Developing MS Services

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Developing MS Services

• Lessons from a three-year evaluation

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MS and Primary Care

• Dr John W Keen

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Whats Going On?

• appraisal
• revalidation
• new options salaried, ltd co
• new GP contract

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Each GP has..

• diabetics 60
• asthmatics 300
• MS 2

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The Next New Case Of..

• heart 2 July
• cancer 2 June
• depression 16 March
• respiratory mid-morning
• MS 2019
• MND 2049

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Whats New in MS Primary Care

• NICE Guidelines for MS Services
• GP National Enhanced Service for MS

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NICE Guidelines

• 2 rapid diagnosis (6 weeks)
• 3 protocols seamless service
• 5 identify hidden problems
• 6 re-referral into neuro/rehab

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NICE Guidelines smallprint

• access in relapse
• use of steroids
• residual urinary volumes
• scoring systems in depression
• botox, sildenafil, SSRIs

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GP National Enhanced Service

• Aim to address proactively the physical health
  care needs of patients with MS, by ensuring they
  receive rounded health care and support. Where
  appropriate, the scheme should encourage the
  primary care team to work closely with the
  patients carer(s), and to encourage closer
  interaction with other support services.

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GP National Enhanced Service

• maintain a register
• establish a lead contact/co-ordinator
• regular assessment
• team training
• carer support
• personal health plan
• annual review

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GP National Enhanced Service

• cost
• accreditation
• equity for patients?
• GPSI / patient poaching
• nursing duplication?

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MS and Primary Care

• should we bother?
• strengths weaknesses?