MDT in the NHS
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Questions and Answers

What is a key commitment in the We are the NHS: People Plan 2020/21?

  • To break down traditional barriers between teams and organisations (correct)
  • To increase the number of pilots and incentive schemes
  • To decrease the focus on long-term health conditions
  • To reduce the number of MDT working initiatives

    • What programmes support the generalism agenda, which is linked to MDT working?

  • NHS England’s pilot schemes and ICSs establishment
  • Future Doctor and Future Nurse programmes (correct)
  • NHS Long Term Plan and New Care Models programme
  • We are the NHS: People Plan and HEE’s initiatives

    • What provides a platform to support and enable MDT working like never before?

  • Changes in health and care infrastructure and establishment of ICSs (correct)
  • Pilots and incentive schemes initiated by NHS England
  • MDT working initiatives in the past decade
  • The NHS Long Term Plan and We are the NHS: People Plan

    • What is a primary goal of MDT working in the NHS Long Term Plan?

    <p>To better support people with long-term health conditions</p> Signup and view all the answers

    What has consistently promoted MDT working over the past decade?

    <p>Policy initiatives, pilots and incentive schemes</p> Signup and view all the answers

    What is the primary goal of transdisciplinary care?

    <p>To optimise the use of skills and abilities of MDT members</p> Signup and view all the answers

    What characterises a unidisciplinary model of care?

    <p>A professional with continuing responsibility coordinating care</p> Signup and view all the answers

    What is the primary difference between a local and core team model of care?

    <p>The number of organisations involved in care coordination</p> Signup and view all the answers

    In which model of care is teamwork and communication between team members typically high?

    <p>Core team model</p> Signup and view all the answers

    What is the primary benefit of transdisciplinary care?

    <p>The whole will be greater than the sum of the parts</p> Signup and view all the answers

    What is the role of the patient in a transdisciplinary model of care?

    <p>Active participant in care planning</p> Signup and view all the answers

    What is the primary characteristic of a transdisciplinary team?

    <p>Non-hierarchical and self-governing</p> Signup and view all the answers

    In which model of care is a shared plan prepared within the organisation?

    <p>Local team model</p> Signup and view all the answers

    What is the primary advantage of a unidisciplinary model of care?

    <p>Quick decision-making in emergency situations</p> Signup and view all the answers

    What is the primary difference between a transdisciplinary and core team model of care?

    <p>The role of disciplines in care planning</p> Signup and view all the answers

    What is the primary goal of the Gloucestershire Urological Cancer Multidisciplinary Team Service?

    <p>To coordinate care and ensure continuity of care for patients with urological cancer</p> Signup and view all the answers

    Who is the key worker who acts as a link between the MDT and wider community teams?

    <p>Clinical Nurse Specialist</p> Signup and view all the answers

    What is the main focus of the Midhurst Macmillan Palliative Care Service?

    <p>To enable people to be cared for at home and die in the place of their choosing</p> Signup and view all the answers

    What is the role of the CNS in the Midhurst Macmillan Palliative Care Service?

    <p>To organize and coordinate care, while other team members retain responsibility for their aspect of the service</p> Signup and view all the answers

    What is the outcome of MDT working in the Midhurst Macmillan Palliative Care Service?

    <p>Care coordination function of the CNS enables close working with GPs and community nurses</p> Signup and view all the answers

    Who is responsible for updating other partners on a patient's status in the Midhurst Macmillan Palliative Care Service?

    <p>The CNS and other team members</p> Signup and view all the answers

    What is the focus of the Oxleas Advanced Dementia Engagement Service?

    <p>To provide a platform for Consultant-led community-based home care for patients with advanced dementia</p> Signup and view all the answers

    What is the composition of the Oxleas Advanced Dementia Engagement Service MDT?

    <p>Consultants, Associate Specialists, Clinical Nurse Specialists, Team Leaders, Nurses, Counsellor, OT, Physio, Volunteers</p> Signup and view all the answers

    What is the outcome of MDT working in the Oxleas Advanced Dementia Engagement Service?

    <p>Fostering a positive, supportive team culture creates an environment where staff can deliver high-quality holistic care to their patients</p> Signup and view all the answers

    What is the key feature of the Midhurst Macmillan Palliative Care Service?

    <p>A vision to provide personalized care responding to the changing needs of patients</p> Signup and view all the answers

    In a multidisciplinary team meeting, what is essential to add value to the team?

    <p>Having a clear understanding of each member's role</p> Signup and view all the answers

    What is a key aspect of personalised care?

    <p>Patient choice and control over care planning</p> Signup and view all the answers

    What enables people to feel informed and connected in a personalised care approach?

    <p>A positive change in power and decision making</p> Signup and view all the answers

    What is the outcome of shared decision making in personalised care?

    <p>More realistic expectations and better treatment choices</p> Signup and view all the answers

    What is a crucial element for successful multidisciplinary team working?

    <p>Effective communication and collaboration</p> Signup and view all the answers

    What is the ultimate goal of personalised care?

    <p>To support people in having choice and control over their care</p> Signup and view all the answers

    What is the primary purpose of 'Families First' in the context of MDT working?

    <p>To address barriers to support families who don't meet the social care threshold</p> Signup and view all the answers

    What is a key challenge to effective MDT working?

    <p>Professional silos and power dynamics</p> Signup and view all the answers

    What is the role of a pharmacist in an MDT team?

    <p>To provide advice on medication and ensure appropriate medication during treatment</p> Signup and view all the answers

    What is the primary goal of MDT working in the context of patient care?

    <p>To deliver comprehensive, coordinated, and person-centred care for patients</p> Signup and view all the answers

    What is the role of a general practitioner in an MDT team?

    <p>To oversee the patient's record and act as a patient's first point of contact</p> Signup and view all the answers

    What is the primary benefit of MDT working in the context of patient care?

    <p>To enhance the quality of care through comprehensive and coordinated care</p> Signup and view all the answers

    What is a key characteristic of MDT working in terms of leadership?

    <p>Leadership roles vary depending on the team's structure and setting</p> Signup and view all the answers

    What is the purpose of the interactive session in an MDT meeting?

    <p>To discuss the patient's case and share essential information</p> Signup and view all the answers

    What is a benefit of MDT working in terms of patient care?

    <p>Better diagnostic and treatment decisions</p> Signup and view all the answers

    What is the role of a social worker in an MDT team?

    <p>To address the social needs of patients, such as housing or financial support</p> Signup and view all the answers

    What is the average age of patients being supported by the service catered to people with a diagnosis of moderate to severe advanced dementia?

    <p>75</p> Signup and view all the answers

    What is the primary focus of the service for people with a diagnosis of moderate to severe advanced dementia?

    <p>Supporting carers in providing ongoing and palliative care at home</p> Signup and view all the answers

    What is the role of the specialist nurse in the service for people with a diagnosis of moderate to severe advanced dementia?

    <p>Coordinating care for each person based on their primary need</p> Signup and view all the answers

    What is the outcome of the MDT working in the service for people with a diagnosis of moderate to severe advanced dementia?

    <p>Improved quality of life for patients and carers</p> Signup and view all the answers

    What is the significance of the 70% achievement in the service for people with a diagnosis of moderate to severe advanced dementia?

    <p>Percentage of patients who achieved their choice of place of death at home</p> Signup and view all the answers

    What is the target population of the Islington model, also known as NHS at Home: Community Children's Nursing Services (CCNT)?

    <p>Children with complex health needs</p> Signup and view all the answers

    What is the purpose of the Patient Identification Tool in the Islington model?

    <p>To identify children from hospital data with specific health needs</p> Signup and view all the answers

    What is the role of the Community Children's Nursing Team (CCNT) in the Islington model?

    <p>To manage acutely ill children in the community</p> Signup and view all the answers

    What is the outcome of the MDT working in the Islington model?

    <p>Seamless service with clear roles and responsibilities</p> Signup and view all the answers

    What is the significance of the involvement of the hospital team in the Islington model?

    <p>To support the CCNT in managing acutely ill children</p> Signup and view all the answers

    What is the main ambition of the NHS Long Term Plan regarding MDT working?

    <p>To break down traditional barriers between teams and organisations</p> Signup and view all the answers

    What has supported the generalism agenda, which is linked to MDT working?

    <p>HEE's Future Doctor and Future Nurse programmes</p> Signup and view all the answers

    What provides a platform to support and enable MDT working like never before?

    <p>The establishment of ICSs across England</p> Signup and view all the answers

    What has consistently promoted MDT working over the past decade?

    <p>Policy initiatives, pilots, and incentive schemes</p> Signup and view all the answers

    What is a key commitment in the We are the NHS: People Plan 2020/21?

    <p>To break down traditional barriers between teams and organisations</p> Signup and view all the answers

    What is the primary goal of the transdisciplinary model of care?

    <p>To optimise the use of team skills and knowledge</p> Signup and view all the answers

    Which model of care is characterised by a professional with continuing responsibility coordinating the care for the patient?

    <p>Unidisciplinary</p> Signup and view all the answers

    What is a key feature of the Core Team model of care?

    <p>All key members needed to carry out the care work closely together</p> Signup and view all the answers

    What is the outcome of using the transdisciplinary model of care?

    <p>Assessments are carried out by different disciplines working together</p> Signup and view all the answers

    What is the primary difference between a Local – ‘Common’ model and a Core Team model?

    <p>The extent of teamwork and communication</p> Signup and view all the answers

    What is a key benefit of using the Core Team model of care?

    <p>Improved patient outcomes</p> Signup and view all the answers

    What is the primary goal of the unidisciplinary model of care?

    <p>To coordinate care with other professionals</p> Signup and view all the answers

    What is a characteristic of the Local – ‘Common’ model of care?

    <p>A shared plan is prepared within the organisation</p> Signup and view all the answers

    What is the primary focus of the transdisciplinary model of care?

    <p>Patient-centred care</p> Signup and view all the answers

    What is a key feature of the unidisciplinary model of care?

    <p>Separate records for each team member</p> Signup and view all the answers

    What is the role of the Clinical Nurse Specialist in the Gloucestershire Urological Cancer Multidisciplinary Team Service?

    <p>Acting as a link between the MDT and wider community teams</p> Signup and view all the answers

    What is the primary goal of the Midhurst Macmillan Palliative Care Service?

    <p>To enable people to die in the place of their choosing</p> Signup and view all the answers

    Who coordinates the MDT meetings in the Gloucestershire Urological Cancer Multidisciplinary Team Service?

    <p>The MDT Coordinator</p> Signup and view all the answers

    What is the composition of the Oxleas Advanced Dementia Engagement Service MDT?

    <p>Consultants, Associate Specialists, Clinical Nurse Specialists, Team Leaders, Nurses, Counsellors, OT, Physio, and Volunteers</p> Signup and view all the answers

    What is the outcome of MDT working in the Oxleas Advanced Dementia Engagement Service?

    <p>Improved care coordination and patient-centred care</p> Signup and view all the answers

    What is the target population of the Midhurst Macmillan Palliative Care Service?

    <p>Patients with severe, intractable complex symptoms</p> Signup and view all the answers

    What is the key feature of the Midhurst Macmillan Palliative Care Service?

    <p>Personalised care responding to the changing needs of patients</p> Signup and view all the answers

    What is the role of the CNS in the Midhurst Macmillan Palliative Care Service?

    <p>Holding overall responsibility for organising and coordinating care</p> Signup and view all the answers

    What is the outcome of MDT working in the Gloucestershire Urological Cancer Multidisciplinary Team Service?

    <p>Enhanced care coordination and patient-centred care</p> Signup and view all the answers

    Who is responsible for updating other partners on a patient's status in the Midhurst Macmillan Palliative Care Service?

    <p>The CNS</p> Signup and view all the answers

    What is the primary focus of multidisciplinary team meetings?

    <p>Addressing administrative issues</p> Signup and view all the answers

    What is the core element of personalised care?

    <p>Giving individuals choice and control</p> Signup and view all the answers

    What is the outcome of shared decision making in personalised care?

    <p>All of the above</p> Signup and view all the answers

    What enables people to feel informed and connected in a personalised care approach?

    <p>Shared decision making</p> Signup and view all the answers

    What is essential to add value to the multidisciplinary team?

    <p>Clarifying roles and responsibilities</p> Signup and view all the answers

    What is the ultimate goal of personalised care?

    <p>Giving individuals choice and control</p> Signup and view all the answers

    What is the primary goal of a multidisciplinary team in healthcare?

    <p>To provide a comprehensive and coordinated care plan for patients</p> Signup and view all the answers

    Which healthcare professional is responsible for providing advice on medication in a multidisciplinary team?

    <p>Pharmacist</p> Signup and view all the answers

    What is the primary goal of the service for people with a diagnosis of moderate to severe advanced dementia?

    <p>To reduce hospital admissions and improve quality of life</p> Signup and view all the answers

    What is the role of the specialist nurse in the service for people with a diagnosis of moderate to severe advanced dementia?

    <p>To coordinate care with GPs, secondary care and social services</p> Signup and view all the answers

    What is a common challenge to effective multidisciplinary team working?

    <p>All of the above</p> Signup and view all the answers

    What is the benefit of a multidisciplinary team in terms of patient care?

    <p>All of the above</p> Signup and view all the answers

    What is the key feature of the Islington model of care?

    <p>A multidisciplinary team with clear roles and responsibilities</p> Signup and view all the answers

    What is the outcome of MDT working in the service for people with a diagnosis of moderate to severe advanced dementia?

    <p>Improved quality of life and a clear, shared aim among staff</p> Signup and view all the answers

    What is the role of a general practitioner in a multidisciplinary team?

    <p>To provide primary medical care and oversee the patient's record</p> Signup and view all the answers

    What is the primary benefit of the Islington model of care for children and young people?

    <p>Reliable, simple and easy access to resources required for optimal care</p> Signup and view all the answers

    What is the purpose of a multidisciplinary team meeting?

    <p>To discuss patient care and treatment plans</p> Signup and view all the answers

    What is the composition of the core team in the service for people with a diagnosis of moderate to severe advanced dementia?

    <p>Consultant in old-age psychiatry, specialist nurses, advanced practice nurse, dementia social worker, and carer</p> Signup and view all the answers

    Who may lead a multidisciplinary team?

    <p>Any healthcare professional</p> Signup and view all the answers

    What is the significance of the involvement of the hospital team in the Islington model?

    <p>To manage acutely ill children in the community with support from the hospital team</p> Signup and view all the answers

    What is the benefit of using 'Families First' in multidisciplinary team working?

    <p>It addresses barriers to support families who don't meet the social care threshold</p> Signup and view all the answers

    What is the target population of the service for people with a diagnosis of moderate to severe advanced dementia?

    <p>People with a diagnosis of moderate to severe advanced dementia being supported to live at home</p> Signup and view all the answers

    What is the characteristic of leadership in multidisciplinary team working?

    <p>Leadership roles vary depending on the team's structure and setting</p> Signup and view all the answers

    What is the goal of multidisciplinary team working in terms of patient care?

    <p>To provide a comprehensive and coordinated care plan for patients</p> Signup and view all the answers

    What is the primary benefit of the service for people with a diagnosis of moderate to severe advanced dementia?

    <p>Reduced hospital admissions and improved quality of life</p> Signup and view all the answers

    What is the role of the carer in the service for people with a diagnosis of moderate to severe advanced dementia?

    <p>An essential element of the team, providing care and support to patients</p> Signup and view all the answers

    What is the primary goal of MDT working in the NHS Long Term Plan?

    <p>To break down traditional barriers between teams and organisations</p> Signup and view all the answers

    What has supported the generalism agenda, which is linked to MDT working?

    <p>HEE’s Future Doctor and Future Nurse programmes</p> Signup and view all the answers

    What is the context in which MDT working is promoted?

    <p>In both the NHS Long Term Plan and the NHS People Plan</p> Signup and view all the answers

    What provides a platform to support and enable MDT working like never before?

    <p>The changes in health and care infrastructure</p> Signup and view all the answers

    What is the benefit of MDT working in the context of patient care?

    <p>Better supporting the increasing number of people with long-term health conditions</p> Signup and view all the answers

    What is the primary focus of multidisciplinary team meetings?

    <p>To address new protocols, educational topics, and administrative issues relevant to the team's practice</p> Signup and view all the answers

    What is essential to add value to the team in multidisciplinary team meetings?

    <p>To ensure familiarity and clarity of role</p> Signup and view all the answers

    What is an outcome of shared decision making in personalized care?

    <p>A better match between individuals' values and treatment choices</p> Signup and view all the answers

    What is a key enabler of multidisciplinary team working?

    <p>Working across boundaries</p> Signup and view all the answers

    What is the core principle of personalized care?

    <p>People have choice and control over their care</p> Signup and view all the answers

    What provides a positive change in power and decision making in personalized care?

    <p>A new relationship between people, professionals, and the health and care system</p> Signup and view all the answers

    What is a characteristic of the Transdisciplinary model of care?

    <p>Barriers between different disciplines break down and roles are redesigned</p> Signup and view all the answers

    What is a key feature of the Local - 'Common' model of care?

    <p>Professionals from one organisation work closely together</p> Signup and view all the answers

    What is the primary goal of the Unidisciplinary model of care?

    <p>To have a professional with continuing responsibility coordinate the care</p> Signup and view all the answers

    What is a characteristic of the Core Team model of care?

    <p>The core team consists of professionals from several organisations</p> Signup and view all the answers

    What is the outcome of using the Transdisciplinary model of care?

    <p>Patient plans benefit from interdisciplinary insights</p> Signup and view all the answers

    What is a key feature of the Unidisciplinary model of care?

    <p>Professionals from one organisation work closely together</p> Signup and view all the answers

    What is the primary difference between the Local and Core Team models of care?

    <p>The composition of the team</p> Signup and view all the answers

    What is the focus of the Transdisciplinary model of care?

    <p>To make the optimum use of team skills and knowledge</p> Signup and view all the answers

    What is the average age of patients in the service for people with a diagnosis of moderate to severe advanced dementia?

    <p>75</p> Signup and view all the answers

    What is a key aspect of the Core Team model of care?

    <p>The team works closely together, including the patient</p> Signup and view all the answers

    What is the focus of the service for people with a diagnosis of moderate to severe advanced dementia?

    <p>Palliative care</p> Signup and view all the answers

    What is the primary goal of the Unidisciplinary model of care?

    <p>To coordinate care for the patient</p> Signup and view all the answers

    What is the role of the specialist nurse in the service for people with a diagnosis of moderate to severe advanced dementia?

    <p>Care coordination</p> Signup and view all the answers

    What is the outcome of the MDT working in the Islington model?

    <p>Improved quality of life for children and young people</p> Signup and view all the answers

    What is the composition of the core team in the Islington model?

    <p>Health Visitor, Community Children's Nursing Team, hospital pharmacist, and paediatrician</p> Signup and view all the answers

    What is the target population of the Islington model?

    <p>Children and young people with complex health needs</p> Signup and view all the answers

    What is the role of the carer in the service for people with a diagnosis of moderate to severe advanced dementia?

    <p>Part of the MDT team</p> Signup and view all the answers

    What is the outcome of the service for people with a diagnosis of moderate to severe advanced dementia?

    <p>70% of patients achieved their choice of place of death at home</p> Signup and view all the answers

    What is the primary benefit of the Islington model?

    <p>Coordinated care for children and young people with complex needs</p> Signup and view all the answers

    What is the focus of the MDT working in the service for people with a diagnosis of moderate to severe advanced dementia?

    <p>Providing palliative care</p> Signup and view all the answers

    What is the role of the Clinical Nurse Specialist in the Gloucestershire Urological Cancer Multidisciplinary Team Service?

    <p>To act as a link between the core MDT and wider community teams</p> Signup and view all the answers

    What is the primary goal of the Midhurst Macmillan Palliative Care Service?

    <p>To provide palliative care to patients with severe, intractable complex symptoms</p> Signup and view all the answers

    What is the composition of the Gloucestershire Urological Cancer Multidisciplinary Team?

    <p>Urology Consultant, Clinical Oncologist, Radiographer, Clinical Nurse Specialist, MDT Coordinator</p> Signup and view all the answers

    What is the target population of the Oxleas Advanced Dementia Engagement Service?

    <p>Patients with moderate to severe advanced dementia</p> Signup and view all the answers

    What is the outcome of MDT working in the Gloucestershire Urological Cancer Multidisciplinary Team Service?

    <p>All of the above</p> Signup and view all the answers

    What is the role of the MDT coordinator in the Gloucestershire Urological Cancer Multidisciplinary Team Service?

    <p>To coordinate MDT meetings</p> Signup and view all the answers

    What is the primary goal of the Oxleas Advanced Dementia Engagement Service?

    <p>To provide community-based care for patients with advanced dementia</p> Signup and view all the answers

    What is the composition of the Oxleas Advanced Dementia Engagement Service MDT?

    <p>Consultants, Clinical Nurse Specialists, Nurses, Counsellor, OT, Physio, Volunteers</p> Signup and view all the answers

    What is the outcome of MDT working in the Oxleas Advanced Dementia Engagement Service?

    <p>All of the above</p> Signup and view all the answers

    What is the primary benefit of the Midhurst Macmillan Palliative Care Service?

    <p>To enable people at the end of life to be cared for at home</p> Signup and view all the answers

    What is the primary goal of a multidisciplinary team?

    <p>To deliver comprehensive, coordinated, and person-centred care</p> Signup and view all the answers

    Which healthcare professional is responsible for providing primary medical care and acting as a patient's first point of contact in the healthcare system?

    <p>General Practitioner</p> Signup and view all the answers

    What is a common challenge to effective multidisciplinary team working?

    <p>All of the above</p> Signup and view all the answers

    What is the role of a pharmacist in a multidisciplinary team?

    <p>To provide advice on medication and ensure appropriate medication</p> Signup and view all the answers

    What is the benefit of using 'Families First' in multidisciplinary team working?

    <p>To address barriers to support families who don't meet the social care threshold</p> Signup and view all the answers

    What is the primary focus of multidisciplinary team meetings?

    <p>To share essential details about the patient's condition, history, and current treatments</p> Signup and view all the answers

    What is the outcome of shared decision making in personalised care?

    <p>All of the above</p> Signup and view all the answers

    Who may lead a multidisciplinary team?

    <p>A senior clinician or specialist doctor, or a nurse or therapist</p> Signup and view all the answers

    What is the primary goal of occupational therapists in a multidisciplinary team?

    <p>To help patients with rehabilitation and recovery</p> Signup and view all the answers

    What is a key feature of a multidisciplinary team?

    <p>Multiple professionals working together</p> Signup and view all the answers

    Study Notes

    Personalised and Efficient Care

    • Effective communication, collaboration, and coordinated planning are crucial to delivering personalised and efficient care.
    • Personalised care emphasizes individual choice and control, focusing on what matters to the patient.

    Models of Care: Continuum Models

    • Research promotes progression from unidisciplinary to transdisciplinary models in Primary Care Teams.
    • Multiple models exist on a continuum, which vary between teams and adapt over time.

    Model 1: Unidisciplinary

    • A single professional coordinates care, involving others as necessary, typically from their own organization.
    • Communication is often limited to patient-professional interactions, rather than discussions amongst professionals.
    • Records are kept separately and informal meetings may occur.

    Model 2: Local 'Common'

    • Professionals collaborate closely within an organization, with varying degrees of patient involvement.
    • Shared records and formal meetings help establish a common care plan, but may face inter-organization discrepancies.

    Model 3: Core Team

    • Involves key members from various organizations collaboratively assessing and developing patient care plans.
    • Strong teamwork is coupled with shared records and responsibilities; leadership can rotate among members.

    Model 4: Transdisciplinary

    • This model breaks down professional barriers, allowing role flexibility to maximize team skills.
    • Collaborative assessments are informed by interdisciplinary insights, fostering a non-hierarchical, self-governing team culture.

    Example: Multidisciplinary Team (MDT) in Cancer Care

    • Consultant-led, focusing on cancer patients in Gloucestershire Hospital; promotes teamwork in care planning and management.
    • Significant strides in communication and education have been documented, facilitating tailored patient care.

    NHS Initiatives & Long-Term Plans

    • NHS policies aim to enhance MDT working to support growing populations with long-term health conditions.
    • Implementation of Integrated Care Systems (ICS) is a key strategy to advance collaborative care in the NHS.

    Practical Tips for MDT Engagement

    • Active participation in MDT meetings enhances information sharing and collaboration.
    • Understanding and clarity of roles improves team effectiveness.

    Enablers of MDT Working

    • Effective communication and a shared culture foster collaboration across boundaries.
    • Establishing common goals and employing a diverse skill mix enhances care delivery.

    Patient-Centric Care Approach

    • Care plans are based on formal assessments and dialogue with patients, emphasizing their preferences and changing needs.
    • Building trusting relationships among professionals improves care coordination and trust.

    Outcomes of MDTs

    • Effective care coordination reduces service duplication and enhances holistic care delivery.
    • Positive team culture focuses on prioritizing patient-centered care, highlighting staff well-being and professional satisfaction.### Advanced Dementia Services
    • Targets patients with moderate to severe advanced dementia, typically in their last year of life, average age 75.
    • Managed by a core team including a consultant in old-age psychiatry, specialist nurses, a dementia social worker, and other health professionals.
    • Strong emphasis on crisis management to prevent hospital admissions and residential care placements.
    • Care is personalized and coordinated by a specialist nurse based on individual needs and local service availability.
    • 70% of patients die at home, fulfilling their end-of-life preferences.

    Community Children’s Nursing Services (CCNT)

    • Developed as part of Islington’s Integration Pioneers, aimed at improving care for children with specific health needs.
    • Includes initiatives like Children’s Hospital at Home, Children’s Nurses in Primary Care, and Multi-disciplinary Team teleconferences.
    • Children identified using a Patient Identification Tool, with coordinated care across primary, community, and hospital services.
    • Families receive comprehensive support, promoting independence and quality of life through accessible resources.

    Gloucestershire Urological Cancer MDT Service

    • Formed to provide seamless service for urology patients, involving a multi-professional team with clear roles and responsibilities.
    • Regular discussions at Urology MDT meetings coordinate patient care plans, integrating feedback from patients and relatives.
    • Key members include urology consultants, clinical oncologists, physiotherapists, and clinical nurse specialists.
    • MDT coordinator ensures smooth information flow and continuity of care across the health system.

    Midhurst Macmillan Palliative Care Service

    • Consultant-led community-based service providing palliative care with a focus on home-based end-of-life care.
    • Goals include preventing emergency hospital admissions and enabling patients to die in their preferred environments.
    • Requires referrals from GPs and community nurses for patients with complex, persistent symptoms.
    • Coordination by Clinical Nurse Specialists fosters collaboration with GPs and community services, enhancing care quality and reducing duplication.

    Oxleas Advanced Dementia Engagement Service

    • Consultant-led service hosted by Oxleas NHS Foundation Trust, aiming to support advanced dementia patients at home.
    • Jointly funded by local CCGs and authorities; integrates health and social care services.
    • Focuses on crisis intervention and tailored care plans to maintain quality of life for patients and support for carers.

    Key Aspects of MDT Working

    • Importance of effective communication, shared goals, and clear roles within a multi-disciplinary team to ensure comprehensive patient care.
    • Emphasizes personalizing care by honoring individual strengths, needs, and preferences, leading to better health outcomes and satisfaction.
    • Shared decision-making enhances treatment choices, aligning with patient values and reducing unnecessary interventions.

    Personalization of Care

    • Represents a shift towards enabling patients to have autonomy over care planning and delivery.
    • Enhances the relationship between patients and health professionals, fostering informed decision-making and community connections.
    • Evidence indicates improved experiences and outcomes when care is tailored to individual preferences and situations.

    Historical Context of MDT

    • Multi-disciplinary team working is supported by numerous NHS initiatives and policy changes aimed at improving long-term care for patients.
    • Part of the NHS Long Term Plan, which promotes collaboration across teams to better serve individuals with chronic health conditions.
    • Supported by the establishment of Integrated Care Systems (ICSs) in England, facilitating more effective MDT integration.### Benefits of Multidisciplinary Teams (MDT)
    • Improved information sharing among healthcare providers enhances patient care.
    • Healthcare plans are tailored based on goals set with parents/carers or competent young individuals.
    • Offers learning opportunities for all professionals involved in patient care.
    • ‘Families First’ initiative helps support families who may not meet social care thresholds.

    Team Composition

    • Core members may include Occupational Therapists, Physiotherapists, Doctors, Social Workers, Nurses, and Pharmacists.
    • Specific knowledge and skills of team members lead to cohesive care plans tailored to individual patient needs.
    • The composition and effectiveness of the MDT depend on the clinical setting and patient requirements.

    Key Benefits of MDT Working

    • Offers multiple perspectives, enhancing the quality of care and preventing service provision gaps.
    • Facilitates better diagnostic and treatment decisions through collaborative discussions among professionals.

    Challenges Faced by MDTs

    • Hierarchical and power dynamics can create professional silos and hinder trust and decision-making.
    • Scheduling and timetabling issues arise from distributed teams and hybrid working models.
    • Differing professional priorities can lead to conflicts and disagreements.
    • Limited resources inhibit the effective delivery of services.

    Examples of MDTs

    Hospital MDTs

    • Involves a range of specialist doctors such as surgeons, oncologists, and psychiatrists.
    • Nurses provide expert care and support, while various therapists assist in patient rehabilitation.
    • Pharmacists ensure appropriate medication use throughout treatment.

    Community/Primary Care MDTs

    • General Practitioners serve as the first point of contact for patients, managing health records.
    • Practice nurses deliver health promotion, immunizations, and management of long-term conditions.
    • Pharmacists play roles in medication management and condition advice, while social workers address patients' social needs.

    Leadership Dynamics

    • Leadership within MDTs is fluid and may change depending on team structure and context.
    • A senior clinician, specialist doctor, nurse, or therapist might take the lead role.

    Goals of MDTs

    • Aim to provide comprehensive, coordinated care tailored to individual patient needs.
    • Effective communication across disciplines is crucial for seamless patient care delivery.

    MDT Meeting Agenda

    • Patient cases are presented with key details regarding condition, history, diagnostic results, and treatments.
    • Interactive discussions allow team members to share insights, analyze cases, and develop consensus on care strategies.

    Historical Context of MDTs in the NHS

    • MDTs have a long-standing history, with initiatives over the past decade promoting collaborative working.
    • NHS Long Term Plan seeks to break down barriers between teams for better support of patients with long-term conditions.

    Specialized MDTs Example: Dementia Care

    • Core team includes a consultant in old-age psychiatry, specialist nurses, and community health professionals.
    • Focuses on enabling patients with advanced dementia to live well at home, involving families and carers in the process.
    • Achieved a high percentage of patients' choice for place of death at home.

    Community Children's Nursing Services (CCNT)

    • The Islington model supports children through multi-disciplinary teleconferences and the "Children's Hospital at Home" service.
    • Aims to provide seamless, coordinated care across various healthcare settings.

    Personalised Care

    • Emphasizes choice and control for individuals regarding care planning based on personal strengths, needs, and preferences.
    • Encourages shared decision-making, enhancing alignment between individuals' values and treatment paths.

    Models of MDT Working

    • Unidisciplinary: One profession coordinates care with irregular input from others.
    • Local: Professionals work closely, sharing plans within an organizational context.
    • Core Team: Key members across organizations collaborate to create shared plans with high communication.
    • Transdisciplinary: Professionals break down traditional barriers, redesign roles for optimal collaboration.

    Tips for Effective MDT Functioning

    • Actively participate in meetings and share information openly.
    • Clarify roles to add value and enhance team effectiveness.
    • Engage in continuous learning and training with team members.

    Enablers for MDT Success

    • Effective communication and shared goals across all team members and settings.
    • Cultivating a culture of collaboration that values every member’s contributions.

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    Quiz Team

    Description

    This quiz assesses your understanding of Multidisciplinary Teams (MDT) in the National Health Service (NHS). It covers the history and development of MDT working, including policy initiatives and future plans. Test your knowledge of MDT in the NHS and its role in supporting patients with long-term health conditions.

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