1. Evidence for the benefit of cancer multidisciplinary working Professor Amanda J Ramirez Director of the KCL Promoting Early Presentation Group & National Clinical Lead for MDT Development National Cancer Action Team Part of the English National Cancer Programme

2. Compliance of MDTs with national standards Improvement has been observed for all tumour groups Increases in median compliance scores Reductions in variations between MDTs One quarter (25%) of MDTs scored over 90% against the peer review measures However, a small number of teams (around 5%) are performing poorly, with compliance score below 50%

3. Compliance of cancer MDTs with national standards over time 2009 – 20102004 – 2008 Median & Interquartile (%) Breast86 (80 – 92)77 (66 -87) Lung87 (81 – 90)74 (66 – 85) Gynae (L)85 (76 – 91)72 (59 – 83) Gynae (S)85 (80 – 94)83 (76 – 92) Upper GI (L)82 (69 – 89)67 (52 – 79) Upper GI (OG)81 (72 – 89)78 (60 – 84) Upper GI (Pancreatic)81 (62 – 89) Urology (L)82 (69 – 87)70 (47 – 81) Urology (S)78 (69 – 89)77 (62 – 84) Testicular85 (72 – 89)74 (63 – 85) Penile67 (52 – 77)89 (56 – 89) Skin (L)60 (47 – 71)n/a Skin (S)61 (50 – 77)n/a

4. Benefits of MDTs Better clinical decision-making Improved clinical outcomes Enhanced patient experience of care Higher quality team member experience Central to national policy priorities National Cancer Action Team Part of the English National Cancer Programme

5. Key characteristics of effective MDT working: categories The team Infrastructure for meetings Meeting organisation and logistics Patient-centred clinical decision-making Team governance National Cancer Action Team Part of the English National Cancer Programme

6. Effective cancer MDT working (1) All relevant professions/disciplines represented with have clearly defined roles & responsibilities Dedicated time in job plans to prepare for and attend MDMs MDT room is appropriate in size and layout Organisational support for MDT meetings & membership demonstrated by adequate funding/resources National Cancer Action Team Part of the English National Cancer Programme

7. Effective cancer MDT working (2) Data collected in real time & validated during the meeting MDT assesses its own effectiveness /performance National Cancer Action Team Part of the English National Cancer Programme

8. Effective cancer MDT working (3) Good chair skilled in: meeting & time management, listening & communication; managing conflict; and, negotiating & facilitating Locally agreed minimum dataset of information Patient views/needs are presented by someone who has met the patient and these inform the decision- making process Team has agreed what is acceptable team behaviour & etiquette National Cancer Action Team Part of the English National Cancer Programme