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

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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