Multiple Sclerosis (Better Care)
The final item of business is a members’ business debate on motion S4M-01107, in the name of Rhoda Grant, on multiple sclerosis and better care. The debate will be concluded without any question being put.
Motion debated,
That the Parliament welcomes the campaign for better health care across Scotland by the MS Society which highlights the need for effective implementation of the Clinical Standards for Neurological Health Services; considers that the standards for neurological conditions published in 2009 mark an important step forward for patients with multiple sclerosis (MS) by setting out key standards for all NHS boards, including access to specialist multidisciplinary teams; recognises that these standards are vital to ensuring that MS patients have access to high quality care wherever they live; welcomes the appointment of a dedicated MS nurse in the Western Isles which it understands follows significant work by the MS Society; recognises the role of individuals and communities in the Western Isles who campaigned successfully for the appointment; notes that Scotland has one of the highest incidences of MS per head of population in the world, and believes that greater investment and government support is needed to further research and provide services.
17:05
I am pleased to introduce this members’ business debate and I thank the members who signed my motion. I was privileged to sponsor a reception in the Parliament this week for the Multiple Sclerosis Society, which MSPs supported well. Many who attended the reception told me that they appreciated that support.
Approximately 10,500 people in Scotland live with MS—that is one of the highest rates in the world. In parts of the world where rates of Scottish immigration have been high, MS is often called the Scottish disease. MS takes many forms. Many sufferers can go through life with little effect on their lives, whereas the disease can be devastating and life threatening for others. It is progressive, and a diagnosis seldom tells a patient what they can expect. The disease is often remitting and relapsing, so its effect is difficult for people to gauge.
Because of those factors, it is important that people receive on-going support and information. People with MS often face a postcode lottery in accessing healthcare. In 2009, the Government published the clinical standards for neurological health services, which sought to address the situation. They go some way towards providing guidance for NHS boards, but services are still patchy.
The MS Society therefore finds itself campaigning for better services. I campaigned alongside the society in the Western Isles recently. Despite having a high incidence of MS, the islands had no specialist nurse. That meant that patients had to travel to the mainland for specialist services. I was first told about that problem by Christine Stewart. The success of the campaign to get an MS nurse for the Western Isles is due largely to her and her fellow campaigners’ tenacity.
The clinical standards for neurological health services set out the standards of care that health boards must meet when treating people with MS. They include access to a multidisciplinary team that specialises in MS—as a minimum, that must consist of a specialist consultant and an MS nurse; access to neurological physiotherapy and rehabilitation, occupational and speech therapy, dietetics, and pharmacy and mental health services; access to an MS education programme; and access to a review by a specialist team every 12 months. People with MS must also be able to self-refer to specialist services.
Progress has been made, but many health boards are still to implement all the standards. Their importance cannot be overestimated. If patients receive the support and information that they need, that helps to improve their outcomes, keeps them independent and helps them to continue to work. That will not prevent relapses, but people will recover more quickly with specialist support.
On specialist services, does the member acknowledge the tremendous work that is done by the Inverness Multiple Sclerosis Therapy Centre, which has tremendous input from paid and unpaid staff? The third sector also plays a vital role in such fantastic services across Scotland.
I agree with David Stewart about that centre, which I visited some years ago. I was impressed by the range of services that was available—the centre had a hyperbaric chamber, aromatherapy and a physiotherapist, when physiotherapy was not widely available to people with MS.
Evidence suggests that physiotherapy helps people with MS to retain muscle tone and mobility and helps to strengthen bones and to prevent conditions such as osteoporosis.
Self-management can help people with MS to develop the skills that they need to manage their MS symptoms. Specialist psychological support, such as cognitive behavioural therapy, can help with depression or behavioural symptoms that are directly or indirectly caused by MS.
MS nurses provide a range of services that would otherwise often be dealt with by a consultant neurologist, a general practitioner or someone in an accident and emergency department in a hospital. Those resources are already stretched and are considerably more expensive than an MS nurse.
Access to an MS nurse also means that patients have a point of contact and are more likely to seek and obtain support quickly. Early intervention improves recovery time, and relieves pressure on other services that might not be the best equipped to help.
Since 2010, Health Improvement Scotland has led the implementation of the programme to assist health boards in meeting the required standards, but we must continue to monitor service provision and improvement, especially at a time when budgets are tight and posts might not be filled as quickly as they otherwise would have been.
I have been concentrating on health services, but many other services impact on people with MS, not least social care and housing. People with MS frequently express concern about the lack of integration between health and social care services. MS can be a fluctuating and unpredictable condition. People with MS might require support only sporadically but perhaps quite suddenly, and they must be able to access equipment or make interim arrangements easily, so that their needs are met without undue delay. It is vital for people with MS that health and social care professionals have an understanding of the condition and share their knowledge.
In 2008, Dundee City Council appointed an MS specialist social worker, and a recent evaluation of that post has produced very positive feedback. People with MS felt reassured that their social worker understood their condition and the fact that their care needs could change rapidly. Healthcare professionals also experienced benefits as a result of the post, because the social worker acted as a single point of contact, which led to much quicker and easier referrals to and from health services. Housing services must also be able to deliver adaptations quickly to help people with MS to remain independent.
Finally, I pay tribute to the MS Society, whose work on campaigning for better services has resulted in increased funding and service improvements throughout Scotland. It works with the Government, the health boards and other authorities to improve services for MS patients. Those improvements have led to better outcomes for those people, and those changes improve people’s life chances and make a real difference to their wellbeing. It is therefore important that local authorities also develop partnerships with the MS Society. It is able to provide social care staff with tailored training and education, which would provide the authorities with an insight into services that would make a significant difference to people’s lives.
I have five members wishing to speak in the debate, and I can offer them up to five minutes each. I call John Wilson.
17:12
I congratulate Rhoda Grant on securing this much-needed members’ business debate. The issue is very important to me, as well as to other members present, as my wife was finally diagnosed with multiple sclerosis in 1988. MS is a debilitating illness that affects the lives of individuals and their families dramatically. The MS Society notes that almost twice as many women as men have MS. Scotland has the highest incidence of MS per head of population in the world. As yet, we have no national register of people with MS, so the numbers affected are not easily quantified, but we know that more than 10,500 people in Scotland have MS.
The first report on the MS incidence register, published in September this year, noted that of those diagnosed in 2010, 9 per cent had waited more than six years to have their MS diagnosed. Early intervention is crucial in tackling the onset of MS and, although there is no cure at this time, some referrals and admissions to hospital can be avoided through adequate early intervention and treatment. I understand that the assessment and treatment of MS are often complex, but that does not mean that we should not continue to strive for faster diagnosis and comprehensive support services for those living with MS throughout Scotland. The MS incidence register should provide a useful tool for redesigning services to ensure that they accurately reflect the needs of those living with MS throughout Scotland and, in turn, raise the standard of treatment.
The clinical standards for neurological health services, published in 2009, should, if adopted correctly, provide a higher quality of healthcare throughout Scotland, regardless of where individuals live, and eliminate the postcode lottery that has for too long denied many diagnosed with MS access to the best treatment available.
A number of excellent support services are available to people throughout Lanarkshire, including the Haven, which is based in Blantyre. It works with NHS Lanarkshire and other local support services to lead and deliver excellent support and advice programmes for those affected by MS and other long-term conditions, without the need for a referral. If an individual cannot travel, the Haven at home service brings highly trained professional services to where they are needed. The MS Society in Cumbernauld works in conjunction with the Haven and its staff, and so does the Revive MS Support centre in Glasgow, as part of its outreach work.
Airdrie hospice provides essential physiotherapy services and counselling for people in the area. NHS Lanarkshire now has in post a specialist MS nurse. That is crucial in providing advice and support to those affected by MS and is useful in promoting self-management of the condition, thereby avoiding hospital visits and admissions and preventing relapses. In accordance with the clinical standards, NHS Lanarkshire is meeting the minimum standard for a multidisciplinary team specialising in MS.
More must be done to support the holistic endeavours of initiatives such as the Haven, which gathers specialist knowledge of MS within a social model of care that is rooted in the community. In my experience, what is apparent is the lack of comprehensive information about what is available in the community. Services often fail to connect with the individual who is struggling to cope with their condition. The Haven must be congratulated on its information pack, which is now available to be given to people on diagnosis. People are vulnerable at that time, as they experience the emotional effects of being diagnosed. Those effects can be severe and can render people unable to process verbal information at the time.
Given the complex nature of MS, it is crucial that those affected are aware that symptoms may be linked to illnesses other than MS that can be treated, instead of jumping to the easy conclusion that MS symptoms have worsened. Self-management courses provided by organisations such as the MS Society offer individuals the opportunity to learn to manage their condition effectively in their day-to-day lives. We must ensure that those courses are widely available in order to keep people as well as possible.
The variable and fluctuating nature of MS itself makes life unpredictable for sufferers and their families. The condition affects people in many different ways and impacts on many different areas of their lives including work, relationships and families. Therefore, it is crucial that advice and support are offered to the family of those living with MS, as they will most likely take on the role of primary carer at various times. The Haven must be congratulated on the work that its children’s services do, providing fun activities that young carers would otherwise be denied.
I once again congratulate Rhoda Grant on bringing the debate to the chamber and look forward to a successful outcome in delivering MS services throughout Scotland.
17:18
I begin by declaring an interest: my son is a director of the Towpath Trust, which is an organisation in the west of Scotland that provides services to MS sufferers, among other groups. I welcome the debate and congratulate Rhoda Grant on bringing it to the chamber.
MS is a very particular condition, and people who suffer from it face significant difficulties. An early diagnosis, while it may be welcome, and is no doubt important, nevertheless confronts the person who is diagnosed with a difficult situation, as the progress of the condition is so variable—ranging from a fairly rapid deterioration to a single attack and no further deterioration. Therefore, uniquely among the things faced by doctors, specialist nurses and support teams, the psychology of the condition and how people face it can be extremely difficult.
The traditional approach, which has now largely gone, was that a doctor, when faced with someone with an initial set of symptoms such as a bit of sensory loss in one limb or a blurring of vision, would not tell the person of the diagnosis, because they wanted in some way to protect them. That is an inappropriate way in which to treat patients. Individuals should very much be partners in their own care.
The pathology of the condition is interesting. As members have said, we do not know the cause. The process of the nerve wires becoming moth-eaten, as the insulation around them breaks down, thus affecting the transmission of neurological impulses, is particularly unique.
The epidemiology is interesting. Rhoda Grant referred to the fact that the UK has a high proportion of MS sufferers and that, in fact, the further north we go, the more people suffer from the condition. We do not fully understand the reason for that, but it must be reflected in the support that is given, so that more services are provided in areas with a high density of MS sufferers. That is self-evident, but when we consider the distribution of specialist services, we find that it is not the case. NHS Ayrshire and Arran has about the most complete team—it has an occupational therapist, for example.
As the condition progresses, people need early adaptations in their houses. That is critical. Care and Repair’s services face the same challenges as many other services face at present, so they must be supported in providing early adaptations. I was appalled to hear that NHS Tayside decided only 18 months ago, as an efficiency saving, to merge its aids and adaptations service with that of the local authority. A similar merger took place 25 years ago in the NHS Forth Valley area. It is necessary to co-ordinate those services.
The key standards that have been published are extremely welcome. I also welcome the monitoring of those standards and the reports on the monitoring. I think that we will receive an interim report in January. I look forward to the minister publishing the results of follow-up of the issues.
The implementation of the specialist nurse programme is of the greatest importance, because nurses who have special training can provide the support that individuals need. People need an holistic approach that not only deals with the physical symptoms and problems of increasing disability, but achieves the psychological adaptation that is necessary. I welcome the work of the MS Society and the progress that we have made, but we have further to go in supporting those who suffer from MS in Scotland.
17:23
I, too, congratulate Rhoda Grant on securing the debate. I acknowledge the support that you, Presiding Officer, have given to people with multiple sclerosis in previous sessions of the Parliament and your commitment to the issue. I remember your members’ business debate on the subject many years ago. I imagine that that is why you are here this evening, which is unusual for the Presiding Officer. I am sure that members are grateful for that.
I welcome the progress that has been made since the Government published the clinical standards for neurological health services in 2009. However, although we should mark that progress, it is worth stating that the MS Society, in its briefing for the debate, states:
“People with MS face a postcode lottery when it comes to their healthcare”.
As others have said, MS is a complex and fluctuating condition. I am sure that most if not all of us know several people who have multiple sclerosis. John Wilson referred to the report on the Scottish MS register. I was shocked to discover that, for 9 per cent of people, it can take more than six years to have a diagnosis confirmed. We are debating the support that is given to people with MS, but it is worth understanding that, according to the report,
“There is no single diagnostic test and other conditions with similar symptoms may need to be ruled out before a final diagnosis can be made.”
However, the necessary help and support cannot kick in until an accurate diagnosis is made.
There is a plethora of excellent research backed by substantial investment—as mentioned in the motion—which will be welcomed by the 10,500 people in Scotland who have MS. However, not only is that incidence one of the highest in the world; as Richard Simpson said, the further north one goes, the higher the prevalence is. With one in five emergency admissions and one in eight GP consultations relating to a neurological condition, it makes sense to focus on self-management and better diagnosis. The research and health services are critical, given the fact that people live with the condition for many years.
As the motion states, the Western Isles now have a dedicated MS nurse. The announcement of the MS specialist nurse in Moray going from part time to full time is also very welcome, as is the creation of the post of area development officer for the Highlands and Moray—a post that has been funded by the MS Society. In fact, NHS Highland is highlighted in the MS Society briefing paper for developing an MS steering group, which has resulted in an increase in the number of staff. There is no doubt that specialist nurse support helps people to stay independent and helps many people to remain active and in work. There is now a better understanding of MS, and MS sufferers benefit from appropriate exercise and cognitive behavioural therapy—which Rhoda Grant highlighted—to alleviate depression. Enhanced self-management, the prevention of crisis and improved adherence to medication can all be assisted by the knowledge and support of a specialist nurse. The investment in myelin repair should also lead the way to clinical trials and new drugs that will, hopefully, transform the lives of people with MS in the future.
I have focused on the role of the specialist nurses, but it is only right and fair to mention the GPs, the consultant neurologists—of whom we have many more in Inverness now than we had some years ago, thankfully—the physiotherapists and the many other health professionals and social care workers who play their part in supporting MS patients. I look forward to the publication of the Health Improvement Scotland report next year, which will address the implementation of the standards by individual health boards. Only through that type of exercise will we ensure that MS patients throughout Scotland have greater equality of access to the services that can do so much to alleviate their condition.
I pay tribute to the MS Society, whose work I fully respect and commend. It also has a wonderful website that is easy to navigate and highly authoritative.
17:28
I, too, congratulate Rhoda Grant on securing the debate. It is an important debate, and everyone who has spoken has highlighted the complexity of the problems for sufferers of MS. I am grateful to Dr Simpson for highlighting the medical profession’s difficulty with the diagnostic aspect. I am also grateful to him for pointing out that healthcare is a partnership and that, when it is psychologically appropriate, the patient should be informed of their condition and the issues that that condition can bring.
Mary Scanlon said that most of us probably know people with MS. I have a dear friend who has MS. She was a professional social worker who delivered care to others, but she now requires care herself. I want to focus on the fact that MS affects more than just the individual. As John Wilson said, we need to take a holistic approach, recognising that, when a person has MS, it affects not just their lives, but the lives of the people who live with them.
The husband of the person I am talking about was a non-driver at the time of her initial diagnosis, and he remained a non-driver for many years because my friend continued in the work that she trained for with great professionalism. She is to be commended for her energy and commitment to her work. Latterly, however, MS took over and she became unable to drive, partly because of restricted vision but mainly because of immobility. One positive aspect of her MS was that her husband learned to drive, although it was not really positive because she then became totally reliant on her carers.
One of the things that my friend found most difficult about living with MS was that she was no longer able to interact with her very young grandchildren. Before the MS, she was able to take them out to the park or the cinema, or just go out for walks and engage with them, as grandparents do. Not being able to do that has affected her and she said that it was probably the most difficult thing that she has had to cope with. She said that she had been robbed of her ability to interact as a grandparent with her grandchildren.
In my previous professional capacity in social work, I met many people who had MS. The main barrier for them was the uncertainty of tomorrow. They often did not know what their future held. They did not know whether they would have visual disturbance, or whether in a month, or a year, or five years, they would be able to do the things that they were doing on the day that I talked to them. The complexity of a condition such as MS is caused by having to live with the uncertainty.
We must ensure that people who have MS get the services that they require. That is where bringing together health and social care agendas is so important. I sincerely hope that the Scottish Government continues with the programme of integration of health and social care services. Until then, patients will continue to face a postcode lottery in the provision of services for people who have MS. Their carers will also have to face a postcode lottery when they have to cope with the condition.
I congratulate the MS Society on its work. I hope that it continues to influence the Government to ensure that a postcode lottery does not impact on people who have MS and their carers in the future.
17:33
I congratulate Rhoda Grant on bringing the motion to the chamber for debate.
In Parliament, we often talk figures when we are making our contributions. To use research jargon, we often discuss quantitative rather than qualitative accounts. I want to make my contribution from a qualitative perspective, and I will do that by talking about what it is like to live with MS from the point of view of one sufferer.
My constituent, John, is one of the 10,000 individuals in Scotland who suffer from MS. He was a fairly normal young man. He enjoyed playing football and golf, he worked hard, and he liked a night out. He was a skilled engineer. Indeed, he was apprentice of the year at the factory in which he worked. When John started feeling extreme fatigue, he put it down to hard work, long hours and playing sport. He then started to feel a loss of dexterity and feeling in his hand and an inability to bend his legs. At the age of 31, he knew that something was wrong.
After several bouts of tests, John was called to his local GP and told not that he had MS, but that he had symptoms that were compatible with MS. That seems to be the way that patients are told. More shockingly for him, he was told, “Get on with it.” He told me that that news and the following discussion should have been in the hands of his neurologist and not his GP, because his GP could not really answer many of the questions that came up.
Perhaps a counsellor should also have been on hand to deal with what is, for many people, shattering news. The news was, of course, devastating for John’s young family, his friends and his extended family, but worse was to come because, soon afterwards, he was sacked unfairly by his employer because of his disability. Eventually, he won a tribunal case for unfair dismissal but, because he had not been in employment for a certain length of time, he was not reinstated.
John tells me that, at the outset, he was treated fine, medically. He was admitted to hospital straight away for a week of intravenous steroids. As time went on, he had to battle to get beta interferon, which was held up as the great hope, at the time. He had to wait for it because it was referred to the National Institute for Health and Clinical Excellence process. It was hard enough for John to cope at that time, without him also having to go through the battle for medication.
John advises me that certain changes would help sufferers. The first is improved support services. He feels that some sufferers who lack family support or the ability to work through the system are being left behind. Self-support is fine for those who have the ability to do that.
Another suggestion concerns MS nurses. There are only two MS nurses for the whole of the NHS Lothian region, but they are based in the Western General in Edinburgh. For many reasons—most notably cost, logistics and fatigue—that is unsatisfactory, especially for sufferers who live 30 miles away in West Lothian. On Tuesday, the MS Society told me that a sufferer is likely to access only one appointment with that service a year.
John also raises the cost of mobility items, such as high ramps, wheelchairs and hand controls for mobility cars. They are very expensive, and many people have to pick up the cost themselves. The daunting prospect of welfare reform on the horizon is relevant in that regard, too.
There has been inadequate tracking of sufferers, although I know that the MS Society is now undertaking a mapping exercise, which is a step forward. We need to keep the profile of MS high on the agenda.
As the illness is a peculiarly Scottish or northern one, we have to be at the forefront of co-ordinating activity to find a cure, which might mean working with other Governments, the pharmaceutical industry and other stakeholders. Obviously, that will require resources.
Is the member aware that, as a result of Professor Harrington’s review, the Welfare Reform Bill now takes account of fluctuating conditions, such as mental health, ME and MS?
I am encouraged by that. We will wait to see what comes out of that process. I hope that Mary Scanlon is lobbying her party hard to ensure that the welfare reforms are as easy as possible on people with such conditions.
Patients need to be better informed of new developments and given basic practical help and advice.
I should declare an interest in the debate—a close, personal interest—because John is my brother. Seventeen years after his diagnosis, he still works full time—not in engineering but in a local authority call centre. He gets on with life and tells me that, despite his illness—or, possibly, because of it—he feels that he is now twice the person he was prior to it.
17:38
I thank Rhoda Grant for bringing this subject to the chamber for debate, and I welcome the terms of her motion.
Like Mary Scanlon, I think that your role in bringing the issue of MS to this Parliament must be recognised, Presiding Officer. One of the most effective MSP lobbying events that I ever participated in was one that you organised many years ago in the Tun. It gave individuals with MS an opportunity to come along and meet their MSPs. It is an event that has stuck in my mind as being extremely effective and groundbreaking.
Neurological conditions are an important issue, but MS merits particular attention because, as others have said, Scotland has a higher rate of MS than any other country in the world. As Rhoda Grant said, MS is often referred to as Scotland’s disease. That is not an enviable position to be in, and we share the MS Society’s position—we want to beat MS.
Excellent work is being done at the MS research centre in Edinburgh, which has an important role in developing new treatments. I know that the work of the Medical Research Centre’s centre for regenerative medicine, especially on stem cell therapies, carries the hopes of many who suffer from MS. The Scottish Government is funding three research projects—at the University of Glasgow, the University of Aberdeen and the University of Stirling—and we are willing to consider other proposals for research in Scotland.
We believe that a further way by which we can promote research is the MS register, which has been developed with investment from the Government and the MS Society. I hope that, in time, the MS register will encourage population and family-based research and potentially international studies in Scotland. Above all, I hope that it will help us to discover why the condition imposes more of a burden in Scotland than in other countries of the world.
Our top priority for people with MS is to ensure that the neurological standards that other members have referred to are effectively implemented. They offer the best mechanism for achieving safe, effective and person-centred care and will help to ensure that people get the earliest and most appropriate treatment at the local level, but with access to the specialist services that they require. That is why we have provided boards with £1.2 million to develop improvement groups as the main vehicles to take forward those standards at the local level. Through its two-year improvement programme, Healthcare Improvement Scotland has been working to ensure that that happens at the local level with each board. To evaluate the progress that they have made, boards have completed an assessment of the generic standards. In January and February, they will conduct a peer review, which will allow us to evaluate the progress that has been made on the MS standards. That will give us a better understanding of the progress that boards have made—Mary Scanlon referred to that.
Will the minister explain the next step in the process? I commended NHS Highland, but I was touched by Neil Findlay’s point that there are many fewer specialists in an area with a much larger population. What action will the minister take if a lack of support for MS is identified?
After the peer review has taken place early next year, the findings will be published in the summer, and each board will use those to inform local development plans and how they intend to move forward, improve services and implement the standards. I hope that that reassures members that work is continuing.
I recognise that there are people who would like to see faster progress, but I hope that members recognise that there is a considerable task for some boards. It is important that we recognise that the standards apply to all neurological conditions and that there are many competing demands on boards, which must take such things within the overall workload. Healthcare Improvement Scotland has therefore adopted a phased approach by supporting boards to focus on agreed priorities.
People who live with neurological conditions have been involved in the process to ensure that they have a say, and an event was held in March this year that focused specifically on the MS standards. I thank everyone who participated in that event, which provided an invaluable insight into those who live with MS and some of the challenges that NHS staff face in improving the overall quality of care.
We have provided £75,000 for the neurological alliance of Scotland to develop its voices programme, which supports people to get involved in developing local services in their health board area. People with MS have taken part in Ayrshire, Forth valley and Tayside, and I know that a further roll-out is planned in other board areas next year. A voices group has been formed in Forth valley, which is my board area. That is a good example of the joint participation that we expect boards to take forward in the coming year.
I am aware that there are concerns about what might happen to the improvement programme when it comes to an end, but I understand that boards are continuing to demonstrate willingness to continue that work. Healthcare Improvement Scotland has asked the local improvement groups to forge links with their planning services to ensure that we maintain momentum beyond March next year, and it is expected that boards will provide evidence on the links that they have achieved in progressing their improvement plans. As the minister responsible for long-term conditions, I encourage boards to ensure that the impetus is not lost, and I will take a keen interest in the outcomes of the review next year.
Rhoda Grant also mentioned the integration of services to ensure that they operate in a more co-ordinated fashion. In the next few weeks, we should be in a position to set out how the Government intends to take forward greater integration of health and social care. Additionally, the introduction of a self-directed support bill will allow individuals who have long-term conditions such as MS to have a greater opportunity to manage their care in a way that is more appropriate to them.
I recognise how much people value MS specialists, particularly MS nurses. Under the facing the future banner, we have committed more than £10 million to nursing initiatives over the past three years. I am also aware of concerns that those in specialist nurse posts have been drawn into other duties. Given the current financial climate, it is right that boards look at the way in which the services are used, but it is important that they also ensure that efficiencies do not compromise the quality of care.
The neurological standards recognise that specialist nurses are core members of the multidisciplinary team. That sends a powerful signal about how important the role is. Boards should also bear in mind, and it is worth mentioning, that the number of specialist nurses in Scotland has increased in recent years to 2,250, including 15 MS nurses.
I am particularly pleased that the Western Isles is soon to have an MS nurse. I acknowledge the efforts of the MS Society and Christine Stewart, whom Rhoda Grant mentioned, to secure that post. It is great that the NHS board will fund the post permanently once the society’s funding comes to an end.
I was also pleased to hear that Western Isles NHS Board is pursuing the managed clinical network approach by supporting its improvement group to evolve into a permanent neurological managed clinical network. It is precisely that type of commitment that we are looking to see from boards across the country.
We know that the standards are powerful drivers to improve services. I would like Healthcare Improvement Scotland, boards and the voluntary sector to build on the progress that has been made and to continue to work to develop services further. I hope that I have reassured members that the Government is committed to continuing to improve services overall for those who have a neurological condition. As the minister responsible for the area of policy, I will continue to monitor the progress that boards are making.
Meeting closed at 17:47.