Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Support the multidisciplinary care of a patient with motor neurone disease (MND) in a primary care setting by:
- Ensuring that the patient is referred promptly to a specialist multidisciplinary team (MDT) with expertise in MND, which includes professionals such as neurologists, specialist nurses, dietitians, physiotherapists, occupational therapists, speech and language therapists, and palliative care specialists NICE NG42.
- Facilitating effective communication and coordination between all healthcare professionals and social care practitioners involved in the patient's care, and ensuring they are aware of key decisions and changes in symptoms NICE NG42.
- Supporting regular, coordinated assessments at the MDT clinic (usually every 2 to 3 months) to review symptoms and needs, and arranging for earlier assessments if there is a significant change in the patient's condition NICE NG42.
- Providing information and support to the patient and their family or carers throughout the diagnostic and care process, including details about the disease, prognosis, management options, and local services NICE NG42.
- Ensuring the patient has a single point of contact within the MDT for ongoing support and guidance, including what to do in emergencies or if issues with equipment arise NICE NG42.
- Addressing psychological and social care needs by discussing emotional impacts, involving mental health and social care services as appropriate, and considering referral to specialist palliative care for complex needs NICE NG42.