MDTs
Multi Disciplinary Teams (MDTs)
In line with the NHS 10-year plan, there is a need to transform the health and care system and move to a neighbourhood health service that will deliver more care at home or closer to home, improve people’s access, experience and outcomes and ensure the sustainability of health and social care delivery.
More people are living with multiple and more complex problems and the relative proportion of our lives spent in ill-health has increased.
General Practice and PCNs have agreed to work alongside community providers to provide more personalised support to those patients most at risk of unplanned, avoidable admission to hospital by participating in the Integrated Neighbourhood Teams programme. This involves regular Community Frailty multidisciplinary meetings (MDTs) to discuss those patients most in need of proactive care planning.
Frailty and an ageing population is a challenge that faces professionals in both the health and social care sectors and more so, in primary care which is the first port of call for the vast majority of patients who suffer from frailty syndromes and live with frailty-related conditions. In Sunderland those with moderate or severe frailty are a priority focus.
MDT coordinators provide an enhanced coordination and support offer to the MDTs, supporting practices through the provision of an MDT Coordinator to organise and deliver Community Frailty MDTs, collating relevant information prior to the MDT, working with patients and their carers to seek consent and involve them in care planning pre and post MDT.
For further information please contact our team.
Tel: 0191 5166 076
sgpa.info@nhs.net