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Support for MS specialist posts

Way Ahead 2006;10(3):2

MS specialist health professionals (HPs) in many areas of England face an uncertain future. Results from an MS Trust survey of all MS specialist nurses in January showed that 27% did not consider funding for their posts to be secure. Since then, a number of MS specialist nurses have contacted us as they become aware that their jobs are, or might be, under threat. Most are hospital based and are at risk because of funding problems in their local Trust. However, as there are funding issues within both primary and secondary care, we anticipate that the issue may become more widespread.

Concerns have also been expressed that the new role of Community Matron may be given greater local priority than MS specialist posts. Community Matrons case-manage people with a number of complex conditions across all the relevant agencies, ie health and social care, together with housing and transport issues. Whilst some people with MS fall into this category, the majority do not. MS specialist HPs need to be able to demonstrate how their support for people with a single, complex condition supports and complements the work of Community Matrons.

The MS Trust has put together a list of actions any members of the multidisciplinary team who consider their post to be at risk can take. Very briefly, these are:

  1. Written justification of the MS specialist post, encompassing:
    • job description
    • supporting evidence from audit (see below)
    • supporting evidence from the literature in terms of efficiency savings. For example, two key pieces of research[1, 2], argue that MS specialist nurses can:
      • be cost effective and provide financial savings for the NHS Trust;
      • help meet the Public Sector Agreement target of reduction of inpatient emergency bed days by 5% by 2008 (Supporting people with long-term conditions[3]);
      • help meet the target to offer everyone with a long-term condition a care plan by 2010 (Our Health, our care our say[4]; paragraph 5.27)
  2. Audit evidence: ideally this will be a local audit of the MS service. If you have not conducted an audit before, and if you have time, section one of the Learning Needs Analysis tool provides a useful framework for auditing your activities. This tool is available from the MS Trust. Any audit should identify savings to the PCT/NHS Trust in terms of:
    • reduced emergency hospital admissions;
    • cost savings overall in terms of other services, especially reduction in hospital visits/neuro appointments/GP appointments.

    Things to think about are how you:

    • promote self-care, eg newly diagnosed courses or fatigue management courses;
    • reduce emergencies among people with MS;
    • reduce unnecessary GP and consultant visits by appropriate management and referrals;
    • aid people with MS to return to or support them in continuing to work.
  3. Consider enlisting the support of your professional organisation and your patients. The MS Trust now has a model letter for patients to use when writing on your behalf, so you can direct them to us or to our website.

Finally, please let us know if you believe your post to be in danger. We will talk through any issues that may be specific to your post, and may be able to help you make your case. Additionally, the MS Trust is very happy to write letters to the relevant parties in support of individual MS specialist posts, to ensure that your voice is heard. Contact Alice Hamilton in the first instance by phone on 01462 476700 or by email.

References

  1. Johnson J, et al
    Evaluation of MS specialist nurses: a review and development of the role.
    London & Letchworth: South Bank University & MS Trust; 2001.
  2. Campion K.
    Meeting multiple needs.
    Nursing Times 1996; 92(4): 28-30.
  3. Supporting people with long-term conditions: an NHS and social care model to support local innovation and integration.
    London: Department of Health; 2005.
  4. Our health, our care, our say: a new direction for community services.
    Cm. 6737. January 2006.

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