For health professionals (MS Clinic)

Referrals to the Cambridge MS Clinic

Please send referral letters for the attention of

Mrs Sally Dell,
Cambridge MS Clinic secretary,
Box 165, Department of Clinical Neurosciences,
Addenbrooke’s Hospital,
Cambridge Biomedical Campus,
Hills Road,
Cambridge CB2 0QQ

Telephone 01223 256208

Relapse management

Guideline for GP's

To access please login to the CUH GP Portal.

• Multiple sclerosis (MS) - Oral steriod administration

NICE guidance

Diagnosing multiple sclerosis

Refer people suspected of having MS to a consultant neurologist. Speak to the consultant neurologist if you think a person needs to be seen urgently.

If a person has an episode of isolated optic neuritis, confirmed by an ophthalmologist, refer them to a consultant neurologist for further assessment.

Diagnosing Multiple Sclerosis - Process Flowchart

1. Diagnosing Multiple Sclerosis

• The process starts with identifying clinical signs and symptoms.

2. Clinical Presentations

• This step involves evaluating the patient's symptoms and medical history.

3. Initial Investigations

• Medical tests, such as MRI scans, blood tests, or other neurological assessments, are conducted.

4. When to Refer to a Consultant Neurologist

• Based on initial findings, if multiple sclerosis (MS) is suspected, the patient is referred to a specialist (consultant neurologist).

5. Making a Diagnosis

• The consultant neurologist assesses all the evidence (clinical and investigative results) to determine if MS can be diagnosed.

6. Outcomes of Diagnosis

• The process branches into two possible outcomes:
• Diagnosis Not Confirmed
  • If MS is not confirmed:
    • The patient is scheduled for Follow-up to monitor their condition.
• Diagnosis Confirmed
  • If MS is confirmed:
    • The patient is scheduled for Follow-up.
    • After follow-up, they proceed to the Management phase, where treatment and care plans are put in place.

Managing multiple sclerosis

Care for people with MS is provided through a coordinated multidisciplinary approach. Professionals who can best meet the needs of the person with MS and who have expertise in managing MS include:

• Consultant neurologists
• MS nurses
• Physiotherapists and occupational therapists
• Speech and language therapists, psychologists, dietitians, social care and continence specialists
• GPs

This flowchart outlines the process for managing multiple sclerosis (MS). It begins at the top and flows downward through key stages:

1. Managing multiple sclerosis

• Start of the management process.

2. Provide information and support

• Patients receive information and guidance about their condition.

3. Coordinating care

• Care plans are organised, and services are aligned for patient support.

4. Lifestyle advice

• Recommendations for lifestyle changes to improve health and well-being.

From here, the flow splits into three parallel pathways:

• Left Path:
  • "Disease-modifying therapies" – Treatments aimed at altering the course of MS.
• Middle Path:
  • "Managing multiple sclerosis symptoms" – Addressing specific symptoms caused by MS.
• Right Path:
  • "Treatments that should not be used" – Identifying and avoiding inappropriate or harmful treatments.

All three pathways then converge into:

5. Comprehensive review

A thorough assessment of the patient’s progress, treatments, and care plan.

Managing multiple sclerosis symptoms