MDT Development : Challenges and Opportunities Dr Grainne Doran RCGPNI Chair

Delivering Together : case for change The inability to meet the extraordinary demands and pressures created by an ageing population The stark differential in health and social care outcomes between the most and least deprived areas The current service delivery model being no longer fit for purpose The challenges in attracting and retaining staff to prop up an outdated system

Aims of Transformation

Starting point for General Practice Increasing demand from increasing population with increasing comorbidity 25.1% growth in over 65 population in 10 years to 2016 Falling number of GP practices in Northern Ireland 363 in 2006 353 in 2012 336 in 2018 Access to locum cover for backfill – holidays and training Stressed system and stressed GPs

More GPs coming? 23.2% GPs aged 55 or over GP Training places applications 2008 – 258 applications (for 65 places) 2015 – 185 applications (for 65 places) 2016/17 – 161 applications (for 85 places) 2015 – 100% of 65 places filled 2016 – 98.8% of 85 places filled 2017 – 91.8% of 97 places filled

Opportunities Need more GPs – work in progress on recruitment Need to support and empower existing GPs Need to explore new ways of working

Opportunities: Workload sharing Autumn 2017 Data collection exercise from 43 practices spread across NI looking at case mix of GP appointments 28.1% of encounters were recorded by the GPs as being capable of management by non GP professional Multidisciplinary support at practice level as a possible solution

Challenges of innovating MDTs Capacity to train to meet to physically accommodate Leadership to develop new roles to adjust to new ways of working

Challenges of innovating MDTs Communication Patient expectation Within the GP Practice Within “the system” Using IT systems Assessing Success Data collection Patient Journeys Staff “happiness”

Opportunities