Enhancing Sleep Services in a District General Hospital (DGH) through the MDT/CAS Model: A Retrospective Evaluation

<bold>Objective:</bold> Evaluate the impact of a Multi- disciplinary Team Meeting (MDT)/ Clinical Assessment Service (CAS) on sleep services in a DGH, with a focus on cost-effectiveness, outpatient clinic optimization, management according to NICE recommendations and reduction of the carbon footprint within the National Health Service (NHS) <bold>Methods:</bold> Single-centre retrospective review (March-August 2023), examined outcomes of MDT/CAS sleep clinics. A fortnightly MDT was established to review patients referred with suspected obstructive sleep apnoea (OSA). A structured policy guided the MDT process, with outcomes included discharge with a clear plan, scheduling follow-up outpatient (OP) appointments, and repeating sleep studies if any quality concerns. <bold>Results:</bold> In six months, 261 patients were discussed in the MDT. 256 (98.1%) patients exhibited either normal sleep studies (n 91) or mild OSA (n165). 5(1.9%) had moderate / severe OSA. 219 (85.5%) patients with normal sleep studies or mild OSA (no significant comorbidities or symptoms affecting quality of life) were discharged with a clear management plan. 37 (14.5%) were planned for OP appointments. Within the next 6 months, among the discharged cohort, only 9 (4.1%) were rereferred to the services for ongoing symptoms. The implementation of MDT/CAS clinics resulted in the creation of 210 new OP clinic appointments, equivalent to 26 new sleep clinics during 6-month period. <bold>Conclusion:</bold> The MDT/CAS model proved effective in freeing up outpatient appointments, reducing costs to the NHS, diminishing the carbon footprint, improving patient care and ultimately alleviating the burden on the healthcare system for patients.