The Multidisciplinary Team (MDT) in Primary Care

The main role and function of a primary care multidisciplinary team (MDT) is to provide a first contact and brief intervention service to patients presenting in General Practice. Each multidisciplinary team is ideally made up of GPs, nursing staff, practice based social workers, senior mental health practitioners, pharmacists and physiotherapists. The roll out of MDTs is ongoing, and not all practices have access yet.

The introduction of MDTs to primary care was relatively recent, and in response to a series of reports. In October 2016, “Health and Wellbeing 2026: Delivering Together” (a 10-year plan for transforming health and social care in Northern Ireland) was launched by the Department of Health (DOH). This plan was the response to a report produced by an Expert Panel led by Professor Bengoa. He was tasked with considering the best configuration of Health and Social Care Services in Northern Ireland. A key element of the plan was the development of multidisciplinary teams (MDTs) of professionals working alongside GPs as first responders in General Practice. Following a period of engagement with the Health and Social Care (HSC) system and service users, the Department of Health (DOH) proposed that the HSCB commission multidisciplinary teams (MDTs) in General Practice in 2018/19. These MDTs aimed to deliver the vision set out in “Delivering Together” with an increased emphasis on a holistic model of health and wellbeing which includes physical, mental and social wellbeing with a greater focus on prevention and early intervention.

  • A GP Practice Manager is a business manager ensuring that patients are cared for within the Surgery.  It is a demanding but extremely rewarding role. The job is varied and covers HR, Finance, Training, IT management, Systems and Protocol development. You need to be motivated, a good communicator, a sympathetic ear and a first class manager to excel in this role. No two days are ever the same and the job satisfaction is a reward in itself

    Some of therr roles include:-

    • Overseeing the day to day working of a GP Practice

    • Strategically planning the future with the Partners in the Practice. 

    • Managing staff, the building, and the finances

    • Orrganising training and skills updates to ensure staff are well trained and able to cope with the demands of a very busy work environment.  

    • Working alongside the GP Partners to ensure practices are safe, efficient and provide a first class service to all patients. 

  • Practice Nurses are highly skilled members of the primary care team. They carry out a range of roles within the practice including:-

    • chronic disease management eg. DM, COPD, asthma, CVD

    • cervical screening

    • childhood/adult vaccination

    • blood monitoring

    The GPN Training Scheme has been designed to reflect the Career Pathway for General Practice Nursing NI (NIPEC 2019) 

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    The Scheme runs over 1 year and includes three primary elements of (a) practice-based learning within a host Practice, (b) the Ulster University Post-graduate/Advanced Certificate General Practice Nursing and (c) knowledge and skills training provided by the Clinical Education Centre. 

    There are a range of courses available for those considering this career pathway https://www.publichealth.hscni.net/directorate-nursing-and-allied-health-professions/nursing/primary-care-nursing

  • This group of Health Care professionals can:

    • Diagnose a range of musculo-skeletal conditions

    • Offer patients advice and exercises to manage their condition

    • Order tests including X-rays

    • Prescribe medication

    • Refer patients to another service if required including to community based activities .

  • Social workers can provide patients with practical advice, help, and support in order to address their problems. They work closely with other members of the MDT, as well as with groups in their local community that can support patient needs.

  • The Senior Mental Health Practitioner can be from one of four professional backgrounds (Social Work, Nursing, Occupational Therapy or Psychology). The Senior Mental Health Practitioner is an integral part of the MDT working alongside other professionals in a seamless and coordinated way effectively meeting the holistic needs of the GP patient and their families.

  • General Practice Pharmacists (GPPs) work as an integral part of the multi-disciplinary general practice team. 

    Every GP practice in NI avails of the services of a GPP through membership of the GP Federation. Although GPPs have a well-defined and wide ranging remit, the GPP role within an individual practice can vary according to practice need and priorities. The role includes some of the following tasks:-

    • resolving day-to-day medicine issues

    • consulting with and treating patients directly. This includes providing help to manage long-term conditions, advising those taking multiple medicines (polypharmacy) and delivering clinical advice about treatments.

    • managing medicines shortages by suggesting suitable alternatives where appropriate

    • mentoring newer pharmacists, depending on their level of experience.