My thoughts • Not necessarily representative of Oundle Drs • Certainly not representative of Oundle Hub • Certainly I make no criticism of any individual
MDT – Must be a good idea • Get all appropriate people in room • Admin support • Lots of positive messages from ‘up on high’ • Intuitively – it feels right
MDT 20 years ago • General practice was different • MDT ‘happened’ with no great effort
Is the process too ambitious? • Services too fragmented. • Are we inventing complex solution for a complex fragmented Social / Health Care system • Mental health • Elderly • Acute • Long term • Under 65 • Social services • Elderly • Hosp discharge • Community based • Younger Person • District Nurses • Community matrons • DNs
Getting right people in the room • Who have we had in Oundle • Hub support – 100% • Community matron – approx. 90% • Social services- approx. 90% • Mental health - approx. 70% • Oundle Dr – 100% • Voluntary sector – approx. 20% • District Nurses – 0% • They have not been given time to go
Computer systems • We are Emis web • Only in the last 2 meetings have we had access to System 1 • Information Governance – Obviously important - but • Adds a layer of complexity • Gets in the way of easy • communication
Resources do not match need • No / little provision for ‘low level’ mental health needs • Anxiety • Low mood etc • Patients often reluctant to pay for care • Happy to have care – until they realise there is a cost • Voluntary sector in Oundle can be limited
Do we have buy in from all members • ? • Of 60+ referrals into Oundle MDT all but one from Drs • 1 from Community Matron • Nil from B 12 and B 14 (PCH) • Nil SS or Mental Health • What do other members do with ‘tricky cases?’
How much time does it take to do it properly • How long do people take to prepare for a meeting? • If you are ‘managed’ are you given enough time? • If you are ‘unmanaged’ like me do you ‘squeeze it in’
Does the MDT process add any thing? • Secretarial support – is great – thank you • Development of Care Management Plan • As of 1/4/14 only one had been done over all Borderline • Does the MDT process slow everything down as referrals to other services can be ‘put on hold’ until the next meeting
How do we feed back? We have been doing this a year Have we been asked what we all think?
How do we get feed back • We all work in our own groups • Would it help to get feedback from other groups?
MDT Workshop 10th Sept 2013 • No real ability to feedback • I though too ‘evangelical’
My negativity • I am sure has upset people • Sometimes has not been constructive • But – One of my aims in my PDP is to make the process work
Things I have found frustrating • Gary's enthusiasm! • If we are told often enough something is good for us we start believing it • Struggling to get my views across • Being told that evidence shows that it works • ‘Process driven by getting numbers through’ • No obvious attempt to measure outcomes
What are we measuring • Number of referrals • Number of Case Management plans • Risk Profiling DES • No. pts with Car Management plans / Total referrals>90% • Is it possible to measure Outcome? • Are patients and carers happy? • They should be – They have had a problem – Resources have been allocated to them • But is that a result of MDT?
How to improve the MDT process? • I don’t know • But in Oundle it does need to improve
Borderline LCGThursday 15th May 201413.00- 16.00pm WHO SHOULD ATTEND? Minimum of one GP from each practice (to fulfil QOF requirements), community nurses, practice staff and PPG members Certificates for PDP given. Venue: Carey Room, 1st Floor, Kingsgate Community Church, 2 Staplee Way, Parnwell, Peterborough, PE1 4YT Phone: 01733 704452 (Whittlesey)