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Title: Multidisciplinary team meetings in community mental health care : a mixed-methods investigation of their functions and organisation
Author: Nic a Bháird, C.
ISNI:       0000 0004 7659 8192
Awarding Body: UCL (University College London)
Current Institution: University College London (University of London)
Date of Award: 2015
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Background Community mental health teams are a central means of delivering specialist mental health care in England. Weekly multidisciplinary team (MDT) meetings are assumed to improve the quality of care by incorporating diverse professional perspectives into care planning. However, these meetings are resource-intensive and there has been little investigation of their operational procedures or their impact. Aim The aim of this PhD is to examine the functions and organisation of MDT meetings in community mental health care, and to identify current challenges to effectiveness and opportunities for improvement. Method A mixed-methods investigation was conducted to examine current practice and stakeholder views in six community-based mental health teams: three general community mental health teams, two memory clinics and one early intervention psychosis service. This involved non-participant observation of 109 MDT meetings; quantitative data on 3,213 MDT case discussions from 181 MDT meetings; and semi-structured interviews with 35 practitioners and patients. Results MDT meetings were perceived to serve a wide variety of functions, ranging from care planning to peer support. However, many practitioners believed that their meetings were poorly managed and lacked clarity of purpose. Teams varied in terms of which patients were discussed, the time dedicated to each discussion, multidisciplinary representation, and operational procedures. Several challenges made it difficult for teams to capitalise on their multidisciplinary diversity, including conflicting models of care, ambiguous leadership, and a struggle to balance profession-specific and generic keyworker roles. Practitioners' ability to implement agreed MDT care plans was limited by a lack of patient involvement, inadequate resources, administrative requirements, and organisational instability. Conclusions A wide range of factors mediate the potential for MDT meetings to benefit patients. The findings highlight the importance of critical reflection on the purpose and organisation of MDT meetings to ensure that they are a valuable use of practitioner time.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available