Research by By Ruth Stross, MS Nurse Specialist, Surrey Downs Health and Care & Dr Ioana Cociasu, Clinical Fellow in Neurology St George’s Hospital

Mentor: Sue Thomas

All of our attendees carry out a piece of research in an area of MS clinical practice or treatment that interests them. 

This snapshot, which won the MS8 project awards, gives you a quick idea of what they found and why. If you want to learn more, just click through to the full research report, or follow the links within the snapshot. 

If you would like to contact the alumni who did the research, drop us a line and we’ll put you in touch where possible.


To assess and highlight major gaps and critical areas for improvement in the current model of care for people with MS in Surrey.

  • understand the current pathway for someone with MS
  • map the ideal pathway for someone with MS


  • Surrey Heartlands is one of the new NHS integrated care partnerships (ICPs) but MS is not a priority, although a number of their aims are applicable to MS.
  • Whilst new in post, Ruth had previously carried out a mapping exercise in Richmond with support from Sue Thomas and felt confident to repeat the process.

Key findings

  • A rigorous process was followed:
    • literature review of current guidance and data sources, 
    • two stakeholder meetings to date (11 and 35 attendees) where pathways were discussed, developed and then prioritised, 
    • actions agreed and pathways developed
    • additional stakeholder event planned for 2020. 
  • Ongoing engagement with stakeholders & utilisation of pathway to improve practice 
  • Recognition of sub-optimal care and initiation of change 
  • Bringing all services and community support together from across Surrey – from all areas 
  • New MS Champions for Social Care Locality teams 
  • New MS Neurologist based in local District General hospital (DGH) 
  • MS Trust have provisionally agreed to fund 1 full-time MS nurse post, working with SDH&C
  • Service now on the risk register due to the lack of capacity within existing service with monitoring of DMTs leaving patients at risk 
  • MS Society compiled a leaflet on known services for MS across Surrey which has been distributed to everyone involved in the project 
  • Neuropsychologist in Community Neuro Rehab Team (CNRT) to help in development of relevant pathways – potential for high risk patients to be seen 
  • Lead Speech & Language Therapist for CNRT working with MSSN on pathways for ‘Swallowing, Speech and Communication difficulties’- prioritized as an area with little data or patient information

Core recommendations

  • Selection of priority areas for immediate attention
    • Psychological support 
    • DMD pathway
    • Speech, Swallow and communication difficulties
  • Identify stakeholders that may be new to MS services e.g. local government, public health
  • Improvement opportunities and highlighting areas of good practice
  • Identify and reduce workforce shortages – both within MS service team & the wider teams (e.g. Psychology)
  • Regular Stakeholder meetings with the aim for continuous audit and improvement of services 
  • Due to the difficulties in providing care via Hub & Spoke model: preference for Network model
  • Where should the prescribing for DMDs be placed? 
  • MS Champions for each Locality (social care) interested in attending regular MS  MDT meetings
  • MSSN/ Clinical Fellow to present the Pathway at the Regional MS Meeting on Friday 17 January 2020

Take action