Multi-disciplinary team meetings (MDTs) are central to the management of patients with cancer. They were introduced over 20 years ago to reduce variation in decision-making and access to best care for patients with cancer.
Over the years, MDTs have come under increasing pressure; due to increases in caseload, a change in case-mix - including patients with greater comorbidities (as a result of an ageing population) and an increasing number of treatment options. MDT meetings require adequate preparation, effective chairing - with engagement and proactive involvement of members to ensure proper discussion of the case, and the ability of the chair to encapsulate the discussion into a clear outcome.
Two important reports recommended changes in MDT working. Among other recommendations, the report of the Independent Cancer Taskforce recommended that NHS England should encourage providers to streamline MDT processes so that specialist time is focused on complex cancer cases with other patients being discussed more briefly. The report from Cancer Research UK also made a strong recommendation to identify pathways for protocolised treatment for the straightforward cases, leaving more time for discussion of complex cases. The report also recommended the development of proforma templates to ensure that all the necessary information about the patient, their performance status and their comorbidities are included in the referral.
These reports have now been formalised in the NHSE/I publication 'streamlining multi-disciplinary team meetings - guidance for Cancer Alliances 2019'. This guidance has been developed to enable cancer multi-disciplinary teams (MDTs) and Cancer Alliances to respond to this changing landscape in cancer care, as recognised in the NHS Long Term Plan and the Independent Cancer Taskforce Report.
- The Characteristics of an Effective Multidisciplinary Team (MDT)
- MDT Referral Form - Example from UCLH
- The Skin MDT Response Report - Reform Paper
- Meeting Patients' Needs: Improving the Effectiveness of Multidisciplinary Team Meetings in Cancer Services
- MDT Improvement Report (2017)
- Decision Making in MDTs: a Structured Observational Study
- The Cancer Multidisciplinary Team from the Coordinators' Perspective: Results from a National Survey in the UK
- An Integrated Literature Review on MDTs
- Cancer Multidisciplinary Team Meetings: Standards for Clinical Radiologists
- Clinical Oncology, Multidisciplinary Team Meetings in Cancer Care: An Idea Whose Time Has Gone
- Streamlining Multi-Disciplinary Team Meetings
- Improving Decision Making in Multidisciplinary Tumor Boards
- Successful Strategies in Implementing a Multidsciplinary Team Working in the Care of Patients with Cancer
- Lung Standard of Care
- Prostate Cancer Standard of Care
- MDT Optimisation RLBUHT Standards of Care (Prostate)
- Breast Cancer Triage SOP - Barts Health & Homerton University Hospital
- Criteria for SMDT Discussion or Standard of Care Pathways for Urological Cancers - Cambridge University Hospital
- How Should we Stratify Skin Cancer Patients to MDT or to Standards of Care?
- Protocols for Colorectal MDT