The guidelines support practice really well and are useful to refer back to when you need legislation to back you up. 

In relation to the first point, I feel we have a broad range of professionals who have experience of MND however we are a team that see people with any physical health condition so are therefore not always "specialist" in MND. I have addressed this issue before and we have tried to allocate people with MND to certain people with experience and the skills required. 

I also find there is a lack of specialist social care workers who understand the challenges of MND and this can cause issues with timings of care provision. 

We do have an MND co-ordinator and this works really well to ensure relevant professional are involved. 

The greatest challenges for an MDT in regards to people who have MND are time. The person can deteriorate so quickly, it is difficult to pull together that MDT to have important discussions in a timely way. There is also huge time pressures on staff so this causes additional issues to be able to respond immediately. I feel we all endeavour to respond as quickly as possible but this if often too late and a person’s situation can have changed almost overnight. As an MDT, we try and future plan as much as possible and having a mix of skill sets and knowledge allows us to make provisions but we do not always get it right and it is important to reflect regularly to improve patient care.

In summary, the NICE guidelines are a really useful tool to remind everyone to work together and that no one person is responsible for the care of the person, we are a team and should work together.