1.5.2 The multidisciplinary team should:

·       include healthcare professionals and social care practitioners with expertise in MND, and staff who see people in their home

I guess my comment on this would be Yes this does reflect my experience of our MDT. Are they all there in the same meeting every time? No, but are they available and so I have access to the expertise I need – yes. On the whole we have representation from Dietetics, S&LT, Hospice CNS, MND Care Centre, OT(ASC) , Physio, occasionally speciality doctors from the Hospice. We also have a strong presence from MNDA area coordinators who represent the association visitors (volunteers). Its nice that they have a voice back into the MDT.    

·       ensure effective communication and coordination between all healthcare professionals and social care practitioners involved in the person's care and their family members and/or carers (as appropriate)

My concern is that sometimes (not always) our MDT meeting has felt like a reporting process rather than a safe space for discussion – though trying to ensure all those present feel able to contribute.

·       carry out regular, coordinated assessments at the multidisciplinary team clinic (usually every 2 to 3 months) to assess people's symptoms and needs

we don’t have a specialist MND clinic as such, our MDT is community based. I.e, clients are visited at home or if they need specialist (such as respiratory (NiV) input) they would attend the acute trust for this appointment. So this feels less familiar. They are offered regular review with neurology and certainly I think they are seen every 2-3 months by at least someone in the MDT if not more.

But are these assessments as coordinated as they could be ? varies. Sometimes people can feek overwhelmed in the early stages byt having lots of new professionals visiting or attending appointments. Some people are reasuursed by this others .. its just too much and we have tried to minimise appointments or joint visit where possible,

·       provide coordinated care for people who cannot attend the clinic, according to the person's needs. [2016]

Yes I think we do this. We can support people who cannot access appointments outside of the home including specialist outreach teams if needed.

How accurately do they reflect your experiences of working in any MDT?

How well do you feel they capture the essential functions of a MDT?

I think 1.5.3 Highlights the varied areas that the MDT need to address = which again highlights the need for representation across many disciplines to address the varied unmet needs of those PLWMND and their carers / supporters.   

What do you consider are the greatest challenges for the MDT approach when applied to MND?

I think one of the greatest challenges is ensuring care is coordinated. This is sometimes outside the scope of influence of the MDT as service parameters may mean delays. Normally people do prioritise however there can still be challenges to wait for essential services.

I try and make efforts to build relationships with our GP colleagues. Many are very appreciative of what we do however others less so. But generally my experience of Gp’s is very good.

One of my other challenges is ensuring the outcomes of monthly MDT meeting are written up and communicated to those unable to attend. This is simply a time issue. Yes I write down key actions but there is lots within the discussions that are not always captured. Fortunately the meetings are recorded on teams if a core member wishes to go back and review.