Information Sharing and Record-Keeping for MDT Working in Physical Disability Services
In physical disability services, multidisciplinary working depends on information moving safely and reliably between people, families, providers and health partners. When information sharing is weak, the impact is immediate: care plans lag behind clinical decisions, staff miss escalation triggers, and people experience repeated questions, conflicting advice or unsafe gaps. Effective services treat record-keeping and information sharing as operational infrastructure for health integration, not as admin. This article sets out practical approaches that stand up to scrutiny, drawing on Physical Disability: Health Integration, Delegated Tasks & MDT Working and Physical Disability: Service Models & Pathways.
What “good information sharing” looks like day to day
Good information sharing is not about sending more emails. It is about ensuring that the right information reaches the right people in time to change practice. In physical disability services, the most important information is usually practical and time-sensitive: changes to medication, new therapy instructions, revised moving and handling guidance, skin integrity concerns, continence/catheter updates, and early indicators of deterioration.
Services that do this well have three consistent features:
- Clarity: staff know what must be recorded, where, and in what format.
- Speed: clinical changes are reflected in plans before the next relevant intervention.
- Translation: professional advice is rewritten into task-level guidance that frontline staff can follow.
Without translation, the record may be “complete” but still unusable on shift.
Consent, confidentiality and appropriate access
People supported in physical disability services often have capacity and clear preferences about who can know what. Providers should make consent operational rather than theoretical by recording:
- who the person consents to share information with (family members, advocates, specific professionals)
- what types of information can be shared (health updates, risk plans, incident information)
- how information should be shared (phone, email, written summaries, meetings)
Equally important is access control. Not every staff member needs access to every detail. Strong providers maintain a practical balance: staff have what they need to deliver safe care and escalate concerns, while sensitive information is shared on a need-to-know basis and in line with the person’s wishes.
Translating professional input into shift-ready instructions
MDT notes often contain clinical language that does not convert directly into daily delivery. Services need a repeatable process for translation. A useful discipline is to convert advice into three elements:
- What staff should do: the action in plain language.
- What staff should watch for: indicators and thresholds.
- What staff should do next: escalation routes and timeframes.
This structure prevents “advice sitting in a report” while the care plan remains unchanged.
Operational example 1: Therapy guidance implemented safely across all shifts
Context: A person receives occupational therapy input recommending changes to transfer technique and equipment use. The report is uploaded, but agency and night staff continue using old methods, increasing injury risk and distress.
Support approach: The provider introduces a same-day translation and briefing process after any professional update.
Day-to-day delivery detail: On receipt of the OT update, the manager produces a short “shift-ready” instruction sheet: step-by-step transfer method, equipment checks, consent prompts, and stop points. The moving and handling plan is updated immediately and flagged in handover. A brief competency huddle is run at the start of each shift for 72 hours, including agency staff, with supervised practice for those unfamiliar. Night staff receive a targeted briefing focused on repositioning and equipment storage. The updated plan is printed in an agreed location and stored digitally with a clear version date so outdated guidance cannot be used accidentally.
How effectiveness is evidenced: Incident/near-miss reports reduce, staff confidence increases in supervision, and audits show the correct plan version in use across shifts. The person reports improved comfort and predictability, evidenced through feedback notes and reduced refusal of transfers.
Operational example 2: Medication change communicated without delay or ambiguity
Context: Following a specialist appointment, a medication dose is changed. Historically, updates reached the team late, leading to missed doses and confusion about what is current.
Support approach: The provider uses a controlled “change notification” pathway with verification.
Day-to-day delivery detail: After any appointment, staff record a provisional change note but do not administer a new dose until verified in writing (updated prescription, pharmacy confirmation, or prescriber instruction). Once verified, the MAR is updated the same day, the change is highlighted in handover, and staff record monitoring instructions (side effects to watch, what to escalate, and by when). A manager or senior completes a 48-hour check to ensure the new regime is being followed correctly and monitoring entries are being completed.
How effectiveness is evidenced: MAR audits show no transcription errors, monitoring is completed consistently, and any side effects are escalated with clear time stamps. Governance minutes show learning actions if a near-miss occurs, including process adjustments.
Operational example 3: Escalation concerns tracked so nothing “falls between services”
Context: A person shows subtle deterioration (fatigue, reduced appetite, increased breathlessness). Staff escalate to health services, but follow-up is inconsistent and concerns repeat across shifts without resolution.
Support approach: The provider introduces an escalation tracker with ownership and closure rules.
Day-to-day delivery detail: Each escalation is logged with: reason, indicators observed, who was contacted, advice received, and required follow-up actions. A named shift lead owns the action until closure, and the manager reviews open escalations daily. Handover includes a short escalation summary: what changed, what was done, what is being monitored, and the next action/time. If health partners do not respond within agreed timeframes, the plan specifies secondary routes (GP, district nursing duty line, NHS 111 where appropriate) and what interim safety steps staff take.
How effectiveness is evidenced: Reduced repeat escalations for the same issue, faster resolution times, and clearer clinical responses. Audits demonstrate that advice was implemented and monitored, and the person experiences more confident, joined-up support.
Commissioner expectation (explicit)
Commissioner expectation: Commissioners expect providers to evidence integrated working through reliable information flow and up-to-date care plans. They will look for proof that professional input changes daily practice, that escalations are tracked to resolution, and that record-keeping supports outcomes such as hospital avoidance, stability and increased independence.
Regulator / Inspector expectation (explicit)
Regulator / Inspector expectation (e.g. CQC): Inspectors expect accurate, contemporaneous records that reflect current risks and needs. They will test whether staff know the latest plan, whether consent and confidentiality are respected, and whether escalation and follow-up are documented and acted on. Outdated plans, inconsistent handovers, or unclear accountability will be treated as safety and leadership concerns.
Governance and assurance mechanisms that make information sharing defensible
High-performing services do not rely on individual diligence; they design assurance around predictable failure points. Practical controls include:
- Version control: clear dates on key plans (moving and handling, delegated tasks, escalation pathways) and removal of outdated copies.
- Care plan update audits: checks that MDT advice is reflected in plans within defined timeframes.
- Handover quality checks: periodic review of handover notes for clarity, action ownership and follow-up.
- Escalation tracker review: trend analysis on delayed responses, repeat concerns and outcomes.
- Supervision focus: real case reviews on how information was shared and whether it changed practice.
When these controls are in place, information sharing becomes a measurable part of quality and safety, supporting confident MDT working and defensible delivery.