National guidelines for multiple sclerosis care and services

United Kingdom

Pregnancy consensus

These guidelines bring together evidence from drug specific pregnancy registers as well as published peer reviewed research. They cover pre-pregnancy counselling and DMDs for men and women, MS management during pregnancy, delivery and anaesthetic options. The guidelines also give advice for the period after birth, for breastfeeding and for the use of DMDs after the birth.

More information about the UK pregnancy consensus.


NICE Clinical Guideline: Multiple sclerosis in adults: management

The National Institute for Health and Care Excellence (NICE) published the revised clinical guideline Multiple Sclerosis in adults: management (NG220) in June 2022. It gives recommendations on how healthcare and other professionals should care for and support people with MS. The guideline covers the NHS in England, and is also used in Wales. This guideline updates and replaces NICE's 2014 guideline (CG186).

The guideline covers diagnosing and managing multiple sclerosis in people aged 18 and over. It aims to improve the quality of life for people with multiple sclerosis by promoting prompt and effective symptom management and relapse treatment, and comprehensive reviews.

The guideline gives recommendations on:

Our news item gives more information about the 2022 update to the guideline. While there are some positive points in the revised guideline, the MS Trust was disappointed that NICE did not recommend Fampyra which has been shown to improve walking for some people. During the guideline review process, we also raised concerns about the recommendations for drug treatments for fatigue and lack of guidance on treatment pathways for disease modifying drugs.

According to NICE, guidelines are evidence-based recommendations for health and care in England. They set out the care and services suitable for most people with a specific condition or need, and people in particular circumstances or settings. Guidelines are intended to help health and social care professionals to prevent ill health, promote and protect good health, improve the quality of care and services, and adapt and provide health and social care services.

Eligibility criteria for disease modifying drugs in England

The NHS in England uses an algorithm for the treatment options in MS. This describes how each NICE approved disease modifying drug (DMD) can be prescribed, depending on the type of MS you have and how it has responded to treatment so far.

More information about the treatment algorithm for MS drugs.


Healthcare Improvement Scotland published general standards for neurological care and support in 2019. The general standards are applicable to anyone living with a neurological condition in Scotland, including MS, and are intended to ensure consistent high quality neurological care and support services across Scotland regardless of neurological condition, care setting, geographical location or personal circumstance.

The standards cover:

  • leadership and governance
  • working together
  • staff education, training and information
  • diagnosis
  • assessment of needs
  • treatment and management
  • person-centred care.


All NICE guidelines are available to use in Wales, although their use is not mandatory.

NHS Wales published Neurological Conditions Delivery Plan (PDF, 440KB) in 2017. This sets out how NHS Wales cares for people with neurological conditions, including MS.

The delivery plan covers:

  • raising awareness of neurological conditions
  • timely diagnosis
  • fast, effective, safe care and rehabilitation
  • living with a neurological condition
  • services for children and young people living with a neurological condition.

Northern Ireland

The Department for Health for Northern Ireland reviews NICE guidance. The previous 2014 NICE MS Guideline was accepted following a review.

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