MDT Self Assessment

Record of Responses from all local Haematology MDT’s, May 2007NICaN

Local Multidisciplinary Teams – Record of Responses from Self Assessment against the Manual of Cancer Services Standards

This paper is a record of the responses received from Trusts. The purpose of this exercise was to enable teams to assess their effectiveness against the standards set out in the Manual of Cancer Service Standards and to identify potential areas for review and development. Proformas were completed on behalf of the local lead Haematology teams by:

Altnagelvin: Sylvia Cole

BCH: Curly Morris

Craigavon: Kathryn Boyd

UCHT: Yong-Lee Ong

UHT: Anne Kyle

Locality / 1 / 2 / 3 / 4 / 5 / 6
MDT Leadership
Is there a single named lead clinician for the haemato-oncology MDM / Y / Y / Y / Y / Y rotate / Y
Team Criteria
Is MDT listed as part of the named services of the locality / N / N / N / N / N / Y
Has the MDT specified the disease types it deals with / N / Y / Y / N / N / Y
For each of the disease types specified, does the Team have an exclusive catchment population for MDT discussion of 500K or more / N / Y / Y / N / N / Y
MDT Structure
Has the MDT a defined core membership / Y / Y / Y / Y / Y
Does Core Membership include:
At least 2 oncologists (this includes haemato-oncologists)
Pathologist
Nurse Specialist
A least one nurse representing each of the named facilities at BCSH levels II, III and IV, which are used by the MDT
Imaging Specialist
MDT Co-ordinator / Secretary / Y
N
Y
N
N
N / Y
Y
N
N / Y
Y
Soon
N
Y
Y / Y
Y
N
N
Y
N / Y
N
N
Y
N
N / N
Y
Y
N
Y
N
MDT Meetings (MDMs)
If there a separate MDT meeting to discuss the diagnosis of all referrals prior to the discussion of definitive treatment, is the membership of the diagnostic meeting named. / N / N / Y / N / Y
Does the MDM hold meetings at an agreed frequency / Y / Y / Y / Y / N
Are core members attendance at MDMs recorded / Y / Y / N / N / Y
Does the Team have a written procedure governing how to deal with referrals which require treatment planning decisions before the next scheduled meeting. / N / N / N / N / N
Do core members have agreed named “cover” for attending MDMs in their place / N / N / N / N / N
Do core members or their “arranged cover” attend half of the meetings / N / Y / N / Y / N
Operational Policies
Does the Team meet at least annually to discuss, review, agree and record some operational policies / N / N / N / N / N
Has the MDT agreed indicators for, and frequencies of re-referrals to the MDT, after their initial treatment planning decision for discussion on their ongoing treatment / N / N / N / N / N
Is there an operational policy for the team whereby it is intended that all new cancer patients will be reviewed by an MDT / N / N / N / N / Y
Is there an agreed policy whereby after a patient is given an diagnosis the patient’s GP is informed of the diagnosis by then end of the following working day / N / N / N / N / N / N
Has the MDT agreed to provide information to referring GPs and others on the appropriateness and timeliness of urgent suspected cancer referrals / N / Y / N / N / N / Y
Is there a policy whereby a single named key worker for the patient’s care at a given time is identified by the MDT for each patient and is recorded in the patient’s case notes / N / Y / N / Y / Y / Y
Extended Team
Has the MDT named members of the extended team to include:
Clinical member of the transplant team (levels III and IV) to which the MDT refers
Pharmacist
Specialist in insertion of semi-permanent aids to vascular access
Dietician
Liaison psychiatrist and/or clinical psychologist
Social worker
Bereavement Counsellor
Palliative care specialist (Dr or Nurse) / N
Y
Y
Y
Y
Y
N / Y
N
N
N
N
N
N
N / N
N
Y
N
N
N
N
N / N/A
Y
Y
Y
N
Y
N
Y / N
Y
Y
N
Y
Y
Y
Y
If your team specifies leukaemia’s in their disease type does your extended team also include:
Microbiologist
Clinical Oncologist / N
Y / N/A / N/A / Y
N / N
Y
If your team specifies myeloma in their disease type does your extended team also include:
Orthopaedic Surgeon
Clinical Oncologist / N
Y / N
Y / N
N / N
N / Y
Y
Functions of the Team
Are there arrangements in place (in addition to the initial consultation in which treatment planning decision is communicated) for patients and /or careers to gain access to members of the MDT to discuss problems or concerns / Y / Y
24hr helpline / Y / Y / Y
Does the MDT offer patients a permanent record or summary of at least a consultation at which the treatment options of their diagnosis was discussed / N / N / N / N / N
Has the MDT undertaken a survey of its patients experience of the services offered by the team / N / N / N / Y / N
Does the Team provide written material for patients and carers which includes:
Information specific to the MDT about local provision of services
Information about patient self-help groups
Information about psychological, social and spiritual/ cultural support
Information about the disease and its treatment options / Y
Y
Y
Y / N
Y
Y
Y / N
Y
Y
Y / N
Y
Y
Y / Y
Y
Y
Y
Treatment Planning Decision
Does the core MDT, at their regular meetings, should agree and record individual patient’s treatment plans / N / Y / Y / Y / Y
Data Collection
Does the MDT have an agreed minimum dataset (MDS) / N / Y / Y / N / Y / N
Does the MDT record the MDS for each patient (proforma or electronically) / N / Y / Y / N / Y / N
Service Improvement
Has the MDT carried out process mapping covering the key stages of their patients journey / N / Y / Y / N / ? / N
If process mapping has been carried out, was an action plan produced for service improvement / Y / pending / N / ? / N

Filename: Haematology MDT Self Assessment_May07Page 1 of 3