Post on 18-Jan-2017
Running an effective MDT
Anita Thomas – Deputy Chief Operating Officer
Nicci Tucker – Cancer Information Manager
Aim for this session
Discuss the aspects that enable an effective MDT, which include
• Clinical engagement
• Layout of the room
• Timed pathways
• Performance reporting
Befo
re
MD
T
Aft
er
MD
T MDT
Definitions
Effective – successful in producing the desired or intended result
MDT – Multi Disciplinary Team
Why do you need an effective MDT
It is nationally recognised that an early diagnosis, optimum and appropriate treatment result in the best possible
prognosis for the patient
What is an effective MDT?
Well…
MDT
Clinical Team
Admin support services
Diagnostics
Cancer Services
What is an effective MDT?
Clinical Engagement
I would like to join the large group of healthcare professional praising the MDT service at Dorset County Hospital. This is the best MDT service i have ever come across in my journey through the NHS hospitals The team spirit, working together with high commitments is exceptional I am so grateful that we have all of you in Dorchester! Tomasz Graja Consultant Surgeon Breast Oncoplastic, Skin Cancer & General Surgery
This team can equally rival and surpass any major teaching hospital – they are a credit to the organisation and most importantly to those patients in Dorset suffering from cancer – a fantastic resource Hilary Maxwell, Gynaecology Cancer Nurse Specialist
The abilities of our local Cancer Services MDT to coordinate the network discussions between all of the specialists in all of the regional centres are truly outstanding. This gives huge reassurance to both patients and Clinicians that the patient’s potentially complex journey is simplified and relatively seamless. I am very grateful that we have such committed Coordinators working for the DCH Cancer Care services who work extremely hard to make this happen day after day, week after week Dr Stephen Bridger Consultant Gastroenterologist
Layout of the room
Why is the layout of the room important?
…Well?
MDT room
Achieving our Goal
Timed Pathways Prostate All urology referrals are triaged and put onto the appropriate pathway 1st seen
MRI
one-stop PSA / TUB clinic
general urology clinic Standard Investigations
MRI
TRUS + biopsy
Template biopsies
Bone scan for metastatic patients Treatments
Active Monitoring
Hormones – only
Hormones + Radiotherapy
Brachytherapy
Robotic Assisted Radical Prostatectomy
Reporting
Total
TreatedBreaches
Achieving
Target
Achieving
Target %
Measure Target Qtr 1 Qtr 2 Qtr 3 Qtr 4 Qtr 1 Qtr 2 Qtr 3 Jan-16
All suspected Cancers Two Week Wait from
urgent GP referral to first seen93% 95.2% 96.4% 93.9% 91.3% 95.3% 87.33% 95.97% 92.61% 588 8 580 98.64%
Breast Symptomatic Two Week Wait from urgent
GP referral to first seen93% 92.8% 95.0% 82.7% 73.5% 94.2% 69.77% 96.43% 100.00% 28 0 28 100.00%
All Cancers - 31 Day Diagnosis to First Treatment 96% 100.0% 99.3% 99.7% 99.6% 99.0% 98.68% 99.65% 100.00% 89 0 89 100.00% 1.0
All Cancers - 31 Day Subsequent Treatment
(Surgery)94% 94.4% 98.4% 100.0% 97.9% 94.7% 100.00% 100.00% 100.00% 7 0 7 100.00%
All Cancers - 31 Day Subsequent Treatment (Anti-
Cancer Drugs)98% 100.0% 100.0% 100.0% 100.0% 100.0% 100.00% 100.00% 100.00% 22 0 22 100.00%
All Cancers - 31 Day Subsequent Treatment
(Radiotherapy/Other)94% 100.0% 100.0% 100.0% 100.0% 100.0% 100.00% 100.00% 100.00% 2 0 2 100.00%
All Cancers - 62 Day Referral to Treatment
following an urgent GP referral85% 81.9% 81.7% 88.0% 87.2% 80.8% 86.94% 84.14% 70.91% 41.5 13.5 28 67.47%
All Cancers - 62 Day Referral to Treatment
following a Screening Service referral90% 100.0% 97.4% 100.0% 95.7% 93.5% 94.44% 93.33% 83.33% 5 0 5 100.00%
Total
TreatedBreaches
Achieving
Target
Achieving
Target %
Total
TreatedBreaches
Achieving
Target
Achieving
Target %
Measure Target
All suspected Cancers Two Week Wait from
urgent GP referral to first seen93% 355 17 338 95.21% 500 30 470 94.00%
Breast Symptomatic Two Week Wait from urgent
GP referral to first seen93% 19 0 19 100.00% 20 1 19 95.00%
All Cancers - 31 Day Diagnosis to First Treatment 96% 30 0 30 100.00% 85 2 83 97.65%
All Cancers - 31 Day Subsequent Treatment
(Surgery)94% 2 0 2 100.00% 11 0 11 100.00%
All Cancers - 31 Day Subsequent Treatment (Anti-
Cancer Drugs)98% 1 0 1 100.00% 32 0 32 100.00%
All Cancers - 31 Day Subsequent Treatment
(Radiotherapy/Other)94% 5 0 5 100.00% 2 0 2 100.00%
All Cancers - 62 Day Referral to Treatment
following an urgent GP referral85% 17.5 6 11.5 65.71% 42 12 30 71.43%
All Cancers - 62 Day Referral to Treatment
following a Screening Service referral90% 3 0 3 100.00% 4 0 4 100.00%
Total
TreatedBreaches
Achieving
Target
Achieving
Target %
Total
TreatedBreaches
Achieving
Target
Achieving
Target %
Measure Target
All suspected Cancers Two Week Wait from
urgent GP referral to first seen93% 1444 62 1382 95.71% 1589 75 1514 95.28%
Breast Symptomatic Two Week Wait from urgent
GP referral to first seen93% 75 0 75 100.00% 76 1 75 98.68%
All Cancers - 31 Day Diagnosis to First Treatment 96% 211 0 211 100.00% 266 2 264 99.25% 1.0
All Cancers - 31 Day Subsequent Treatment
(Surgery)94% 23 0 23 100.00% 32 0 32 100.00%
All Cancers - 31 Day Subsequent Treatment (Anti-
Cancer Drugs)98% 56 0 56 100.00% 87 0 87 100.00%
All Cancers - 31 Day Subsequent Treatment
(Radiotherapy/Other)94% 14 0 14 100.00% 11 0 11 100.00%
All Cancers - 62 Day Referral to Treatment
following an urgent GP referral85% 114 35.5 78.5 68.86% 138.5 41.5 97 70.04%
All Cancers - 62 Day Referral to Treatment
following a Screening Service referral90% 11 0.5 10.5 95.45% 12 0.5 11.5 95.83%
SCR Cancer Dashboard
Feb-16
Qtr 4
PredictedActual (2015/16)
Qtr 4
Predicted (2015/16)
Mar-16
Current Quarter
The actual figure for the Qtr, is based on the actual outturn for Jan-16, Feb-16 and Mar-16
.
Advisory note for Qtr 4 2015/16 Actual
Actual (2015/16)
Mar-16
The prediction figure for the end of the month, is based on the outturn of the
same month for the previous year and the activity that has taken place in the
preceeding 3mths
The prediction figure for the end of the month, for 2ww's is the execpted number
of breaches due to pt choice
The prediction figure for the end of the month, is based on known concerns and
likely treatment dates
1.0
1.0
1.0
Monitor
weighting
Qtr only reference
only
Advisory note for Qtr 4 2015/16 Prediction
The prediction figure for the Qtr, is based on predictions for Jan-16, Feb-16 &
Mar-16 in which outturn for the corresponding months in 2015 is used as a
baseline
The position will be revised throughout the period to reflect the actual outturn of
the months and known concerns / issues
Guideline: Predition for Total Treated
Guideline: Predition for Breaches 2ww targets
Guideline: Predition for Breaches all targets excluding 2ww
Advisory note
1.0
1.0
1.0
Previous Month(s) / Quarter(s)
Actual (2014/15) Monitor
weighting
Qtr only reference
only
Achieving Target %
Current Month Please be advised that the SCR Cancer Dashboard indicates the attainment of the
CWT targets that we upload Nationally.
It can however differ from the position we eventually report to Monitor, because
where our patients on a 62 day pathway are treated at tertiary centres we are
reliant on them uploading the treatments, if they don't we will have orphaned
records and our share of the treatment will not be included in our denominator
Achieving Target %
Actual (2015/16)
Overview
MDT
Clinical Engagement
Layout of the Room
Timed Pathways
Reporting
Thank you for your time today