Project Name: Basildon MS Service and Capacity Redesign
Project Summary:
The Collaborative Working Project aims to understand the Basildon University Hospital Multiple Sclerosis (MS) pathways as part of Mid and South Essex NHS Foundation Trust and recruit one MS Coordinator to support only the Basildon University Hospital MS service with the administration side of the management, review, and follow-ups of MS patients. This will address the staff shortages being experienced by the Basildon University Hospital MS Service part of Mid and South Essex NHS Foundation Trust and help tackle the backlog of patients not on disease modifying therapy, requiring treatment reviews, and new patients entering the MS Service.
Specifically, via conducting the pathway mapping and integrating the MS Coordinator into all aspects of the service, the Collaborative Working Project aims to:
- Support the MS Service to improve efficiency, service effectiveness, and address the local challenges for the benefit of patient care
- Improve the delegation of activities to ensure the most qualified staff are providing the right MS Service
- Reassigning released nurse capacity to enhance patient management and optimisation of therapies
Planned Milestones:
| Milestone | Description |
|---|---|
| 1 | Kick off CWP meeting held between Novartis and CW Partner |
| 2 | Completion of pathway mapping, recruitment of MS Coordinator, and baseline Service Data collected |
| 3 | 6 months clinical Service Data collected |
| 4 | 12 months clinical Service Data collected |
| 5 | Project Outcomes Summary Completed |
Expected Benefits:
Expected benefits to NHS:
- Improved understanding of the current MS service pathway and associated efficiencies and inefficiencies, with a potential to lead to solutions to enhance patient experience and outcomes.
- Reduced administration burden on nursing staff
- Increased number of Clinical Nurse Specialist led activities
- Decreased the administration burden of the nurse team
- Reduced the waiting time and aligned to 18-week NHS ambition
Expected benefits to Patients:
- Improved patient outcomes due to faster time from referral to treatment time
- Improved access to NICE recommended therapy
- Enhanced patient experience of the NHS MS service by reducing unnecessary waiting time
Expected benefits to Novartis:
- Understand opportunities to partner with the NHS to enhance patient outcomes and experience
- Learnings relating to the involvement of MS Coordinators within the MS Service
- Better understanding of overall NHS customers’ and patients’ needs;
- Optimal use of medicines (including Novartis medicines) in appropriate patients
Start Date & Duration: January 2023 Until November 2024 (22 months)
FA-11319315 I November 2024
Project Name: Basildon MS Service and Capacity Redesign
Partner Organisation(s): Mid and South Essex NHS Foundation Trust (CWP) on behalf of Basildon University Hospital NHS Trust
Completion Date: December 2024
Outcome Summary:
The objective of this pathway mapping was to initially map the MS service and identify future opportunities for efficiency redesign by the NHS Trust, This was achieved as highlighted in Key project data and outcomes below.
Key Project Outcomes Data:
The key areas identified from the mapping process were:
- Identified the need to standardise a referral template to be used in the electronic referral system (e-RS), giving clarity to Primary Care, ensuring patients align to the correct clinic, potentially reducing the time from referral to potential diagnosis.
- A need to Upskill HCPs in primary care, patients and broader NHS workforce on MS referrals.
- Create or obtain a functional database via liaising with colleagues from within the Basildon Trust for support & sharing best practice
- Develop a protocol for the MS team to link with Radiology so all appropriate HCPs have access to MRI referrals & potential for the GP to refer for MRI at the same time as referral to neurology team to tackle the MRI backlog.
Outcomes:
Seven main areas were discussed and assessed as part of the project, they were: Referrals, waiting times, education, coding, workforce and workload, MRI backlog and the departments database. The potential future considerations, in order, for each are listed below:
Referrals - Standardise a referral template to be used in the e-RS. This will give clarity to Primary Care, potentially ensuring all appropriate patients will align to the correct clinic, as well as possibly reducing the time from referral to potential diagnosis. Advice & Guidance service - Educate and remind Primary Care to utilise this service, it may impact on clinic capacity and appropriate referrals.
Waiting times – A need to Standardise referrals, which could ease the administration burden, allowing more patient clinic time. Drive confidence in Primary Care to manage MS patients for non-MS related health conditions and utilise the Advice & Guidance service appropriately.
Education – Run educational sessions for HCPs in Primary Care to increase knowledge, understanding and confidence in managing MS patients; to include upskilling of community pharmacists, community nurses, and other HCPs who may have a point of contact with patients. Conduct patient education, develop resources, and encourage empowerment, with the view to have local patient groups and advocates.
Coding – Run a data cleanse exercise to gain full perspective of existing patients and establish proposal to seek those currently without a diagnosis registered. Ensure upskilling of non-clinical staff to increase accuracy of coding when reading letters or booking appointments. Create codes specifically for CNS led clinics, so that patients are aware of which HCP they’ll be expecting to see at their appointment.
Workforce/Workload - Gather evidence to support a business case, to be presented to the MSE Trust, to secure additional funding to support the MS service. Defining which role(s) would be most beneficial to ease the challenges currently within the MS service
MRI backlog – Post establishing why the backlog is in place, despite appropriate training by the Clinical Nurse Specialist ( CNS); build and launch a protocol for the MS team to link with Radiology, ensuring all appropriate HCPs have access to MRI referrals.
Review the potential for the GP to refer for MRI at the same time as referral to neurology team. Seek advice around linking MRI data from radiology into e-PR system to allow appointments to be made in a timely manner.
Conclusion:
This review is a starting point, which, through engagement of the stakeholders involved within the MS service at Basildon Trust, has started some thinking on how the MS pathway could be developed by the people who work within the service to improve patient care.
This early work has sought to start to develop some principles; what should be done where, by who, and when? It doesn’t set out to try and create uniformity across MSE, l, but it sets out potential expectations that can be delivered and aspirations for the future MS service(s).
FA-11414761 | May 2025