Advanced MS Champion (AMSC)

What is an AMSC?

An Advanced MS Champion (AMSC) is a specialist health professional (nurse or therapist) who focuses on care for people with complex advanced MS.

The Advanced MS Champion will:

• Work with people across different services to coordinate care and referrals
• Provide specialist, person-centred care to people with advanced MS and their families; helping them understand their condition, manage symptoms, and identify problems.

In Dorset, there are two services which support people with advanced MS, depending on where you live. The AMSC in the Dorset MS Service mainly covers people living in the west and north of the county.

The Community Neurology Service supports people with advanced MS in the east of the county.

Please see this link for further information.

The Dorset MS Service AMSC will see you at home and support you and your family or carers in all aspects of your MS. You may be seen for a short period by the AMSC, if you are having certain difficulties. You may then go back under the care of an MS nurse, or you may remain under the care of the AMSC. You may also be referred to other health care professionals to support you with symptom management in relation to your MS.

There may be times when you may need to be seen more urgently by the AMSC so that they can support you - we aim to see you within 2-3 weeks. If you have any symptoms which are life-threatening, or you need urgent medical attention please call 111/999.

What is Advanced MS?

Advanced MS describes the level of the effect that MS is having on an individual, rather than the type of MS they have.

People with advanced MS have:

• multiple, ongoing, and often complex symptoms which may occur at the same time
• to rely on others for some or all care and support needs
• high levels of disability

MS Trust's Advanced MS Champion Programme

The Dorset MS Service's Advanced MS Champion started as part of the MS Trust’s Advanced MS Champion Programme.

For more information about the programme please see the MS Trust's webpage.

Further information on Advanced MS

Multiple Sclerosis Trust - Advanced MS

MS Society - Advanced MS

MS Service Appointments and Clinics

The MS Service runs appointments and clinics for different aspects of Multiple Sclerosis (MS).

Many of our clinics have waiting lists, some of which can be very long. We therefore ask that you please confirm and attend these appointments.

If for any reason you can't attend an appointment, please contact the MS Service helpline, in plenty of time, to enable this appointment to be offered to someone else. If you fail to attend an appointment, you will receive a letter, and this will advise if this appointment can be re-booked.

To confirm an appointment or to discuss anything else related to MS Service appointments, please contact the MS helpline on 0300 019 2362 or This email address is being protected from spambots. You need JavaScript enabled to view it..

Please note that the MS Service does not manage neurologist appointments or neurologist letters. If you need to discuss anything related to your MS Neurologist, you should contact the Neurologist's secretary.

You need to contact the secretary for the hospital in which you saw the MS Neurologist. The contact details are:

Poole Hospital:

Dr CE Hillier 0300 019 2225

Dr SU Memon 0300 019 2225

Dr CHE Lim 0300 019 8706

Initial Assessment – for those new to the MS Service

One of the MS Practitioners (MS Nurse, Physiotherapist or Occupational Therapist) will spend one and a half to two hours getting to know you. They will discuss your MS and symptoms, and answer questions you may have about your diagnosis. The practitioner will go through a standard assessment, which ensures all areas are covered. This document is then used and updated at future MS review appointments.

Before your appointment, it may be helpful to think about and write down anything you wish to discuss with the MS practitioner. This may be questions that you have or things that may be worrying you.

The MS Trust has a useful webpage where they give advice on preparing for you appointments: Making the most of appointments | MS Trust

The first assessment will usually be at your home, but there may be times when we need to do it somewhere else. If this is the case, you would usually be offered an appointment at Poole Hospital.

Disease modifying drugs (DMDs) for a person with MS need to be agreed at a special DMD meeting, as per national requirements. DMDs may be discussed at your first appointment but it may be later if the meeting hasn't taken place.

MS Review

MS review appointments are normally offered annually. The MS Nurse or practitioner will usually go through your last MS assessment with you to see if anything has changed and to ensure that all areas are covered.

If there is anything you wish to cover in more detail, the nurse or practitioner will be happy to do this instead of fully reviewing your last assessment template with you, (this will mean that your record will not be updated for the areas not discussed and will therefore hold older information).

An MS review clinic appointment usually lasts 35 minutes. It may be helpful to think about and write down anything that you are worrying about and any questions you may have before you see your MS nurse.

The MS Trust has a useful webpage where they give advice on preparing for you appointments: Making the most of appointments | MS Trust

MS annual review clinics are held by video call or in face-to-face clinics. Telephone calls are not felt to be as effective as video consultations which is why these aren't offered or recommended.

Face to face MS review clinics are currently held in:

• Poole Hospital
• Royal Bournemouth Hospital
• Blandford Community Hospital
• Bridport Community Hospital
• Westminster Memorial Hospital (Shaftesbury)
• Westhaven Community Hospital (Weymouth)
• Portland Community Hospital
• Frederick Treves House GP Surgery (Dorchester)
• Puddletown GP surgery

We are only able to offer home visits for people who have very complex or advanced MS (specific criteria apply). Appointments for people with advanced MS may be conducted by our Advanced MS Champion (AMSC) (See Advanced MS Champion role on Welcome page.)

NICE (National Institute for Health and Care Excellence) guidance recommends that all people with MS have a comprehensive review at least once a year. If you feel that you do not wish to have a regular, booked review with the MS Service, please discuss this with one of the practitioners or contact the MS Service helpline.

Where appropriate, we can place you on our ‘SOS’ caseload which means that you won’t receive an appointment with the service but will still have access to our helpline services and can re-start the annual reviews at any stage. You will receive a letter from us annually seeing if you wish to book an appointment and reminding you of our contact details.

Please note, if you are on a disease modifying drug (DMD) it is a requirement that you have an appointment for review of this annually.

Disease Modifying Drug (DMD) Clinics

MS DMD education

DMD education sessions are usually conducted via video call where the MS Nurse/practitioner will go through the drug or drugs with you and answer any questions you may have.

It is useful to have a pen and paper, to be able to write yourself notes. If you are eligible for more than one DMD it may also be useful to download the MS Trust's DMD comparison chart which can be found here: Disease modifying drugs: comparison chart | MS Trust

These sessions may be held in a group format where there is more than one person to be educated on the same drug or drugs.

MS Nurse DMD follow-up

MS DMD follow-up clinic appointments are 15-minute appointments by video to review how you are getting on with your DMD, including any side-effects you may be experiencing. If you need to discuss symptoms of MS, please ask to be booked into a review clinic as these can’t be addressed in the short DMD clinic consultation slots.

For your safety you must attend all disease modifying drug (DMD) review appointments with the team and consultant, as per national requirements and safety protocols. If you don't attend these appointments your treatment may be stopped.

For more information on DMDs and safety monitoring please see DMD section.

Occupational Therapy (OT) Appointments

The MS Occupational Therapy team currently provides face to face clinics in Poole Hospital.

In some cases, where people are unable to attend an outpatient clinic, a home or workplace visit may be offered (specific criteria apply).

They also provide video appointments for things like fatigue management and advice relating to work.

MS OTs will usually follow up treatment with a review over the phone.

It is helpful to come prepared to your OT appointment and write down any questions you may have.

See MS Specialist Occupational Therapists section for more information.

Physiotherapy Appointments

The MS Physio team currently holds face to face clinics in:

• Poole Hospital
• Blandford Community Hospital
• Weymouth Community Hospital
• Christchurch Hospital

In some cases, where people are unable to attend an outpatient clinic, a home visit may be offered (specific criteria apply).

They also provide video and telephone appointments, usually as a follow-up, if appropriate.

Before you attend your MS Physio appointment, it would be good to think about what you would like to achieve from your session or if you have any goals.

If you have any orthotic devices or splints that you wear, or walking aids that you use, it is good to bring them with you. It is also better to wear clothes that are easy to move in, such as loose trousers or shorts.

See MS Specialist Physiotherapists section for more information.

Other Appointments

The MS Service offers some specialist clinic appointments. These are usually held by video or telephone call. These include:

• Pre-conception clinics
• Pregnancy clinics
• Sex and Intimacy clinics

The MS Service often links with other services and professionals. You may be referred to other services and organisations to help you live well with MS and manage your MS symptoms.

Appointment confirmations and cancellations

• Our clinics are very busy, and we have a limited number of clinic slots available, so please make sure you attend your appointments.
• Please confirm your appointment by leaving a message on the answer phone or emailing us as soon as you can.
• If cancelling, please give as much notice as you can to enable us to offer this appointment to someone else.
  
  Please let us know why you are cancelling and whether you need the appointment to be rebooked. This will then be looked at when the next round of bookings are made.
  
  Due to the number of calls we receive, we are unable to ring back regarding these types of queries, but please be assured that your appointment will be rescheduled as able.
  
  We have limited availability and there could be a long wait before you will be offered another appointment.
• For your safety you must attend all disease modifying drug (DMD) review appointments with the team and consultant, as per national requirements and safety protocols. If you don't attend these appointments your treatment may be stopped.
  
  See DMD section for more information.

Disease Modifying Drugs

Disease modifying drugs (DMDs) are a group of treatments for people with Multiple Sclerosis. Many DMDs are approved for people with Relapsing Remitting MS (RRMS), but some are also approved for a group of people with progressive MS.

In the UK, a wide range of disease modifying drugs are approved for use by the NHS. There are different benefits and risks associated with each drug.

Benefits of DMDs

DMDs offer the following benefits:

• Fewer relapses
• Less severe relapses
• Reduce the build-up of disability which can occur if you don't recover completely from relapses

To reduce inflammation caused by MS in the brain and spinal cord, DMDs work with different parts of the immune system. As a result, fewer relapses occur and the severity of them is reduced.

DMDs work with different parts of the immune system to reduce the inflammation caused by MS to nerve cells in the brain and spinal cord. This helps reduce the number and severity of relapses.

Symptoms of inflammation are not always visible or result in clinical relapse. The invisible activity may mean that even if you feel well, there are still changes caused by your MS that are only visible on a brain scan. As shown in MRI scans, taking a DMD can result in fewer, smaller, or no new areas of brain and spinal cord damage (lesions). It is becoming more important to treat both the visible (clinical relapses) and invisible (changes seen only on brain scans) aspects of MS; the goal being no visible or invisible MS disease activity.

The average person with Relapsing Remitting MS has one or two relapses per year. DMDs are prescribed in the NHS based on your frequency of relapses. NHS England describes Relapsing Remitting MS as being either active or very active.

Effectiveness of DMDs

There is no clear answer to whether one DMD is better than another. There are different ways in which they work, and what works for you may not work for someone else.

It may take three to six months for some DMDs to be fully effective.

Some people will still experience symptoms of MS because DMDs do not have an effect on MS damage that has already happened.

Prescribing DMDs

You will be told if you are eligible for DMDs, and if so, which are suitable for you. Recommendations will be made based on your MS activity level, how relapses have affected you, and the number of relapses you have had.

MS DMDs are funded by NHS England and not the hospital or Trust. When prescribing a DMD, your MS team must work within strict NHS England criteria. DMDs can only be prescribed by certain neurologists, consultant nurses, pharmacists, or allied health professionals.

If you are given an option of treatment, you should consider the pros and cons of each option. You may consider things like ease of taking a drug to be an advantage. Disadvantages may include side effects or the inconvenience of attending a hospital setting for treatment. Every person will have a different perspective on what they consider an advantage and disadvantage. The MS Decisions aid | MS Trust may be useful in comparing different treatments.

Starting treatment

You will not be required to pay for the DMD if you are eligible for NHS treatment, although you may be required to pay prescription charges for some of the drugs.

Depending on which drug you are prescribed, you may have it delivered and dispensed to you at your home, or chosen address, by a designated pharmacy homecare delivery company, receive it in the hospital as a day patient, or collect it from the Poole Hospital pharmacy (Boots). If your drug is one being delivered and dispensed by a pharmacy homecare delivery company, it is important that you consider how your drug needs to be stored; if it needs to be stored in a fridge, you will need to get it into a fridge as soon as it is delivered.

Before starting a DMD, the MS team will educate you on how the drug works, how to take it, how to manage side effects, what monitoring is required, and who to contact if there are any issues.

If you are starting an injectable treatment, you may need to attend Poole Hospital for your first injection so your MS nurse can show you how to do the injection and monitor for any possible reactions.

The treatment of DMD requires a long-term commitment. The MS team will review your treatment regularly to see if it is still effective. We will also monitor how you are managing any side effects and ensure there are no complications. Please see appointments and clinics section for more information about appointments related to DMDs.

Please note that by commencing on a DMD you are agreeing to have safety monitoring for that drug. This will include attendance at appointments with the consultant and nurse/practitioner, and having blood tests and other monitoring when required. The appointments and tests for safety monitoring are required for the ongoing prescription of this medication. If you miss appointments or tests, it is likely that your DMD medication may be stopped.

Travel

Different countries have different regulations about medications that can be brought into their country. It is important to check the rules for each country you will visit before traveling, even if you are only passing through.

When traveling with MS drugs, keep them in their original packaging. Your medications must be kept in your hand luggage.

To travel with medication and/or syringes, you must have a letter from the MS team. This ensures your medication will pass through customs and can go into another country. Make sure you give the MS team plenty of notice when requesting a travel letter. This can be done by emailing the MS helpline with your passport number and travel dates.

When traveling with injectables that need to be refrigerated, it is recommended that you put them in an insulated bag with a freezable ice pack. When travelling on a long haul flight, we recommend contacting the airline to see if your injectable can be stored in the aircraft refrigerator.

If the medication needs to be stored in a fridge, or you are going somewhere where the room temperature is likely to be above 25°C, talk to your travel company before you leave to make sure you will have access to a fridge. Many drugs shouldn't go above a certain temperature and can’t be put back in a fridge once they have warmed up.

Vaccinations

People with MS are generally encouraged to have vaccinations which are part of the national vaccination programmes. When travelling abroad, vaccinations are often recommended. See here for more information Travel vaccination advice - NHS.

Non-live vaccines are generally considered safe for people with MS, including those taking a DMD. Depending on the DMD that you are taking, it may be recommended that the vaccine is timed around your DMD treatment.

People on certain DMD treatments, cannot have live vaccines as they are immunosuppressed. If you have any queries about this, please contact the MS Service on 0300 019 2362 or This email address is being protected from spambots. You need JavaScript enabled to view it..

Other resources

Disease modifying drugs (DMDs) | MS Trust

Guide to decision making | MS Trust

Frequently asked questions (FAQs) | MS Trust

Treatments and therapies

Dorset Multiple Sclerosis (MS) Service

Welcome to the Dorset MS Service Website

This site brings together information about the Dorset MS Service and gives advice about living well with MS. It offers hints and tips on how to manage symptoms and signposts you to further information.

Hopefully, you will find all the information that you need on this website. However, if you need to talk through any of the information, please contact us at 0300 019 2362 or This email address is being protected from spambots. You need JavaScript enabled to view it..

The Dorset MS Service

The MS Service is based at Poole Hospital and consists of specialist nurses, physiotherapists, occupational therapists, pharmacist, and administration staff. It provides a service for people with MS who are under a registered Dorset GP.

The service is managed by the Lead MS Specialist Practitioner and links closely with the MS Specialist Neurologists for Dorset.

The team provides advice, information, and support for people with Multiple Sclerosis and their families/carers, from diagnosis onwards. They offer practical help with managing symptoms and day-to-day living with MS, as well as providing advice and support with disease modifying drug (DMD) treatments for MS.

Referrals are accepted from GPs, consultants, and other health care professionals for people with a confirmed diagnosis of MS.

The MS Service works in partnership with the Community Neurology Service in South and East Dorset, Bournemouth, and Poole.

Contact Details

Helpline telephone: 0300 019 2362

Helpline email: This email address is being protected from spambots. You need JavaScript enabled to view it.

MS Telephone Helpline

For us to deal with your query in a timely and efficient way, please see our guidance below:

• The answerphone is monitored regularly by our administration team Mon – Fri 8.30am – 4.30pm, excluding bank holidays and weekends.
• If you are a patient, please state your name, hospital number, your telephone number, and brief details of your enquiry (particularly if you feel you are experiencing a sudden change in symptoms or new symptoms that have lasted longer than 24 hours). If you are suffering new symptoms or acute deteriorating symptoms, this will be triaged for the next available telephone clinic slot with a duty professional.
• Telephone clinics are run daily Monday to Friday (excluding bank holidays), usually in the morning.
• If you do not hear back within 48 working hours, please ring again.

Please be advised that this is not an emergency service. If your call is an emergency, please contact your GP or dial 111 or 999.

MS Appointments - confirmations and cancellations

• Our clinics are very busy, and we have a limited number of clinic slots available, so please make every effort to attend your appointments.
• Please confirm your appointment by leaving a message on the answerphone or emailing us as soon as you can.
• If cancelling, please give as much notice as you can to enable us to offer this appointment to someone else.
• Please let us know why you are cancelling and whether you require the appointment to be rebooked. This will then be triaged to the next round of bookings. Due to the number of calls we receive, we are unable to ring back regarding these types of queries, but please be assured that your appointment will be rescheduled as able.
• Please note we have limited availability and there could be a significant delay before you can be offered another appointment.
• For safety monitoring purposes, you are expected to attend all disease modifying drug (DMD) review appointments with the team and consultant, as per NHS England requirements and safety protocols. Failure to attend these appointments may result in your treatment being stopped. See Disease modifying drugs (DMD) section for more information.

For more information regarding appointments with the MS Service please see Appointments and Clinics section.

Please note that appointments with the Neurologists are not managed by the MS Service. Please contact the Neurologist's secretary if you have any queries or need to cancel a Neurologist appointment.

You need to contact the secretary for the hospital in which you saw the MS Neurologist. The contact details are:

Poole Hospital:

Dr CE Hillier 0300 019 2225

Dr SU Memon 0300 019 2225

Dr C-HE Lim 0300 019 8706