Improving the efficiency of DMD provision

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Our report Improving the Efficiency of DMD Provision outlines how DMD management and monitoring can be improved and modernised, and makes a number of recommendations.

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Improving the efficiency of DMD provision

We looked at how teams could manage and monitor an increasing number of people with MS on disease modifying drugs safely and efficiently. Our report highlights the ways DMD management and monitoring can be streamlined.

Download the report

Priorities to improve services

Roles needed in MS teams

The report recommends that, for efficient practice, not everything should be done by MS specialist nurses. There is a role for DMD/Therapies nurses, DMD coordinators (or combined MS and DMD coordinators in smaller teams), and an increased role for pharmacists and pharmacy technicians.

The Poole Hospitals service has developed a model job description for an MS and DMD coordinator (DOC, 108KB) based on an original used in Cardiff.

Our practical resources on capacity planning and business cases provide tips on making the case for new staff.

Enablers to efficient practice

The report recommends that DMD services should have:

  • a lead for the DMD service, responsible for ensuring that monitoring protocols and systems are in place and are adhered to
  • clearly defined pathways and processes for DMD delivery and monitoring
  • information systems which allow them to keep track of everyone on treatment (including those whose treatment is monitored in ‘spoke’ teams)
  • multidisciplinary team meetings to make decisions about treatment at individual patient and service level.

Reducing unnecessary face-to-face appointments

The report highlights that in many cases, people with MS on DMDs are having a specialist consultation every time their bloods are monitored. Some of these reviews are important, but some may be wasteful and reduce the availability of specialist input for people who are not on DMDs.

Involving people with MS on DMDs in their own care

The report recommends involving people with MS in understanding their own DMD treatment and monitoring through:

  • having clear, shared expectations up front about what will be required – not only for treatment but also for monitoring
  • encouraging people with MS to use the MS Decisions tool and then talking through the results with them can help.
  • using treatment agreements
  • keeping people informed about their results: patient portals which allow patients to log on and view their own records can be helpful.
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