Multidisciplinary team working in cancer: what is the evidence?BMJ 2010; 340 doi: http://dx.doi.org/10.1136/bmj.c951 (Published 23 March 2010) Cite this as: BMJ 2010;340:c951
- Cath Taylor, research fellow1,
- Alastair J Munro, professor of radiation oncology2,
- Rob Glynne-Jones, consultant clinical oncologist3,
- Clive Griffith, consultant breast surgeon4,
- Paul Trevatt, Macmillan network nurse director5,
- Michael Richards, national cancer director6,
- Amanda J Ramirez, professor of liaison psychiatry7
- 1King’s College London, Florence Nightingale School of Nursing and Midwifery, London SE1 8WA
- 2Surgery and Molecular Oncology, Ninewells Hospital, University of Dundee, Dundee DD1 9SY
- 3Mount Vernon Cancer Centre, Middlesex HA6 2RN
- 4Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP
- 5North East London Cancer Network, London E1 1BB
- 6National Cancer Action Team, St Thomas’ Hospital, London SE1 7EH
- 7Cancer Research UK Promoting Early Presentation Group, Adamson Centre, St Thomas’ Hospital, London SE1 7EH
- Correspondence to: C Taylor
Multidisciplinary team working has been implemented in cancer care systems throughout much of Europe, the United States, and Australia, without any clear evidence for its effectiveness. In the UK, multidisciplinary teams have more recently been recommended for the management of other conditions including diabetes,1 stroke and neurological rehabilitation,2 chronic obstructive pulmonary disease,3 and coronary heart disease.4 The rationale for introducing multidisciplinary teams is that as the management of disease becomes more complex, it is important to involve all key professional groups in making clinical decisions for individual patients. The widespread introduction of these teams illustrates a recurring paradox in the modern UK National Health Service: we demand an evidence base for individual clinical decisions but not for overall organisational decisions. Here, we describe the implementation of multidisciplinary teams in cancer services in England and review the international evidence for their effectiveness.
Implementation of multidisciplinary teams
Multidisciplinary teams were introduced to overcome several shortfalls in UK cancer care and as such are multifunctional. They aim to ensure that all patients receive timely treatment and care from appropriately skilled professionals, that there is continuity of care, and that patients get adequate information and support. The teams also facilitate communication between primary, secondary, and tertiary care as well as collection of reliable data for the benefit of individual patients and for audit and research. Teams can monitor adherence to clinical guidelines and can promote the effective use of resources. They may also improve participants’ working lives, not least by providing opportunities for learning and development.
The implementation of multidisciplinary team working in cancer was given impetus by the launch of the NHS breast screening programme in 1988, but by the mid-1990s team …
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