National Cancer Action Team

Programme Overview

Before the early 1990s only a relatively small proportion of cancer patients benefited from their care being managed by a MDT of cancer specialists, meaning:

• diagnostic assessments were often made and cancer treatments often delivered by generalists without specific knowledge and skills related to a specific cancer;
• staff were often working in isolation;
• information was not being collated, making audit virtually impossible and hampering the onward flow of data to cancer registries; 
• communication with patients was often poor as was communication between primary, secondary and tertiary care.

 Cancer MDTs were established to overcome these and other challenges and there are now around 1500 in England and the National Cancer Action Team (NCAT) has introduced a programme of work to support their working.

MDT Development Work Programme

NCAT has issued

• characteristics of an effective MDT based on the views of MDT members. Read more...

The NCAT has issued the characteristics of an effective MDT based on the views of over 2000 MDT members who responded to a survey in early 2009 (see below) along with the views of stakeholders who attended various workshops and meetings throughout 2009.

Anyone involved in, or with, MDTs is encouraged to:

• look at these characteristics and see how their MDT(s) compare to them; and to
• initiate discussions within their MDT(s) and Trust(s) about what actions might need to be taken to bring MDTs in line with these characteristics.
• a DVD to demonstrate these characteristics
• the survey results on which the MDT characteristics have been based

NCAT is now working on the next steps to support MDTs to meet and sustain these characteristics.

MDT Working - DVD

A short film has been produced based upon interviews with MDT members plus footage from real MDT meetings. These have been re-created using actors. Patient and staff names have been changed. Any resemblance to real people is co-incidental.

The DVD includes a number of clips (using actors) from MDT meetings.  It does not aim to set out best practice but instead reflects real views and practices that have been witnessed. It is for viewers to determine if what they see is effective practice or not.

The DVD is divided into sections based on characteristic groupings. It can be watched in its entirety or individual sections can be selected. MDTs are encouraged to watch the film and then discuss.

• What they agreed or disagreed with from what they heard and saw?
• How what they heard and saw compares to life in their MDT(s)?
• Did the film prompt any ideas for how MDT working could be improved or changed locally?
• What actions could be taken locally to further enhance MDT working?

If you have any feedback on this DVD, including how you have used it and actions taken as a result please send them to claire.morris@ncat.nhs.uk

View the DVD here

Survey

A survey ran for 6 weeks  in early 2009 to seek the views of MDT members and other stakeholders on MDT working.  Over 2050 MDT core & extended members responded along with around 200 other stakeholders. There was a good mix of responses from different professional groups and also good representation from different tumour areas. Key messages included:

• MDT members need dedicated time for preparation & attendance at meetings;
• good leadership is a prerequisite for a good MDT;
• dedicated MDT meeting rooms should be the gold standard with robust and reliable technology;
• patient views should be presented by someone who has met the patient;
• MDTs need support from their Trusts.

Click here to view:

• a summary of the findings
• the full data analysis
• responses to free text questions by professional grouping

The characteristics of an effective MDT provide the framework for a broader NCAT work programme which includes:

• developing a self assessment and feedback process for MDTs  - known as 'MDT-FIT' (feedback for improving team working) - to help teams to improve elements of their teamworking;
  • MDT-FIT consists of 4 stages - appraising the team from inside, observing the team from outside, feedback on team performance, moving forward as a team
  • MDT-FIT should be ready for a National roll-out by Spring 2013
  • the next stage of work will identify the likely components of a development package required to support cancer teams to work effectively.
• liaising with the National Peer Review Team to refine or add to peer review measures to help MDTs assess themselves against some of these characteristics;
• exploratory work looking at possible models of MDT working for people with active and advanced disease;
• ensuring MDT-FIT links in with other NCAT initiatives, such as the patient information prescriptions programme and advanced communications skills training;
• liaising with the National Clinical Intelligence Network (NCIN) in developing a suite of e-learning modules aimed at MDT co-ordinators.