Let’s team up and work together
A new report I co-authored has revealed the huge burden that clinical commissioning groups (CCGs) are under due to emergency hospital admissions for people with multiple sclerosis (MS).
In 2013/14 these emergency admissions cost the NHS £43 million. While emergencies account for just 27% of all admissions for people with MS, they make up 46% of the costs. The most common reasons for these episodes were preventable ones, such as urinary tract and respiratory infections, and constipation.
The avoidable nature of these problems offers an opportunity for CCGs to better manage these patients. Providing appropriate anticipatory care to people with MS and other long-term neurological conditions can prevent costly crises and has the potential to make savings that can be reinvested into services.
People with MS rightly value the support of their MS nurse specialists, but practice and community nurses have a role in providing proactive support to high risk patients who run the chance of getting an infection.
These high-risk patients need to be managed using integrated care pathways that draw on the skills of the full multidisciplinary team
The first step towards reducing emergency admissions is to identify those most at risk who would benefit from early intervention in the community. These high-risk patients need to be managed using integrated care pathways that draw on the skills of the full multidisciplinary team. An integrated MS care pathway can be used to co-ordinate each patient’s journey through the condition, but respiratory, bladder and bowel pathways are also essential to support all clinicians, including GPs, in preventing crises.
The NHS has been guilty of developing care silos for some conditions, making them the province of specialists. But to manage the volume of people living with conditions such as MS, we need health and social care teams to work together in co-ordinating care, supporting patients to self-manage, identifying early signs of complications and implementing preventive treatment strategies. Community nurses can be an essential part of this.