Implementing the Primary Care Multidisciplinary Model in Newry and District GP Federation

In  2018, the DOH NI announced the Multi -Disciplinary Teams in Primary Care (MDT’s) initiative as part of a £15m transformation fund allocation to primary care. The Southern Health & Social Care Trust (SHSCT), in partnership with the Newry and District Federation of GP Practices, were one of the early implementers of MDT’s in NI. The MDT project commenced implementation early 2020 just when the Covid19 pandemic was emerging. This was an incredibly challenging time with the need for GPs to adapt to a quickly changing situation and reconfigure the delivery of services but despite this, the MDT project team kept a focus to ensure patients had access to high quality MDT services.  MDTs bring together the expertise and skills of professionals such as First Contact Physiotherapists, Social Workers and Mental Health Practitioners with an enhanced service to District Nursing and Health Visiting. 

MDTs provide a platform for improved collaborative working  focusing on:

oClose working relationship with Clinical Services 

oCollaborative working - MDT and GP staff

oEnhanced primary/secondary care partnership working

oWorking and developing regional / national networks

oTraining and development for MDT roles

oImproved relationships with community/voluntary sector

oCommunity profiling to explore population health needs 

Patient involvement and feedback is crucial for ongoing evaluation of Primary Care MDTs. Patient feedback has been captured both locally and regionally and a series of patient stories told through video animation have been co-produced.  The nursing aspect of the MDT team use the Care Opinion platform to capture patient experience.

Progress so far (2022/2023) :

• MDT staffing model in 24 practices out of 29 (139,500 patients with direct access to MDTs out of total population of 160,615)
• 25 community development initiatives
• Investment of £ 2,608,124
• Improved Access to Primary Care Services
• Over 6,000 patients accessed MDT FCP Service
• Over 4,400 patients accessed the MDT MH Service
• Over 2,000 patients have accessed the MDT SW Service
• 66% patients no onward referral to secondary care
• 32,000 Patient Contacts
• 96.0% of patients who accessed MDT FCP Service in year were managed within primary and community care with only 4% referred to secondary care
• 91.6% of patients who accessed MDT MH Service in year were managed within primary and community care with only 8.4% referred to secondary care
• 89.8% of patients who accessed MDT SW Service in year were managed within primary and community care with only 10.2% referred to secondary care
• Health visiting caseloads have been reduced by up to 27% for 0-4 years
• Alignment with GP and other MDT colleagues allows MDT District nurses to quickly and easily communicate patient needs and develop excellent working relationships.

Data quality issues are a considerable barrier to understanding the true impact of MDTs; there is lack of regional standardisation and fragmented systems especially in community data infrastructure.

The learning will inform the next steps for the wider roll out of MDTs across the SHSCT and Southern Federation.