National clinical guidelines for the management of multiple sclerosis in primary and secondary care in the NHS


The aim of this project was to inform the NICE clinical guideline on multiple sclerosis which covers the full range of care that should be available from the NHS to adults of all ages with MS. The guidelines include how the diagnosis should be made, how people should be told they have MS and the treatments that should be offered. Treatments for MS may involve medicines but also include physiotherapy, rehabilitation, and psychological and emotional support.


The guideline development group used the systematic review evidence to inform their recommendations. The priorities for implementation included provision of specialist neurological and neurological rehabilitation services for every person with MS, when they need them. Coupled with service provision was the need for rapid referral to the specialist service for individuals suspected of having multiple sclerosis, and the need for every health commissioning organisation to ensure that all organisations in a local health area agree and publish protocols for sharing and transferring responsibility for, and information about, people with MS.

All services and service personnel within the healthcare sector should recognise - and respond to - the varying and unique needs and expectations of each person with MS. Health service professionals in regular contact with people with MS should consider in a systematic way whether the person with MS has a 'hidden' problem contributing to their clinical situation, such as fatigue, depression, cognitive impairment, impaired sexual function or reduced bladder control. Every person with MS who has been seen by a specialist neurological or neurological rehabilitation service should be informed about when and how to make contact with the service when he or she is no longer under regular treatment or review.

Conducted by: CRD

Related guidance

Published as supporting evidence for NICE clinical guideline 8: Multiple sclerosis: management of multiple sclerosis in primary and secondary care. London: National Institute for Health and Clinical Excellence; 2003

The National Collaborating Centre for Chronic Conditions. Multiple sclerosis: national clinical guideline for diagnosis and management in primary and secondary care. London: Royal College of Physicians of London; 2004


Commissioned by the National Collaborating Centre for Chronic Conditions, Royal College of Physicians