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Academy of Royal Medical Colleges – What does an effective multi-professional team approach look like to deliver population health outcomes?

15 November 2017

On Friday 27 October we joined other royal colleges at the AoRMC’s recent event to share learning on how better multi-disciplinary team working can improve population health. The day was opened by Carrie MacEwen, Chair of the AoMRC, and attended by RCOphth president Mike Burdon, Jane Harcourt, our Workforce Committee Chair and myself, Policy Researcher, Laura Coveney.

Introducing the subject, Martha Roberts, Head Staff Engagement at NHS England spoke about building effective MDTs. Martha described the ‘pseudo team’ – a team that exists in the organisational structure, but where key ingredients are missing, such as shared goals and objectives, clearly differentiated but inter-dependent roles and high levels of trust and support – all vitally important to MDT working. Data from NHS staff surveys shows that pseudo teams can result in poorer outcomes and job satisfaction than where there is no team at all.

During the World Café session, Jane hosted a roundtable to showcase the innovative approach of the Grampian Eye Health Network, managing patients with ophthalmic disease through effective working with optometrists, GPs and ophthalmologists.

I joined a table hosted by the national lead for advanced critical care practitioners (ACCPs), Simon Gardner, consultant cardiothoracic anaesthetist at South Tees. Simon explained how the ACCP role developed, initially to address severe senior staff shortages on the intensive care unit. However, the department found that the role delivered much more, improving retention of nurses, a more flexible hybrid medical/ACCP rota, improved handover process, upskilling non-ACCP nurses, and expanding the service to include follow up which reduced readmissions.

We heard how the Faculty of Intensive Care Medicine formalised the two-year work-based course, publishing the curriculum in 2015, and a CPD programme last year. It is not cheap – Trusts need around £200,000 per trainee and to be able to cover the loss of a senior nurse until they rejoin as an ACCP. But the evidence so far suggests that those willing to make this initial investment will reap the long-term benefits of improved MDT working, job satisfaction, patient care and ultimately population health.

The RCOphth is looking at similar initiatives for our eye care MDTs.  As members know, last year the RCOphth collaborated with other professional bodies to produce a common clinical competency framework for upskilling non-medical eye health professionals. This signalled an appetite from across the sector for improving MDT working and training, which we are exploring with local and national education and training organisations.

Laura Coveney, Policy Researcher