Cancer teams across the east of England are leading the way in transforming patient care through better sharing of expertise when they meet to plan crucial next steps for their patients.

More than 100 cancer specialists who already take part in multidisciplinary team meetings have signed up to join a ground-breaking learning programme, created in the region and believed to be the first of its kind in the country.

Multidisciplinary teams (MDTs) meet weekly to make crucial recommendations regarding the care and treatment of patients. The new training, funded by the East of England Cancer Alliances, shares recognised best practice for a more consistent approach and is in line with NHS England’s Long Term Plan directive to transform MDTs.

Improvements are needed in the effectiveness of meetings due to the record numbers of people being diagnosed with cancer, increased complexities as people live longer and the wider ranges of treatment options.

Bringing together a range of cancer specialists – including nurses, radiologists, oncologists, surgeons and pathologists – and improving the way they engage with each other, offers multiple benefits, including:

• Better patient outcomes;
• Better decision-making; and
• Improving efficiency for busy teams.

Following evaluation, it is intended that the 18-month training programme will be shared across the country.

The course is led by international experts Ben Lamb and Tayana Soukup, PhD, who together have more than 20 years’ experience in studying MDTs and delivering MDT improvement and training in the UK and overseas.

Consultant urologist Ben, who specialises in the management of prostate and bladder cancers, said: “MDTs are seen as the gold standard of cancer care and are essential to high quality patient care. Evidence shows that MDTs influence treatment or outcomes in more than half of all cases. That means they have significant influence in what happens to patients and we want to ensure that they can consistently embed a culture of quality and improvement.”

Previously based in Cambridge, Ben has worked with clinicians and scientists from around the UK and overseas on understanding and improving cancer MDTs.

“Teamwork is recognised as a critical factor in enhancing patient safety and patient experience. It also provides greater opportunity to consider the patient’s personal wishes and preferences,” he said.

“MDT meetings are a crucial part of the cancer care pathway. They routinely review information and make treatment recommendations, but with better information and more team involvement they can make better decisions.”

The new training introduces validated tools to address this and supports the development of additional materials based on local team requirements.

There are approximately 1,500 cancer MDTs across England and based on the time taken for radiologists and pathologists alone to prepare for these meetings, it is estimated that attendance and preparation costs £100 million a year. That could equate to around £10 million in the east of England.

Tayana, a research scientist at the Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, said: “All too often, decisions are not reached or are not implementable. Sometimes this is because team members do not contribute equally and all too often the patient’s own wishes or preferences are not considered.”

A psychologist by training, Tayana has completed a PhD on cancer MDT functioning and teamwork and has published numerous papers on evaluating and improving MDTs.

Consultant oncologist Professor Peter Hoskin, clinical director for the East of England Cancer Alliance (South) said: “The ‘one-size-fits-all’ approach needs to change, with MDTs adapting to their local circumstances as an immediate response to ever increasing workloads. There is an urgent need for evidence-based approaches that can be used by MDTs to streamline services, while improving the safety and quality of patient care.

“We are pleased to have funded a novel work programme designed by clinicians and MDT experts, that will deliver quality improvements, supporting our cancer MDTs to work more effectively.”

The programme is delivered over six study days. The sessions are delivered through a learning platform with a combination of facilitator led and self-directed workshops and activities.

The three phases are:

• Training in the use of assessment tools and quality improvement approaches;
• Facilitating quality improvements and measuring their impact; and
• Developing resources to support continuous quality improvements.

At the end of the training the participants have a greater understanding of their role and responsibility within the MDT along with enhanced knowledge of self-efficacy tools which will help to build confidence, competency and resilience.

One of those taking part is Holly Taylor, Cancer Performance Manager at the Princess Alexandra Hospital NHS Trust in Harlow. She said: “This training jumped out at me as it provides an objective and measurable way of evaluating MDTs that’s also quite simple to apply. We’ve not had that before.

“We knew we needed to come up with an objective way of identifying areas for improvement in our MDTs. This tool gives that objective framework and because it’s external, has been created by clinicians involved in MDTs, and is tried and tested, it is automatically more credible.

“The training will make a real difference to the teams we have taking part. They are able to identify the strengths and weaknesses of their MDT meetings in a collaborative and well supported way, which will lead to high quality improvements that have strong team buy in.

“Hopefully that means any changes made will be sustained as a result. Things like making sure the right patients are discussed at MDT, ensuring everyone in the MDTs feel able to contribute equally and that the patients’ holistic needs are considered are all big positives that can only benefit our patients.”

Holly’s team is already planning how to share the best elements of the training more widely.

Holly added: “This provides a framework for making positive changes to MDTs. The initial training session might seem like a big time commitment but it is worth it for the tools that you come away with that can be used long after the programme. The increasing time pressures everyone faces in cancer services is actually a reason to take part in the programme as it makes you look at MDT time differently and identify how to best use everyone’s time in the meeting – which drives up the quality for the patients. It’s a win win.”

The training is in line with the ambitions of the East of England Cancer Strategy in driving forward improvements in patient care and supporting staff in their vital work. See: www.canceralliance.co.uk/strategy