Merck Serono - September 2023 - case study 1

Specialist centres for multiple sclerosis (MS) aspire to meet the highest standards of care for their patients, including the treatment milestones developed by the National Neurological Advisory Group. These treatment milestones set out the optimal pathway for care and support for someone with MS, from first presentation with symptoms to a GP, through to diagnosis, treatment and monitoring,

With current capacity, resources and staffing shortages across the NHS, meeting these milestones is challenging. Like many trusts, St George’s hospital became aware that they were not meeting their aspiration of each diagnosed patient receiving their prescription within 12 weeks of a treatment decision being made. St Georges’ chose to work with Merck Serono UK to investigate the cause of this and address the issue. Merck was the partner of choice due to the strong working relationship developed though previous pathway mapping projects.

As part of a grants and donations agreement, Merck Serono UK provided support from a Field Access Manager to map the existing pathway of care at St George’s. This mapping identified the key stakeholders who had a role within the 12-week pathway. Each stakeholder was then interviewed to understand their role in service provision. On completion of the mapping and interviews, Merck produced a visual version of the pathway which highlighted that the delivery of pharmacy and homecare services were experiencing delays and likely preventing St George’s from meeting the 12-week treatment decision milestone.

This visibility generated a discussion between the MS and pharmacy teams which uncovered that varying staffing levels within the pharmacy were likely causing these delays. These staffing constraints and variations meant for example, that if a prescription was sent past a certain day of the week, it would not be picked up until two weeks later when that role was back in rotation.

Understanding the cause then led to a solution with the MS and pharmacy teams building in greater coordination so that all prescriptions were sent to the pharmacy in accordance with the staffing rota, so they could be processed in real time. All staff also received updated guidelines on expected timelines, which helped standardise the time taken for a patient to move onto treatment following diagnosis.

This project meant that treatment times were brought back into line with the 12-week treatment to diagnosis expectations in the optimal care pathway. Earlier treatment initiation also enabled patients to begin managing their condition more quickly. The project also demonstrated that the use of pathway mapping is an effective tool in improving clinical efficiencies and reducing patient waiting times. It also demonstrated the critical role that industry can play in sharing skills and working in partnership to ultimately improve patient care and experience in the NHS.

Benefit for patients:

• Reduced waiting time to start treatment for their condition: 2-4 weeks faster.
• On medication faster to manage their condition, with the potential of preventing deterioration. This has a positive effect on quality of life and reduced anxiety about the diagnosis.

Benefit for the NHS:

• Providing optimal care for their patients, maximising the efficient use of their resources and being able to treat patients in line with the optimal timelines set out by the National Neurological Advisory Group.

September 2023 | UI-NONNI-00584