TABLE 1.

Manchester Airways Service multidisciplinary team (MDT) members and roles

MDT member	MDT role
Respiratory physician	Triage referrals
	Diagnose, treat, and manage upper airway and other respiratory conditions
	Request and interpret additional respiratory tests (e.g. imaging and lung function, bronchoscopy)
	Prescribe or discontinue medication as appropriate
Speech and language therapist	Provide expert assessment of upper airway dysfunction, contributing to differential diagnosis and non-pharmacological management
	Provide a provocation laryngoscopy service
	Provide individualised therapy programmes to resolve upper airway symptoms to premorbid state or maximal potential
Clinical nurse specialist	Provide specialist knowledge, skills and leadership in triage, diagnosis, and treatment
	Manage patients in a nurse-led clinic independently, providing individualised care plans
	Provide non-medical prescribing; working in alignment with local and national nurse prescribing guidelines
	Liaise with the severe asthma service where appropriate
Physiotherapist	Provide expert comprehensive assessment of suspected BPD
	Develop individualised physiotherapy treatment programmes and self-management strategies, in collaboration with the patient and in response to patient need
	Improve symptoms and functional ability to maximal potential
Clinical psychologist	Provide comprehensive assessment and formulation to show the psychological impact of respiratory disease
	Enable patients in understanding the nature and implications of their respiratory condition
	Enable patients in developing therapy goals, addressing unrealistic expectations
	Enable patients to adapt to their respiratory condition, exploring ways to reduce the impact of their condition
	Build self-efficacy and coping abilities
	Address any fears, concerns or misunderstanding about their respiratory diagnosis
	Help patients to cope with the emotional triggers of breathing difficulties such as anxiety/depression
	Support the MDT in the treatment of patients presenting with complex difficulties by offering consultation, complex care planning and indirect formulation
Pharmacist	Provide education on the role of inhaled medication
	Provide training on correct inhaler technique
	Provide reassurance on the side-effects of medication
	Improve patient adherence to inhaled therapies
	Provide advice on reducing oral corticosteroids
MDT coordinator	Support the MDT team in collating all information needed
	Coordinate booking of all clinics
	Ensure effective communication across the patient pathway
	Attend MDT meetings: ensuring all correspondence and investigations are available; making notes and actioning any outcomes
	Work collaboratively with medical secretaries and operational delivery network leads to ensure appropriate management of patient information and coordination of patient pathways
	Dealing with patient telephone enquiries and promptly communicate to the team any urgent actions
All team members	Participate in MDT meetings
	Contribute to education and training
	Dissemination of respiratory updates through in-service training and supervision
	Hosting visits from external teams
	Support research

BPD: breathing pattern disorder.