About
The Advanced MS Champion role aims to support those living in SWL or Surrey with advanced MS.
Roles and responsibilities
- Ensure timely referrals to relevant health professionals and organise complex MS MDTs
- Re-engaging patients with advanced MS with essential patient care
- Coordinate the care of people living with advanced MS by working across teams and social care to deliver a joined-up care plan
- Attend home visits to assess people in their home environment
- Help people with advanced MS to live as independently as possible
- Helping people to access funding including PIP and approaching charities for funding where applicable
- Educating carers on the management of MS symptoms, increasing their confidence and knowledge
Referral guidelines
- Diagnosis of Advanced MS (AMS) with an EDSS ≥ 7.0
- Catchment area: South West London and Surrey
And at least 1 of the following:
- Housebound (temporarily/permanently)
- Complex needs relating to Multiple Sclerosis
- Benefit from a holistic assessment at home
- At risk of hospital admission/has had a recent hospital admission
- Sudden change in MS symptoms leading to admission or increased care
- Poorly managed MS symptoms or secondary complications requiring increase in health professional intervention
- Risk of or safeguarding has been raised