Table 1.
Whole-time equivalents per clinic size: full-time paediatric patientsa.
| The MDT | 50 patients | 150 patients | ≥ 250 patientsb |
|---|---|---|---|
| Consultant 1 | 0.5 | 1 | 1 |
| Consultant 2 | 0.3 | 0.5 | 1 |
| Consultant 3 | – | – | 0.5 |
| Medical trainees | 0.8 | 1.5 | 2 |
| Specialist nurse | 2 | 3 | 4 |
| Physiotherapist | 2 | 3 | 4 |
| Dietitian | 0.5 | 1 | 1.5 |
| Clinical psychologist | 0.5 | 1 | 1.5 |
| Social worker | 0.5 | 1 | 1 |
| Pharmacist | 0.5 | 1 | 1 |
| Secretary | 0.5 | 1 | 2 |
| Database coordinator | 0.4 | 0.8 | 1 |
Patients with CFTR-related disorders should not be counted.
When clinics care for significantly more than 250 patients, additional consultants should be added to the multidisciplinary team (MDT) at a rate of approximately one additional consultant per extra 100 patients. Additional allied health professionals and support staff will also be required. There is likely to be a limit to the number of patients who can be cared for effectively in a CF Centre. This number will vary according to the facilities available in the hospital housing the Centre and the capacity of that hospital to support adequate staffing for the Centre. The MDT in individual Centres should review patient numbers annually and appreciate when resources are becoming stretched beyond the limit allowing care to be delivered to the standards recommended in guidelines. Paediatric patient numbers are likely to remain relatively stable but adult numbers are increasing every year. The need to establish a new adult Centre in any region must be considered proactively. Supply must precede, or coincide with, need.