The 'Principles of multidisciplinary care' provides a flexible definition of MDC, allowing for variation in implementation according to cancer type and the location of service provision. The principles are designed to be relevant for all cancers, across a range of health-care settings. A summary of the 'Principles of multidisciplinary care' include:
- a team approach, involving core disciplines integral to the provision of good care, including general practice, with input from other specialties as required
- communication among team members regarding treatment planning
- access to the full therapeutic range for all patients, regardless of geographical remoteness or size of institution
- provision of care in accordance with nationally agreed standards
- involvement of patients in decisions about their care.
Team
| Principle of care | Outcome | |
|---|---|---|
|
a |
The disciplines represented by the core team should minimally include surgery, oncology (radiation and medical oncology), pathology, radiology and supportive care. The individual patient’s general practitioner will be part of the team |
The core team is established and known |
|
b |
In order to ensure that the patient has access to the full range of therapeutic options, the core team may be expanded or contracted to include services (may be off site), such as genetics, psychiatry, physiotherapy and nuclear medicine |
Referral networks established for non-core team specialist services |
Communication
| Principle of care | Outcome | |
|---|---|---|
|
a |
A communications framework should be established which supports and ensures interactive participation from all relevant team members at regular and dedicated case conference meetings |
Communication mechanisms are established to facilitate case discussion by all team members |
|
b |
Multidisciplinary input should be considered for all patients with cancer, however, not all cases may ultimately necessitate team discussion |
A local protocol is established for deciding which cases may not require team discussion |
Full therapeutic range
| Principle of care | Outcome | |
|---|---|---|
|
a |
Geographical remoteness and/or small size of the institution delivering care should not be impediments to the delivery of multidisciplinary care for patients with cancer |
Systems are established for ensuring that all patients have access to all relevant services |
|
b |
The members of the team should support the multidisciplinary approach to care by establishing collaborative working links |
Systems are established to support collaborative working links between team members |
Standards of care
| Principle of care | Outcome | |
|---|---|---|
|
a |
All clinicians involved in the management of patients with cancer should practice in accord with guideline recommendations |
Local clinician data is consistent with national benchmarks |
|
b |
The treatment plan for a patient should consider individual patient circumstances and wishes |
The final treatment plan is acceptable to the patient, where possible |
|
c |
Discussion and decisions about treatment options should only be considered when all relevant patient results and information are available |
Final reports are available to all core team members before treatment planning |
|
d |
In areas where the number of new cancers is small, formal collaborative links with larger units/centres should give support and foster expertise in the smaller unit |
Systems are established for the exchange of knowledge and expertise between larger and smaller caseload centres |
|
e |
Maintenance of standards of best practice is supported by a number of activities which promote professional development |
Systems are established for the support of professional education activities |
Involvement of the patient
| Principle of care | Outcome | |
|---|---|---|
|
a |
Patients with cancer should be encouraged to participate as members of the multidisciplinary team in treatment planning |
Patients are supported to have as much input into their treatment plan as they wish |
|
b |
The patient diagnosed with cancer should be fully informed of his/her treatment options as well as the benefits, risks and possible complications of treatments offered. Appropriate literature should be offered to assist his/her decision making. This information should be made available to the patient in a form that is appropriate to his/her educational level, language and culture |
All patients are fully informed about all aspects of their treatment choices |
|
c |
Supportive care is an integral part of multidisciplinary care. Clinicians who treat patients with cancer should inform them of how to access appropriate support services |
All clinicians involved in the management of patients with cancer ensure that patients have information about and access to support services |
|
d |
The patient with cancer should be aware of the ongoing collaboration and communication between members of the multidisciplinary team about his/her treatment |
Patients with cancer feel that their care is coordinated and not fragmented |