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Background Motor neurone disease (MND) is a progressive neurodegenerative condition requiring complex, multidisciplinary team (MDT) management. The MDT framework across Wirral was fragmented, with delays in care coordination, inconsistent communication, and poor patient and carer support. An MND keyworker role was introduced in 2021 with the intention to improve this.Aims To improve the quality, efficiency, and coordination of care for patients with motor neurone disease by overhauling the existing MDT approach. The goal was to create a structured, communicative, and patient-centred system that supported timely interventions, enhanced team collaboration, and improved patient and carer experiences.Methods Inconsistencies in the existing MDT approach became apparent following a review of pathways, team communication and patient feedback. Findings were presented at a multidisciplinary operational group meeting, where the referral process and key service gaps were collaboratively examined. The keyworker focused on strengthening relationships with external agencies, including health and social care community teams, palliative care services, and specialist clinics. This informed the redesign of the MDT structure and care pathways for MND patients.Results An MDT was established to meet virtually every 6 weeks, with improved attendance and engagement from all partners. Monthly data showed measure improvements, including earlier referrals to the MND Key Worker and allied services such as speech and language therapy, dietitians, respiratory, palliative care and other hospice services. This enabled earlier conversations about interventions like gastrostomy, non-invasive ventilation, and advance care planning, supporting more proactive, coordinated care. MDT members also adapted their pathways to deliver a more responsive service.Conclusion This approach has led to people reporting feeling better supported from the onset and less isolated. Overhauling the MDT approach enhanced the efficiency, responsiveness, and person-centredness of care delivery. This model provides a sustainable framework that can be adapted to other complex, progressive conditions requiring coordinated multidisciplinary input.