New innovative fortnightly Advice and Guidance MDT meetings enable CUH respiratory team, Primary Care and CPFT respiratory link nurses to simplify 2-stage referral process, spending time collectively to streamline the care path and making decisions in a holistic way, provide quicker access to specialist diagnostics to avoid unnecessary referrals.


Led by CUH consultants (Dr Jonathan Flud and Dr Martin Knolle), teams collectively review cases brought to the meeting by PCNs. MDT meetings strive to have a more intuitive response and usage of Advice and Guidance and lead to better and quicker decision making and appropriate treatment – greater peer learning, problem solving and capacity building to decide on the best course of action for the patient.


How this works? PCNs are asked to hold on to referrals they would otherwise be sending as Advice and Guidance on ERS (but not 2WW referrals) to discuss at the meeting. Patients notes get updated in real-time on Epic and SystmOne and clinical minutes recorded in the meeting.


If you or your respiratory team member would like to receive a Starleaf invitation, please email


To find out more and submit your cases (NHS Number), please contact