One of the ways partners are working together to transform is to work in a more ‘integrated’ way delivering care, through an integrated care approach to help you to manage the ups and downs of your condition, supporting you to self-manage and to recognise when there is a worsening of your condition. And the second, is through the creation of enhanced multi-disciplinary team meetings (EMDTs).
EMDTs bring together different professionals to discuss and plan a person’s care in a way which is personal to them and created for their specific needs. The person receiving care is at the heart of the discussions and care planning and is encouraged and supported not only to be involved but to lead those discussions by attending these meetings (with or through a carer/guardian or representative if not in person) to ensure their voice and needs are at the forefront of the discussions.
The teams can support people to tackle day-to-day problems and advise them about looking after their health and wellbeing, as well as how best to cope with stress and anxiety. Alongside the individual, the teams can develop a personalised plan of care which will address a range of needs.
Traditional MDT
- Traditionally medically led
- Difficult to access
- Panel based
- Restricted group of decision makers
- Invite by exception
- Closed door
- Exclusion criteria
- Health based
- Signpost and refer
- Awaiting outcomes
Enhanced MDT (EMDT)
- No wrong door
- Departure from ‘referral’ and a move towards a ‘one team approach’
- Team use a request for assistance document to secure time to discuss an individual
- Health, social care, physical health, VCSFE, service users and carers as partners
- Expanded across to multiple primary, community and intermediate-based care.
- Based on need, rather than diagnosis.
- Promotes empowerment and collaborative care.
- Allow the exchange of relevant and necessary information to support the conversations and care of the patient (following DPIA).
- Provide the most appropriate care as and when it is required (Step up and step down), ensuring the right intensity of support is applied to mitigate a crisis or hospital admission.
The teams may vary slightly from place to place and will also change to reflect the specific needs of the person. However, generally speaking this is how they are made up:
EMDT meeting core members:
- Community Mental Health Team
- Mental health practitioners
- Peer support workers (VCFSE)
- Local authority colleagues
Examples of other professionals brought in to support as and when required:
- NHS Talking Therapies
- Older People’s Mental Health Team
- Eating disorder services
- Psychology
- Pharmacy
- VCFSE sector professionals
- Employment support
- Debt advice
- Substance misuse services
- Housing support
- Physical health care such as rehabilitation services and learning disability teams
This list is not exhaustive, we are working to engage as many different types of services and support providers into the team, to ensure our patients and carers get the support they need.
Find out more about these professionals and how they can contribute to care.
An EMDT means you can communicate what matters to you to those supporting you. You can create a treatment plan that works for you and with you. It will allow you to converse about your care, concerns, issues, and priorities in one conversation. It will also enable the professionals supporting you to understand you better, agree on the plan, and work towards your aims and goals.
During an EMDT, if you choose to attend (this can be virtually or face-to-face) the person who generated the referral, or your key worker will participate with you. You will have the opportunity to meet and greet those around the table, join in the conversation around your health, explain and demonstrate what is important to you, and work with those in the room to agree on a plan. It may take more than one conversation, or you may need to continue outside of the allocated time but the result, will be a personalised plan that works for you.
An EMDT should leave you feeling empowered, motivated, and confident. You should feel more involved and in charge of your recovery/day-to-day management.
Request for access to the EMDT
The EMDT’s focus is on the patient's voice, the patient is encouraged to attend (can be arranged virtually or face to face and with a carer/guardian as well as the referrer) to ensure the next steps are developed and agreed upon collaboratively.
If you feel you, your patient or the person you care for would benefit from an EMDT meeting please speak to your main point of contact in health or social services (this may be, your GP, your OT, pharmacist or your community nurse). They will be able to complete a ‘Request for Assistance’ form on your behalf and you will be invited to attend the meeting to discuss your care (or the person for whom you have encouraged a referral).
Request for access - information for professionals
A request for access to the EMDT can be facilitated when:
- The complexity of an individual’s presentation requires intervention from more than one organisation/practitioner and especially where the requirement may extend beyond traditional/statutory services.
- The current care plan does not reflect the needs of the individual and wider support is required.
- In instances where the existing care plan needs to be reviewed, given deterioration or emergence of further needs/risks that cannot be currently managed by the existing support.
- In instances where there is not an obvious pathway upon presentation/assessment.
- Where a person has completed a DIALOG scale and subsequent need identified in ‘My Care Plan’ that requires input from other members of the EMDT.