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109  UK multiple sclerosis service audit of 70 centres: observed staffing, proposed staffing, coping

Introduction The UK MS service audit builds upon GIRFT’s recommendation for disease-specific data. Here, we address MS Team staffing and their levels of coping. Aim To document the observed MS Teams staffing levels, ascertain their proposed staffing requirements and determine the extent to which they feel are coping with their workload. Methods MS services completed service questionnaires, supplemented with individual clinician interviews. Specifically, we asked about MS Team composition and contribution to MS care, estimated sustainable caseloads per MS neurologist and coordinator, referencing the MS Trust’s recommendations for nurses. Finally, participants graded the degree to which their service was coping. Results MS Team structures varied. MS coordinators (44%) or neuropharmacists (40%) were uncommon and the ratio of prescribing neurologists to ms nurses varied (4:1 to 1:4). Based on respondent’s subjective estimatesa,b and empirical evidencec for sustainable caseloads, implied per centre staffing shortfalls of: 1.8 MS neurologistsa, 2.4 MS nursesc, 2.6 MS coordinators b. No centre felt that they were “coping very well”, 42% were “struggling to cope”. Neither caseloads, nor staffing numbers, per se, predict levels of coping. Conclusions Staffing shortfalls and perceived lack of coping imply the value of: strategic delivery of networked-services, formalising MS team structures and staffing ratios, role and responsibilities, and the need to work differently. Acknowledgements.Neurology Academy david.rog@srft.nhs.uk