses were central to delivering both the comprehensive annual review and acting as a single point of contact.
The latter would usually involve patients being provided with a phone number to ring so they could be re-directed to the appropriate healthcare professional, she told Nursing Times.
Ms Bowen, a nurse herself, claimed NICE was often reluctant to assign roles to specific tasks for fear of hampering service improvement, but suggested that “in this instance” it had made a mistake by not doing so.
“When you are talking about a long term, complex condition that affects individuals very differently and has a huge range of symptoms and treatments, there is clearly a crucial role for a critical nurse specialist in the provision of care,” said Ms Bowen.
Dr Paul Cooper, chair of NICE’s MS guideline development group, emphasised that the document recommended multi-disciplinary care, including nursing.
“We are not devaluing the role of the nurse. We think they maybe perhaps better used”
But he told Nursing Times that an MS specialist nurse was a “very expensive animal and needs to be used appropriately”.
“One of the problems is how to make the most effective use of nurses’ time,” said Dr Cooper, a consultant neurologist at the Greater Manchester Neuroscience Centre.
“If what they’re doing is acting as a call centre to book a physio appointment, that is not maybe the best use of their time,” he said.
“We are not devaluing the role of the nurse. We think they maybe perhaps better used – rather than being an expensive call centre, which some of them are nowadays, actually focussing on treating patients,” he added.
But Ms Bowen said that while each MS specialist service would have to decide how to use its resources in the most cost effective way, nurses were ideally placed to deliver this function because they had the breadth of knowledge to navigate the range of services available to the patient.
“Lots of nurses deliver that service already,” she said. “What we want to make sure of is that there are enough nurses out there to make that service fully responsive.
“It doesn’t mean, if you are the single point of contact that you are going to deal fully with every requirement that is raised by the individual when they make contact with the service. It’s about pointing people to the right place,” she said.