Quality statement 6: Comprehensive review

Quality statement

Adults with multiple sclerosis (MS) are offered a comprehensive review at least once a year by healthcare professionals with expertise in MS.

Rationale

A comprehensive review for people with MS ensures that they have the opportunity to hear from healthcare professionals about any new treatments, to be kept informed of their options, and for any issues or changes that might need referral to different services or other healthcare professionals to be identified. A planned review will also pick up people who have not been in contact with services, whose condition is not being monitored and who are not receiving support. These people may have more unmet needs than those in regular contact.

Quality measures

Structure

Evidence of local arrangements to ensure that adults with MS are offered a comprehensive review at least once a year by healthcare professionals with expertise in MS.

Data source: Local data collection.

Process

Proportion of adults with MS who have a comprehensive review by healthcare professionals with expertise in MS within 12 months of the previous review or diagnosis.

Numerator – The number in the denominator who have a comprehensive review by healthcare professionals with expertise in MS within 12 months of the previous review or diagnosis.

Denominator – The number of adults with MS.

Data source: Local data collection.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (GPs, community health teams and neurology services) ensure that adults with MS are offered a comprehensive review at least once a year by healthcare professionals with expertise in MS.

Healthcare professionals (members of the multidisciplinary team with expertise in MS) ensure that they offer adults with MS a comprehensive review at least once a year.

Commissioners (NHS England local area teams and clinical commissioning groups) ensure that they commission services that offer adults with MS a comprehensive review at least once a year by healthcare professionals with expertise in MS.

What the quality statement means for patients, service users and carers

Adults with MS are offered an appointment at least once a year to discuss their condition with healthcare professionals with experience in MS. At this appointment they are asked about their symptoms, their medicines, their overall health and wellbeing, and how their condition affects their day‑to‑day life (family life, work and other activities). They can raise any problems and mention any extra support they need. A planned yearly appointment will also pick up people who have not been in contact with services over the past year but need some support.

Source guidance

Definitions of terms used in this quality statement

Comprehensive review

A comprehensive review involves reviewing all aspects of care for a person with MS. The review should be carried out by healthcare professionals with expertise in MS and its complications, be tailored to the needs of the person with MS, and assess the following:

  • MS symptoms

  • the course of the disease and number of relapses in the past year

  • general health, including mental health

  • social activity and participation

  • care and carers

  • palliative care, when needed.

Other health and social care practitioners with expertise in specific areas of the review should be involved if needed. It is likely that the emphasis in the review may change over time and that different healthcare professionals may carry out the review. Any issues identified during the comprehensive review should be referred to other members of the MS multidisciplinary team and to other appropriate teams so that they can be managed. People with MS should also be offered a medication review.

[Multiple sclerosis in adults: management (NICE guideline CG186) recommendations 1.6.1, 1.6.2, 1.6.3, 1.6.4 and 1.6.5, full guideline section 11.6 and expert opinion]