MDT Steering Group Terms of Reference


The Department’s 20 year primary care strategic framework (Caring for People Beyond Tomorrow) was published in 2005 with a focus on person centred care, access, a team based approach with multi-agency linkages, engaging people in their care and focussing on prevention, education and self care. 

In October 2015 the then Minister for Health established a cross-cutting group to look at how to address the challenges specifically facing GP-led primary care.  The group reported in March 2016, setting out a series of recommendations to strengthen and stabilise primary care. 

In October 2016 the former Minister of Health, Michelle O’Neill committed in ‘Health and Wellbeing 2026’ to taking forward a new model for primary care.  The document set out a vision for the delivery of primary care in the community with GPs and multi-disciplinary teams playing a key role in improving population health and wellbeing – as well developing care pathways and services to meet population needs.  The focus is intended to be on developing fully integrated multidisciplinary care, not just medical or nursing care. 

The former Minister also set out that this new model will be rolled out incrementally over the next 5 years and highlighted the need to, for instance, develop social prescribing models and build linkages to other early support schemes.  Additional funding has been focussed on building these multi-disciplinary teams. 

A programme of work was started in 2017 to develop and implement the model of primary care multi-disciplinary teams set out in Delivering Together.  The initial stages of the programme of work were focussed on best practice, evidence gathering and engagement with stakeholders.  Following the publication of Delivering Together, a £200m Transformation Fund for health over 2 years was announced as part of the confidence and supply agreement between the Conservative Government and the DUP.  The Transformation Implementation Group, which is overseeing work to deliver Delivering Together considered and approved initial allocations for work on Primary Care Multi-Disciplinary Teams. 

A competitive process was then undertaken, through which the Derry GP Federation area (population 205k) and the Down GP Federation area (population 75k) were selected as the two initial areas for full roll-out.  West Belfast, initially selected as the reserve area and the next areas for roll-out of the model, will now benefit from the rollout of MDT Physiotherapists.


The purpose of the MDT Steering group is to oversee the wider development of the primary care multi-disciplinary team model. 


The group will:

  • Oversee the further development of the primary care MDT model
  • Work with the initial roll-out areas to share learning and practice
  • Continue to continue consider national and international best practice and evidence
  • Ensure effective evaluation and consider progress towards benefits
  • Advise on the approach to future roll-out of the model
  • Reflect any issues or concerns from organisations or stakeholders
  • Consider implications regionally of developments in the two initial roll-out areas
  • Ensure strong communication about the MDT model
  • Ensure other areas are well prepared to start roll-out of the MDT model

Steering Group Membership

It is expected that the group will include membership from:

  • Department of Health
  • Health and Social Care Board
  • Public Health Agency
  • All HSC Trusts
  • GP Federations
  • Third sector organisations
  • Patient and carers

Members will be selected to reflect a range of knowledge, skills and experience within the HSC which will be necessary to support successful delivery of the MDT project. Membership will be kept under review to enable group to draw on expert advice/critical friends as required. 

Frequency of meetings

The group will meet quarterly, though meeting frequency will be kept under review and may be stepped up or down as appropriate. 

Key Factors and Interdependencies

The Steering Group should give due regard to the following key factors which will play a significant role in the success of the MDT project:

  • Workforce availability – The new roles and expanded capacity necessary in primary care will need to be factored into planning
  • Ongoing Service reviews – Where changes to care pathways are likely to have implications for the capacity and skills needed in primary care
  • Infrastructure – Where the current pressures on existing accommodation will have implications on General Practice capacity to receive additional staff
  • Other HSC Transformation projects – Which may be competing for same accommodation and staffing resources e.g:- Raid
  • Leadership – to ensure MDT roles are effectively bedded in to Primary Care setting and can work effectively as a team
  • Community development – to support the development of capacity in communities and individuals for self management and prevention


The Senior Responsible Officer (SRO) for the MDT Project is Mark Lee (Director of Primary Care), The Project manager is Aaron Thompson.

The group will provide update reports to DoH top management Group (TMG) and the Transformation Implementation Group (TIG) via Mark Lee as required. 

These terms of reference will be kept under review

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