Abstract
Introduction: The regional development of new Primary Care Multidisciplinary Teams (PC MDTs) is a central element of ‘Health and Wellbeing 2026: Delivering Together’ for Department of Health (DoH) in Northern Ireland (NI).
The PC MDT Programme has been established to transform the planning and delivery of Primary care services by:
- Better meeting existing demand for primary care services;
- Providing a platform for service reform – supporting the shift of care into primary and community settings; and
- Boosting capability and capacity for early intervention, prevention and focus on wellbeing.
The PC MDT model comprises First Contact Physiotherapy (FCP), Senior Social Work Practitioners (SSWP), Social Work Assistants (SWA) and Senior Mental Health Practitioners (SMHP) co-located in GP practices.
The WB PC MDT is a partnership between West Belfast (WB) GP Federation and Belfast Health and Social Care Trust funded by DoH.
Commencing in 2019, with incremental recruitment dependent on funding, the team now comprises 69 WTE staff providing services to 93,000 patient population of the 16 GP practices within the WB GP Federation.
First Contact(FC) FCP, MH and SW staff are co-located in GP practices and have been embedded within the existing practice teams to provide new enhanced services for patients.
With an aim of not just managing ill-health, but also on a holistic approach to physical, mental and social wellbeing, there is a focus of prevention and early intervention across the team. There is a strong emphasis on partnership working with community and voluntary sector organisations via joint seed money projects.
Results/Impact: Patients now have rapid access to FC services within WB GP Federation practices. Practice reception staff are trained as care navigators to direct the patient to the most appropriate professional in a timely manner. Patients can see FC professionals without first needing to see their GP. MDT staff also refer inter-professionally in the practice team as appropriate so that required elements of the MDT are wrapped around the patient in a truly holistic way. Only if medical intervention is required will the FC staff request GP input. This releases significant pressure on limited GP resource to focus on those patients who most urgently require their care.
Since implementation WB PC MDT FC services have provided over 116,000 patient consultations which would otherwise have been potentially undertaken by a GP. Of the referrals to the service, the majority are being addressed within primary care ( >80% for FCP, > 65% for SW and >65% for MH) with low levels of onward referral to secondary care ( FCP 3.5%, SW 13% and MH 5%).
46 joint community projects delivering 13,000 patient contacts.
Patient feedback about the service has been overwhelmingly positive with 100% of patients satisfied or very satisfied with their care and 90% extremely likely to refer to friends and family.
The Primary Care MDT in West Belfast provides much needed multi-professional additional resource, which has been a significant element in stabilising GP practices by delivering enhanced services for patients in primary care in West Belfast.
(www.health-ni.gov.uk/articles/primary-care-multi-disciplinary-teams-mdts).