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Background In Lanarkshire, many MS patients receive annual home visits with few clinical outcomes, while consuming significant resources. It is proposed to implement Patient-Initiated Follow Up (PIFU) to reduce unnecessary home visits and missed appointments, and improve MS service capacity.Methods Data includes all patients (n=184) receiving home visits from MS Specialist Nurses (MSSN).Results MS patients receiving home visits in Lanarkshire differ from the broader MS population across Scotland: they have higher rates of physical disability, co-morbidities, polypharmacy, socioeconomic deprivation, mental health challenges and cognitive decline.50% report mental health issues, cognitive decline and pain. One third have vision, sleep, speech and swallowing issues. Over two thirds report inability to walk, impaired manual dexterity, bowel/bladder issues, fatigue and sensory symptoms.89% have adaptations to property and mobility equipment. 71% have a Package of Care. 51% are under the care of District Nurses. 54% receive daily family support.62% live in deprived areas, and 26% contribute towards their healthcare costs.14% are regular smokers, 63% take over 6 regular medications, 44% have 3 or more co-morbidities. 53% had an ED admission in the past 12 months.Only 65% had their last MSSN visit in person. 24% have a record of not attending neurology services.Conclusion Introducing PIFU can alleviate MS staff shortages and resource constraints. Implementation requires effective communication strategies, a risk assessment, phased implementation strategy, and a feedback loop.ginevrabubani@gmail.com