(From left to right: Kirsty Stanley, Sarah Collyer, Helen Conyers, Michelle Davies, Dorset Multiple Sclerosis Service and Trishna Bharadia, MS patient advocate)
“It was amazing and a big surprise to have our name called as winners of team of the year. It is wonderful to be recognised for what we are doing, especially when we know how good other services are and how hard the MS community overall works for their patients. For us as a team it validates what we are trying to achieve and has given us a drive to keep developing our services for our patients even though at times it is not easy. It is great for us, our hospital Trust and for our patients.”
Michelle Davies, MS Service Lead and Specialist Practitioner, Dorset Multiple Sclerosis Service
Multidisciplinary team offers different care streams for MS patients
This year’s QuDoS recognition programme, organised by pharmaphorum and the Multiple Sclerosis Trust, recognised the best practice in care. As part of a series of articles profiling the winners, pharmaphorum speaks to Michelle Davies, team lead at Poole Hospital NHS Foundation Trust’s Dorset Multiple Sclerosis Service, winner of the Team of the Year category.
Q: Can you describe the team?
A: We are a multidisciplinary team of specialist multiple sclerosis nurses and therapists who work as MS specialist practitioners, and support staff. Although the majority of team members are part-time we have one team lead who is also an MS specialist practitioner (a physiotherapist by background), three MS nurses, two MS physiotherapists, and two MS occupational therapists; we have a full time dedicated administrator and have been lucky to have the recent addition of a disease-modifying drug (DMD) coordinator/support worker who focuses on optimising the DMD pathway and also provides telephone triage. The team has a caseload of about 1,200 people with MS across Dorset.
Q: Can you tell me more about the service?
A: We are trying to model the service to different patient streams, so that people with MS (pwMS) and their families get the best care to meet their individual needs and to ensure that it is patient centred. Every patient is different, so very often people will be in more than one stream. We use pathways and templates to ensure nothing is missed and for there to be equity of care across the county of Dorset and across different patient groups.
We have four different streams – the DMD stream, the advanced MS stream for those with more complex needs who need more time for review and coordination of care and usually are unable to attend clinics, those who are able to come to the clinic for regular MS review, and a stream for those who opt out of regular review and choose to have open access to the service and contact on request. By considering the service around these streams we can more easily divide up resources aiming to best meet people’s needs and achieve equity.
The service has set up a rolling programme of MS competency based training with the objective of keeping the team up to date and maintaining competencies, as well as training for newer members of staff. We have also opened this training to other services both hospital and community based who come into contact with pwMS to try and optimise knowledge and skills in MS across services which will have a positive impact on patient care, and will hopefully spark interest in professionals who may wish to specialise in MS in the future.
The team works closely with the Poole Hospital NHS Foundation Trust’s neuro research department to optimise inclusion in trials and to generally support research in MS.
Q: What difference does it make having staff trained to MS practitioner level?
A: MS specialist practitioners are individual nurses or therapists skilled to work at an advanced level across professional boundaries in the management of MS, thereby working in a truly holistic manner. Having professionals working as practitioners means that care is more focused, there is less fragmentation for the pwMS, and it can save time, thereby making the service more efficient and effective. This professional then seeks further profession specific assessment, advice and intervention when required in a timely way.
Q: What are your plans to develop the service?
A: We currently have two main areas of focus: the first is to further develop competencies in the MS practitioner role so that the full benefits of this can be realised. The other is to look at capacity modelling the service in terms of our streams and where our patients are located across Dorset to ensure the service is best matched to our patients. We can then look at, for example, whether we have the right number and types of clinics in the right locations, and the right balance of resource between the patient streams.
We have really strong links with community services. Going forward we want to strengthen our links with palliative care services so that we can facilitate people to better plan for their future care needs and optimise quality of life and choice for those with advanced MS and those at the end of life.
Q: What did winning mean for you?
A: We were delighted to be shortlisted as finalists but were not expecting to win, so it was amazing and a big surprise to have our name called as winners of team of the year. It is wonderful to be recognised for what we are doing, especially when we know how good other services are and how hard the MS community overall works for their patients. For us as a team it validates what we are trying to achieve and has given us a drive to keep developing our services for our patients even though at times it is not easy.
Q: What’s the biggest satisfaction that you get from your job on a day-to-day basis?
A: It is all about the patients – knowing that you’ve made a difference to someone’s life and you’ve done the best that you can.