Caring without burning out: How smarter workload strategies for (multiple sclerosis) nurses can safeguard qualitative care in European healthcare systems

MS Nurse PROfessional is building a stronger voice for specialised multiple sclerosis nursing across Europe. We advocate for health systems that enable nurses to deliver high-quality, coordinated and efficient care for people living with MS.

Our advocacy is grounded in practice, shaped by nurses and people living with MS, and translated into concrete policy recommendations for decision-makers at European and national level.

Why this matters

Across Europe, people living with multiple sclerosis do not always have access to the coordinated, multidisciplinary support they need. At the same time, many nurses work under growing pressure, with too much administration, uneven access to specialised training, and limited recognition of their role within the care pathway.

This is not only a workforce issue. It is a quality-of-care issue.

Over 1 million Europeans live with Multiple Sclerosis (MS), most diagnosed in their 20s and 30s. MS is a chronic disease of the central nervous system, causing symptoms such as fatigue, vision and motor problems, cognitive changes, and difficulties with speech, mobility, and bladder function.

• 80% of people with MS are unemployed within 10–15 years of diagnosis.
  
• 40–60% reduce social and leisure activities, especially in advanced stages.
• There is no cure, but modern therapies and rehabilitation can delay disability and improve quality of life, work participation, and wellbeing.

The evidence behind our advocacy

In 2024, MS Nurse PROfessional launched a multinational survey to better understand the workload management of nurses caring for people with MS in Europe.

The survey included 108 nurses from 15 countries and highlighted a clear need for systemic change:

• An average caseload of 516 patients per nurse, far above the recommended level;
• Widespread unfinished clinical and psychosocial work, largely due to excessive administrative burden and lack of integrated care;
• Strong consensus among MS nurses on the need for systemic change: more specialised staff, integrated and multidisciplinary care teams, streamlined processes, and referral authority.  

These findings reinforce what nurses have long been saying: better workload management is essential to safeguarding high-quality MS care.

In response, the nursing community identified clear priorities: more specialised nurses, better access to psychological support and allied healthcare professionals, stronger multidisciplinary care, less administrative burden, and greater referral and prescribing authority for appropriately trained nurses.

You can explore the evidence in more detail through our supporting materials:

Our evidence-based policy recommendations

1. More specialised nurses caring for PwMS (incl. digital skills)​

• We need more secondary school students to pursue a career in nursing and more available positions for them to study
• We need affordable and accessible advanced training following the nursing degree on neuroscience nursing and this should include multiple sclerosis
• We need affordable and accessible continued medical education opportunities for nurses on multiple sclerosis treatment and care
• We need affordable and accessible trainings on digital skills for neuroscience nurses

2. Access to psychologist, physiotherapist, occupational therapist, social worker for PwMS​

• We need reimbursement schemes that enable PwMS to be referred in an affordable manner to allied healthcare workers
• We need these HCP to be available (sufficient in number) and accessible (in-person or virtually) for PwMS

3. Access to and a central role for nurses within the multi-disciplinary team (MDT) and ability to independently refer​

• Any nurse getting in contact with a PwMS should be part of a multi-disciplinary care team, working in the same electronic patient health record (ePHR).
• Nurses that have advanced training in multiple sclerosis treatment and care should be the person that keeps the overview of the treatment and care provision to the PwMS (It is: monitoring from the healthcare provider’s point of view the clinical care pathway of the PwMS).
• Nurses that have advanced training in multiple sclerosis treatment and care should be able to independently refer a PwMS to a psychologist, physiotherapist, occupational therapist or social worker.

4. Less and more efficient paperwork & streamlined administration utilising digital technology

• Projects should be implemented that map the current admin burden on nurses and other care workers with the objective to reduce it by 25% by 2030.
• Any nurse should have access to in-person or remote administrative support
  Nurses should have access to effective digital tools that make any administrative work more efficient (e.g. note taking, updating ePHRs, …)
• PwMS should remain owner of their own health data and should have access to an ePHR that allows them to see their clinical care pathway, including upcoming appointments (and ability to reschedule), test results and contact details of their care team. 

5. Nurse independent prescriber qualification is available*

• Nurses that have advanced training in multiple sclerosis treatment and care should be granted the authority to prescribe certain medications related to multiple sclerosis symptom management.

* We acknowledge that in many healthcare systems, this requires an evolution of the legal and training framework.

From evidence to action

Our advocacy is built on four pillars:

Research

We are gathering evidence on workload management, nursing roles, training pathways, and differences across healthcare systems. Our 2024 survey on nurses caring for people with MS provides a strong evidence base for reform and has helped identify where workload pressure is affecting the quality and coordination of care. 

Real-life experience

We are collecting testimonials from nurses and people living with MS to show what good care looks like in practice — and where systems still fall short.

Community engagement 

Following the survey, we presented our findings at ECTRIMS2024 and again at ECTRIMS2025, helping raise awareness of the workload challenges facing nurses caring for people with MS and of the solutions nurses are calling for. 

Policy engagement

We bring this evidence into European and national policy discussions through targeted stakeholder meetings and advocacy events. We recently held an online policy meeting with Member of the European Parliament Kateřina Konečná (CZ), Executive Director of the European Specialist Nurses Organisation Ber Oomen, MS Consultant Nurse Noreen Barker (UK), University College London Hospitals NHS Foundation Trust, and national clinical experts, and are preparing a live event at the European Parliament to discuss how smarter workload strategies for MS nurses can safeguard high-quality care in European healthcare systems.

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Our ambition 

We advocate for value-based nursing in multiple sclerosis, where digital tools and intelligent systems meaningfully reduce administrative burden and enable nurses to practise at the top of their expertise.

Within a well-structured multidisciplinary care team, MS specialised nurses take a leading role in coordinating care and focus their clinical work on high-value, specialised nursing activities.

Tasks that are better addressed through other professional expertise are appropriately delegated to trained colleagues, ensuring that skills across the care team are applied where they add the greatest value and helping to safeguard both care quality and workforce sustainability.