Are muti-disciplinary teams helpful in managing respiratory referrals?

Introduction Respiratory conditions, including COPD, are a common problem which generates many outpatient referrals from primary care to hospital. We have introduced a community respiratory team supported by consultants undertaking clinics in the community underpinned by a multidisciplinary team meeting (MDT). At the MDT all referrals from general practitioners are received on a specific proforma where spirometry, old clinical notes / letters and chest x-rays are reviewed. Patients are triaged into different care pathways from this weekly MDT. We have audited our output from this. Results Over a 3 year period 2011 to 2013, 1534 patients referred from one primary care trust serving a population of 193.000 patients were discussed. The outcomes from the MDT are tabulated below. Conclusion Over a 3 year period there has been a consistent ability to ensure referrals are placed in the community setting with few patients who would have previously attended hospital now doing so (14%) This represents a considerable cost that may be saved by directing patients from hospital to a community clinic where there is on-going support of nurses, parking is easier and fulfils the desire for care closer to home.