A Critical look at the NICE guideline on MND

I have now reviewed recommendatons 1.5.2 and 1.5.3 within NICE guideline NG42 and reflected on the following questions:

• How accurately do these recommendations reflect your experiences of working within an MDT?

I feel our team captures the essential functions effectively as the document states 'carry out regular, coordinated assessments at the multidisciplinary team clinic (usually every 2 to 3 months) to assess peoples symptoms and needs'. Currently our MND patients are invited to clinic to be seen approx. every 3 months. We also uphold the recommendation 'provide coordinated care for people who cannot attend the clinic according to the persons needs'. - as the MND specialist nurses also do weekly home visits. 

• How well do they capture the essential functions of multidisciplinary working?

I feel our team captures the essential functions effectively as the document states ‘carry out regular, coordinated assessments at the multidisciplinary team clinic (usually every 2 to 3 months) to assess people's symptoms and needs’. Currently our MND patients are invited to clinic to be seen aprox every 3 months. We also uphold the recommendation ‘provide coordinated care for people who cannot attend the clinic, according to the person's needs’ – as the MND specialist nurses also do weekly home visits.

• What do you consider to be the greatest challenges of applying the MDT approach in MND care?

General NHS issues such as space – we often don’t have the room capacity for all the members of the MND to see patients in clinic. Often different practitioners are required to share rooms, which can then impact waiting times.

Also MND meetings could be more regular if all the members of the team had the time to meet up together, however often there are members who are unable to meet the team due to work pressures and time constraints.