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The Multidisciplinary Team (MDT)

Optimal management requires prompt diagnosis, early referral to an experienced MDT working together with families and school, community and primary healthcare providers. The MDT will comprise various professionals including doctors, nurses, therapists, ophthalmologist(s), psychologist(s) and social workers. 

The clinical nurse specialist is central to providing education and support - this will often extend into the local community nursing team and school health nurses. Community and local support is essential for families unable to give treatment themselves at home. Physical therapists work closely with the nurses in their liaison with schools to facilitate integration and performance in school.

The following are typical queries the nurses, physiotherapists or occupational therapists may address:

  • 'They can’t brush their own teeth because their fingers are sore....'
  • 'My child complains their legs are sore and limps....'
  • 'I don’t understanding my child’s condition.'
  • 'Medication how do I get it / how do I give it?'
  • 'I am really worried.'
  • 'There is chicken pox in the class what do I do?'
  • 'What do I do if my child is poorly?'
  • 'I think my child needs a wheel chair where do I get one?'
  • 'I need an appointment for my child.'
  • 'My child is really tired at school.'
  • 'My child is going away on a school trip what do I tell the teachers?'
  • 'HELP ! I can’t do the injections.'
  • 'My child complains their hand hurts when they are writing.'
  • 'Can they do PE ?'
  • 'Why does my child need an eye check?'

The roles of the MDT include the following:

  • Knowledge – making sure families and patient understand the diagnosis and treatment plan.
  • Co-ordination of care – getting treatment started and then ongoing - this may be treatments given at home or on the day case unit (e.g., infusions of corticosteroids, biologics or cytotoxics or joint injections).
  • Support and guidance – helping families when they are worried / concerned.
  • Training – training families or local nurses to give care to child or young person.
  • School support – contact with schools / nurseries so that the child is able to fully participate and achieve full educational potential.
  • Supporting children receiving day case treatments involving cannulation or anaesthesia.
  • Facilitate communication between MDT members and families. 

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