Multidisciplinary Teams: The way forward in Cancer Care

Background

Authors: Jitin Sekhri, Jo Roach and Jeanie Karalis

In 1995 Cancer survival rates were compared

across Europe, and the UK performed poorly,
lagging behind Germany, Austria, France, the
Netherlands and Spain1. In the UK, there has been
no improvement in cancer survival rates for 30yrs
with regional variation in survival rates 2.

A Patients perspective

Aim: To look at the evolving

cancer care model

My husband had 8 doctors.. The cardiologist told me that

(he) was doing reasonably well.. (the) lung specialist said
that he is not getting better, hes worse, he may die.. A
nephrologist informed me that (his) kidneys were failing
finally a specialist in infectious diseases appeared.. This
doctor.. took the time to explain that each of the
doctors had given an assessment only of the particular
organ system he specialised in, not of (his) overall
condition.4

Consultant
Radiographer

Physiotherapist

Developments

Source: Office for National Statistics Cancer Survival. England and

Wales.

This prompted the Calmin-Hine report: The aim

was to create a network of care in England and
Wales enabling any patient in UK to receive
treatment and care of a uniformly high standard 3.

Dietician

Nurse

Key recommendations:
1. Multi-disciplinary consultation and management
are essential.
2. The services of the cancer unit should include
palliative care, access to counselling and other
services such as physiotherapy, dietetics, speech
therapy, occupational therapy, chaplaincy and
social services.

Occupational
Therapist

Speech and
Language
therapist
Social
Worker

References
1. Sant et al (2003) Eurocare-3: survival of cancer patients diagnosed 1990-94 Annals oncology 14: v61-118
2. Babu et al (2008) Developments in the management of patients with lung cancer have improved quality of care Proc Am Thorac soc Vol5. pp816-819
3. DOH (1995) The Calmin-Hine Report "A Policy for Framework for Commissioning Cancer Services
4. Penson et al (2006) Teams: communication in multidisciplinary care The Oncologist 2006;11:520-526
5.Jeffries and Chan (2004) Multidisciplinary team working: is it both holistic and effective? Int J Gynecol cancer 2004, 14, 210-211

- Cancer Services Collaborative (CSC)

initiated in 1999: 30 cancer networks
promoting the development of a holistic MDT
in parallel with the medical model2.
- The aims were to ensure that all patients
have equal access to highest quality care by
developing MDTs who reviewed all patients
before treatment.
- MDT grew outside the realm of just doctors
and nurses to include ward manager,
physiotherapist, dietician, OT, social worker
ensuring5:
- Early referrals to dieticians,
physiotherapists, occupational
therapists, social workers
- Discharge plans are discussed
- Information is shared easily

Conclusion
There was a recognised need to change the way cancer
care was organised.
MDT is the main mechanism for ensuring holistic care for
patients throughout their disease trajectory.
Patient and family wellbeing are directly linked to the
quality of communication among a medical team.