Technology
Reforming MDT reviews in cancer care
Professor Kevin Moore discusses why smarter data management matters more than an EPR overhaul, when it comes to reforming cancer care MDTs.
Cancer multi-disciplinary team (MDT) meetings have been a statutory feature of NHS cancer care since the 2000 NHS Cancer Plan. It established that every new diagnosis should be formally reviewed by a specialist team. For a quarter of a century, this model has been the cornerstone of cancer treatment planning. Evidence confirms that MDT review is associated with a reduction in the risk of death across cancer types, albeit with considerable variation of 4-90%.1
The collaborative
scrutiny of specialist clinicians, when it works well, creates a governance layer that promotes clinical excellence. Today, the model is under strain. Driven by an ageing population, rising cancer incidence and two-week wait referrals, and the growing complexity of cases with multiple comorbidities, today’s MDT meeting has ballooned in both length and volume, while the time available for each individual patient has simultaneously contracted. A clinician in one widely cited survey captured the problem plainly: “Sometimes we discuss up to 70 patients. This is after a whole day of clinics, and we don’t finish until 19.00. Would you want to be number 70?”2 Research using the validated Metric for the
Observation of Decision-making (MODe) tool, applied across 1,335 patient reviews in a single breast cancer MDT, demonstrated measurable decision-making fatigue: both information quality and team contribution scores fell significantly from the first to the second half of meetings.3 A larger multi-centre observational study
corroborated this finding, identifying positive associations between meeting position and
decision quality, with cases reviewed early consistently receiving more substantive discussion.4
The implication for patients
reviewed towards the end of overloaded agendas is uncomfortable.
A policy inflection point These structural problems have not gone unnoticed at a national level. In February 2026, the government’s National Cancer Plan for England acknowledged reports of MDT meetings becoming “unwieldy and rigid” and formally tasked the Royal College of Radiologists (RCR) with reviewing opportunities to modernise MDT working, with input from other Royal Colleges. The RCR, whose vice-president for clinical oncology welcomed the mandate as an opportunity for “radical reform of inefficient multidisciplinary team meetings”, is expected
Today’s MDT meeting has ballooned in both length and volume while the time available for each individual patient has simultaneously contracted.
to launch new guidance in spring 2027, following the publication of a major report.5 A parallel report from The King’s Fund, published in April 2026, following a roundtable with clinicians, policymakers, researchers and patient advocates, described urgent MDT reform as a central solution to the capacity crisis facing cancer services — and one of the most pressing changes required.6 Against a backdrop of a projected 39% shortfall in consultant radiologists and 19% shortfall in oncology consultants by 2029, the report argued that clinical time is not being deployed where it adds most value. The calls, led collectively by the RCR, Royal College of Physicians, Royal College of Nursing, Royal College of Pathologists and the Association of Cancer Physicians, are unambiguous: the architecture of MDT decision-making must change.
The data problem at the heart of MDT inefficiency The most immediate barrier to an effective MDT is incomplete data at the point of discussion. When test results are missing,
October 2026 I
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