Despite all the advances in available treatments, data for England in 2018/19 show that nearly one in five people living with multiple sclerosis (MS) were admitted into hospital as an emergency. With an average stay of 7.7 days, the average emergency admission cost is £2844.1 But the most common reasons for emergency admissions are often preventable with patient risk stratification and proactive care. The MS Academy ‘Raising the bar’ initiative was set up in 2018 to bring all health professional stakeholders together, identify the barriers to care, and collaborate in workstreams to address practical problems in a timely fashion.

Although all involved are passionate about improving care and health outcomes in MS, it was quickly realised that leadership skills are fundamental to implementing system-wide change. However, leadership is not usually part of formal training and people are often expected to simply ‘pick up the skills while on the job’. To this end, one of the key workstreams being implemented is the MS Leaders Academy which, following a robust application and vetting process, has identified 9 potential leaders for development. Course participants represent the spectrum of people working in MS services; from consultants to pharmacists, nurse specialists and service coordinators. The MS Leaders Academy is based on the learning model successfully run by the American Academy of Neurology (AAN), which has enabled a young generation of neurologists to take on leadership roles and has come full circle by these very leaders, newly elected to serve on Board and Committees, updating the policies of the AAN to meet the changing needs of its membership. The 6 month course is run by Professor Gabriele De Luca (University of Oxford) who is himself a graduate of the AAN leadership programme, and his leadership coach Barbara Hoese who brings her skills and experience from the AAN and similar programmes.

The first face to face meeting of the MS Leaders Academy took place in Sheffield on the 19th-21st February. Course participants were challenged to think about the differences between leadership and management, to define the requirements for modern leadership, and to think about how they would like to lead others. Delegates noted that they hardly ever take the time to reflect on their own skill sets and the learning experiences that have shaped their approach. Discussions touched upon how good health services are led by people who have a clear vision and who effectively match ‘what they say’ with ‘what they do’. Many of the participants found themselves agreeing that, because of time and resources pressures, they often find themselves taking a management role (problem solving, controlling, budgeting, staffing and organising) whereas a leadership role (setting a direction, aligning and inspiring the team and having a commitment to act) is what is required.

The February meeting focused on the need for leadership, leading self and leading others. Participants were taken through a series of exercises where they considered different communication and work styles, the importance of team synergy, understanding systems and personal agility. The discussions were sometimes personal, not always comfortable, and left delegates motivated to learn. There was agreement that the course content was directly applicable to their roles but was clearly missing from their prior training. Each of the participants has been paired with a senior mentor, and both mentor and mentee have committed to a series of monthly calls where they can discuss problems, go through proven strategies to address the diverse and often unpredictable problems that people working in MS services often face and ideas for further leadership development. Alongside these mentoring calls, participants will also benefit from 1 on 1 and group coaching calls, and will also work on a group project aiming to minimise emergency admissions for people with MS. The leadership group will work together in a shared leadership model and use the resources available to them on the course to develop a detailed proposal, which will be presented first to key stakeholders, and then the wider MS community at the next Raising the bar meeting in November. This will be a key test because the MS Academy comprises members from almost every MS centre in the country, patient advocacy groups as well as NHS England.

Ultimately, the real work of leadership is to create new leaders. The goal is to develop this leadership project into an ongoing programme starting with MS and then moving into other areas of neurology.


  1. Thomas et al (2020). MS Hospital Episode Statistics Emergency Admissions 2018/19 Wilmington Healthcare London. Available at

Further reading:

Read ACNR’s report on the recent MS Academy meeting on tackling service variance.