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The Multidisciplinary Parkinson's Disease Clinic.

The Multidisciplinary Parkinson's clinic is based in the Specialist Assessment and Rehabilitation Centre (SPARC) at the Derbyshire Royal Infirmary. The core multidisciplinary team includes:
Dr Rob Skelly FRCP, consultant physician
Lisa Brown, PD nurse specialist
Fiona Lindop, senior physiotherapist
Clare Johnson, senior occupational therapist [OT]
Sr Rosetta Hamilton, SPARC manager
Elaine Bowler, staff nurse
Suzanne Filon, staff nurse

Weekly clinic
We hold a clinic most weeks on Friday. Patients are usually asked to attend in the morning. They see the physio for a mobility assessment and advice, the OT for assessment of mood, memory and activities of daily living, and the nurse for review of bowels and bladder and a medication check. In the afternoon, the doctor or PD nurse will see the patient and carer with all the assessments to hand. This allows for rational changes in treatment. Patients are reviewed every 6-12 months, often sooner if the treatment has been altered.

Additional services
In the course of assessment, the team may recommend:
-a specific programme of physiotherapy
-the anxiety management group
-a speech therapy assessment
-assessment by the continence adviser
-referral to a dietitian.

Virtual clinic
Our patients often phone for advice. Often the nurse can deal with the query. If not the matter can be discussed at the weekly team meeting. This may result in:
- telephone advice,
- a therapy review,
- an early PD clinic appointment,
- or a home visit by the PD nurse or OT
Patients too frail to attend the PD clinic may also be discussed by the team at this weekly meeting.