Multidisciplinary team working: Getting it Right 4 U

Kersiebank Medical Practice operates a multidisciplinary team model. The aim of this innovative person-centered structure is to ensure patients get seen by the right person, at the right time.

This means that the GP or Practice Nurse you are used to seeing may no longer be the most appropriate member of our team. The page introduces you to the roles of our various staff groups.

Multidisciplinary team working also focuses on us working together as a team. This means that you may see multiple professionals at the same time: for example, an physiotherapy practitioner for backache and a mental health nurse to assess how it is affecting your mental health.

Our multidisciplinary team starts every morning with a huddle. This is a short meeting model taken from the hospital that allows us to meet every day to discuss urgent pressing issues, including patients the team is concerned about and changes within the practice. We also have monthly multidisciplinary meetings for the whole team, case reviews for complex patients, palliative care meetings and child protection meetings. These ensure we can deliver safe, patient-centred care.

 

Reception and Administrative team

The administrative and reception teams are care advisors who are here to ensure you get seen by the right person, at the right time.

Their role involves ensuring you are directed to the correct clinical professional or service. This means that when you call the practice to ask for an appointment, you will be asked what the nature of your illness is.

As well as directing you to the correct professional, your reception and administrative team do a lot of the work behind the scenes. They ensure your medical record is up to date, prescriptions are ready to collect and you get test results promptly.

Doctor

Your GP is a doctor that is trained in all aspects of general medicine.

These clinicians will see all patients - from the very young to the old.

You might need to see a doctor if you have a number of different conditions that are interacting to make you unwell. You might also need to see a doctor if you have an acute condition directly related to the heart.

Our GPs provide support to all other clinical groupings. If you see another clinician, they may ask a doctor for a second opinion.

Advanced Nurse Practitioner

Your ANP is a specially trained nurse who can see and treat people with a variety of ailments, including UTIs, chest infections and abdominal pain.

Our ANPs can assess, examine, treat, prescribe and refer you to secondary care if necessary. Most of our ANPs will see patients over the age of five.

Our ANPs are specialists in acute care. In collaboration with the doctors, they manage the triage and ensure that urgent care is delivered promptly to patients.

We also have trainee ANPs in the practice. These are highly experienced nurses who, with the support of our lead ANP and GPs, are working towards a level eleven qualification in Advanced Practice.

Primary Care Mental Health Nurse

Your Mental Health Nurse is a specially-trained nurse who is based in the GP surgery. They can see and treat patients with mild to moderate mental health problems.

Your first contact with a member of this team will be via a mental health telephone appointment. They will assess your circumstances over the phone and make a decision about the best steps foward with you. They may agree that treatment is the best way forward, this might include medication and therapies.

These nurses can assess, examine, treat, prescribe and refer you to secondary care services if required. They will also provide signposting support - directing you towards appropriate other services.

Our mental health nurses will only see patients who are over the age of eighteen.

Physiotherapy Practitioner

Your Physiotherapy Practitioners are specially-trained physiotherapists with expertise in musclulosketal problems, such as sore backs and sciatica.

Physiotherapy Practitioners can examine, assess, diagnose, provide treatment and give advice on pain or movement. They mainly work with acute cases in primary care. They will see patients aged sixteen and over.

The team can also arrange for diagnostic tests to be done, such as x-rays. If you have a chronic condition that requires ongoing physiotherapy treatment, they may refer you to secondary care.

Practice Nurse and Healthcare Assistants

Your Practice Nurse is a specially-trained nurse who is focused on the management of long-term health conditions.

If you have certain long-term health conditions, they will see you in the practice on an annual basis. Our practice nurses can examine, assess, prescribe and refer if appropriate.

Our practice nurses also run well person and well women clinics, do pre-school immunisations and can provide advice on a number of areas such as weight management and smoking cessation.

Your Healthcare Assistants are specially trained members of the team who support the work of the nursing team.

This team focus on ensuring many of the diagnostic tests can be done. They take bloods and blood pressure, do ECGs and test urine samples. This team also focus on ordering clinical products and stocking rooms.

Primary Care Pharmacists

Your primary care pharmacists are specialists in medication. This team provides advice and support to other clinicians regarding complicated combinations of medication.

Our pharmacists also manage acute prescription requests, post-hospital medication changes and reauthorisation of medication to ensure you receive appropriate medication.

If you have requested a medication, you may get a phone call from one of the members of our pharmacy team to discuss your condition.

The team are also working towards being able to provide a pharmacotherapy service, which will allow you to make an appointment with them to review your medications.