Virtual multi-disciplinary team meeting to support staff to deliver care and advice remotely

Sussex Musculoskeletal Partnership (SMSKP) is a not-for-profit organisation bringing together primary care, specialist musculoskeletal care, community care, mental health and well-being experts to deliver the whole musculoskeletal service in central Sussex. The Sussex MSK Partnership comprises these organisations:

• HERE – Care Unbound (formerly known as Brighton and Hove Integrated Care Service (BICS))
• Sussex Community NHS Foundation Trust
• Sussex Partnership Foundation NHS Trust

Situation

The COVID-19 outbreak created an urgent need to increase remote working across the health and care system. SMSKP needed to adapt to ensure support from secondary care is available remotely to help inform referral decisions, and get expert advice, as opposed to the routine face-to-face MDT meetings.

Aspiration

The aim of the virtual MDT meeting is to enable a formal mechanism for multidisciplinary input into advising clinicians regarding the ongoing management and care of patients, to ensure patients are seen in the right place at the right time.

Solution and impact

MDT meetings were previously carried out in a face-to-face setting to discuss patient cases to support referral management. The meetings mainly consisted of physiotherapists, osteopaths and psychologists and often had limited input from medics and orthopaedics due to the geographic location and timing.

Since the roll-out of the virtual MDT meetings using Microsoft Teams during COVID-19, SMSKP was able to continue to discuss, assess and diagnose patients as well as work more closely with specialist partners (for example, radiologists from the Medical Imaging Partnership) and secondary care to provide joined-up care.

Now a truly MDT meeting can take place, as neurosurgeons, spinal orthopaedic consultants, pain consultants, GPs with special interest in rheumatology and advanced practitioners in pain and spine all share the same virtual space, discussing and streamlining patients’ care.

The patient’s images are shared with the radiologist a few days before the MDT meetings via the use of picture archiving communication system (PACS). Virtual MDT meetings can then take place remotely using Microsoft Teams. The use of Teams enables remote sharing of patient notes and images securely, getting faster and better input from the consultants and allows for a rapid consensus on further care and management.

This virtual MDT model reduces the burden on the secondary care as the right person is referred at the right time, avoiding unnecessary referrals. The stakeholders found the new MDT model very useful and it is planned for the new model to be replicated across Sussex.

Benefits included:

• Allows clinicians who may be working off-site to provide advice and guidance
• The ‘blue light’ function on PACS helps to manage emergency patient cases for improved clinical safety
• The new model creates capacity for clinicians to review patients’ images and data at a convenient time, allowing them to utilise downtime
• Improved MDT input enables patients to be signposted to the most appropriate service and shortens the patient journey significantly during challenging times
• Share screen function on Microsoft Teams for images and scans enables useful, interactive training opportunity
• Creates trust, cohesion and mutual respect between the healthcare professionals and encourages cross-working relationships and learning
• Reduces the risks of infectious cross-contamination between staff
  

Functionality

• Secure instant messaging, and audio and video calls between NHS colleagues
• NHS staff have free access during the pandemic. Organisations not using NHSmail can access Teams by applying directly to Microsoft

Capabilities

Virtual meeting capabilities

Scope

• Microsoft Teams can be used for one-to-one or MDT meetings
• Shared display of images or files with the virtual screen-share option
• Ability to upload and store documents, image files or MDT outcomes that can be shared amongst members of the clinical team

Key contact

Johan Holte, consultant physiotherapist – clinical spine lead

johan.holte@nhs.net