MDT case study

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Questions and Answers

What is the main focus of community-based multidisciplinary teams (MDTs) mentioned in the text?

Reducing emergency hospital use in the short term

Implementing reforms to the NHS in England

Providing care for adults with complex health and care needs (correct)

Coordinating primary care services

What is a common approach in the development of community-based multidisciplinary teams (MDTs)?

Focusing on reducing emergency hospital use in the short term

Involving only health professionals in planning and coordinating care

Being based around general practices (correct)

Establishing area-based integrated care systems (ICSs)

What did the Improvement Analytics Unit (IAU) evaluations find regarding the impact of MDTs on emergency hospital use?

MDTs had no impact on emergency hospital use

MDTs led to significant reductions in emergency hospital use

MDTs consistently reduced emergency hospital use across all evaluations

MDTs did not reduce emergency hospital use in the short term (correct)

What was the timeframe for observing reductions in emergency hospital use as a result of the broader programmes in which MDTs were implemented?

Between 3 and 6 years Signup and view all the answers

What did studies assessing the impact of MDTs on health outcomes find?

No, limited, or mixed evidence of impact Signup and view all the answers

What was the longer-term impact of integrated care programmes across outcomes, vanguard areas, and population groups?

Showed inconsistent results Signup and view all the answers

What was the overall impact of MDTs on emergency hospital use initially?

Little impact initially Signup and view all the answers

What did evidence indicate about emergency admissions and average length of stay in certain areas over 3 to 5 years?

Reductions in emergency admissions and average length of stay Signup and view all the answers

What was the trend towards A&E attendances over time?

Trend towards lower A&E attendances over time, significant in some areas Signup and view all the answers

In which area was there a trend towards lower emergency admissions rates in years 5 and 6?

Mid-Nottinghamshire Signup and view all the answers

What did meta-analyses of nurse-led integrated care models involving MDTs find?

No effect on hospital admissions or emergency department visits Signup and view all the answers

What is the ambition for ICSs and MDTs?

To deliver high-quality care for people with chronic conditions Signup and view all the answers

What was the broader evidence of MDT impact?

Limited and mixed Signup and view all the answers

What are MDTs a core part of efforts to provide?

More integrated care for people with chronic conditions Signup and view all the answers

What did a meta-analysis of nurse-led integrated care models find regarding the impact on hospital admissions or emergency department visits?

No effect Signup and view all the answers

What did the evidence indicate about the impact of MDTs on hospital measures, including elective admissions and outpatient appointments?

Mixed evidence Signup and view all the answers

What was the focus of the IAU's evaluation of the MDT initiatives in England?

Effect of MDTs on A&E attendances and emergency hospital admissions Signup and view all the answers

What was the aim of the New Care Models vanguard program?

To reduce unnecessary emergency hospital use Signup and view all the answers

Which areas did the MDT programs covered under the New Care Models vanguard program target?

Patients at higher risk of emergency hospital use Signup and view all the answers

What was the composition of the MDTs in England?

Medical and non-medical staff meeting regularly to plan and coordinate services Signup and view all the answers

What was the role of the Integrated Care Transformation program in Mid-Nottinghamshire?

It included MDTs and received vanguard status in 2015 Signup and view all the answers

What did the IAU's evaluation findings inform efforts to develop in England?

More integrated care Signup and view all the answers

What were the differences in the referral criteria and patient identification for the MDTs?

Some programs replaced patients' usual GP, while others provided additional support to GP care Signup and view all the answers

What was the focus of the IAU's review of the evidence on MDTs?

MDTs involving at least one health care professional Signup and view all the answers

What did the MDT initiatives in England use to identify and address the needs of high-risk patients?

Risk-stratification tools and care planning Signup and view all the answers

What did the MDT initiatives in England aim to reduce?

Unnecessary emergency hospital use Signup and view all the answers

What type of patients were the MDT programs in England targeting?

Patients with complex health conditions or social risk factors Signup and view all the answers

What did the IAU's evaluation findings focus on?

MDTs involving at least one health care professional Signup and view all the answers

What was the main focus of the rapid review of systematic reviews on the impacts of community-based MDTs?

Assessing the quality of evidence from reviewed studies Signup and view all the answers

What was a potential limitation of the analysis of the three MDT programmes evaluated?

Subtle differences between the groups, such as patients being more severely ill in the MDT group in Fylde Coast Signup and view all the answers

What did the IAU's evaluations compare emergency hospital use against?

Comparable areas in England Signup and view all the answers

What was the focus of the reviews studied in the rapid review of systematic reviews on the impacts of community-based MDTs?

Interventions that make use of MDTs Signup and view all the answers

What was the timeframe for the evaluations comparing emergency hospital use before and after the integrated care programmes?

4.5 to 6 years Signup and view all the answers

What was the quality of evidence from the reviewed studies in the rapid review of systematic reviews on the impacts of community-based MDTs?

Weak and inconclusive Signup and view all the answers

What did the evaluations by the IAU cover in addition to Fylde and Mid-Nottinghamshire?

Fylde, Wyre, Blackpool, and NEHF Signup and view all the answers

What was the main initiative of the Integrated Care Transformation programme in Mid-Nottinghamshire?

Implementation of MDTs in primary care settings Signup and view all the answers

What did the reviews in the rapid review of systematic reviews on the impacts of community-based MDTs focus on?

Focusing on older people with complex needs as the common target group for MDTs Signup and view all the answers

What were the populations considered in the evaluations comparing emergency hospital use before and after the integrated care programmes?

Aged 18 years and older and 65 years and older Signup and view all the answers

What was the trend regarding emergency hospital use among those enrolled in MDTs over the study periods?

It was consistently higher than for those in the comparison groups Signup and view all the answers

Study Notes

Community-Based Multidisciplinary Teams in England

Multidisciplinary teams (MDTs) in England include patients and their representatives and operate in various settings, not exclusive to health and social care.
MDTs use risk-stratification tools and care planning to identify and address the needs of high-risk patients, such as those with complex health conditions or social risk factors.
The IAU evaluated three MDT initiatives in England, comparing outcomes of patients receiving care from MDTs to a comparison group with similar characteristics.
The evaluations focused on the effect of MDTs on A&E attendances and emergency hospital admissions, using routine health data for analysis.
The MDT initiatives evaluated were Integrated care teams (ICTs) in North East Hampshire and Farnham (NEHF), Extensive care services (ECS) in Fylde Coast, and Enhanced primary care (EPC) in Fylde Coast.
All three programs were community-based and targeted patients at higher risk of emergency hospital use, consisting of medical and non-medical staff meeting regularly to plan and coordinate services.
There were differences in the referral criteria and patient identification for the MDTs, with some programs replacing patients' usual GP, while others provided additional support to GP care.
These MDT programs were part of the New Care Models vanguard program, aiming to reduce unnecessary emergency hospital use, and covered areas with varied demographics, rurality, and deprivation.
The Integrated Care Transformation program in Mid-Nottinghamshire, which included MDTs, also received vanguard status in 2015.
The IAU's evaluation findings may not reflect the current impact of the MDTs, as the programs evaluated are likely to have evolved since the study periods.
The IAU's evaluation findings were used to inform efforts to develop more integrated care in England and were put in the context of broader evidence on the effect of community-based MDTs in the UK and other countries.
The IAU's review of the evidence focused on MDTs involving at least one health care professional, and the methods used for evaluation are detailed in the Appendix.

Community-Based Multidisciplinary Teams: Evaluations and Evidence

Fylde Coast introduced support for frequent 999 callers, while Mid-Nottinghamshire introduced proactive care planning for frequent A&E service users.
Evaluations by the IAU covered areas like Fylde, Wyre, Blackpool, and NEHF, comparing emergency hospital use before and after the integrated care programmes.
The IAU also evaluated the Integrated Care Transformation programme in Mid-Nottinghamshire, including MDTs as a main initiative.
The evaluations compared emergency hospital use against comparable areas in England for a period ranging from 4.5 to 6 years.
A rapid review of systematic reviews on the impacts of community-based MDTs included eight studies, focusing on MDTs from high-income countries, including the UK.
The quality of evidence from the reviewed studies was weak, with most focusing on older people with complex needs as the common target group for MDTs.
Across the three MDT programmes evaluated, emergency hospital use among those enrolled in MDTs was higher than for those in the comparison groups over the study periods.
Potential limitations of the analysis included subtle differences between the groups, such as patients being more severely ill in the MDT group in Fylde Coast.
The evaluations covered the areas of Fylde and Wyre, Blackpool, and NEHF, comparing emergency hospital use before and after the integrated care programmes.
The IAU evaluated the broader integrated care programmes that implemented the three MDTs over a longer time period.
The evaluations compared emergency hospital use against comparable areas in England for a period ranging from 4.5 to 6 years, considering the whole populations aged 18 years and older and 65 years and older, respectively.
The reviews studied MDTs in a mix of ways, including interventions that make use of MDTs, such as community mental health teams for older people and intensive primary care support, among others.

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Description

"Community-Based Multidisciplinary Teams in England: Evaluations and Evidence" Quiz Test your knowledge on the impact and evaluations of community-based multidisciplinary teams (MDTs) in England. Explore the role of MDTs in addressing the needs of high-risk patients, the evaluation findings by the IAU, and the broader evidence on the effect of MDTs in the UK and other countries.