Streamlining urology cancer multidisciplinary team meetings: Implementation and outcomes

Objectives

This work aimed to evaluate the implementation and impact of a pre-multidisciplinary team (MDT) triage model using Standards of Care (SoC) for streamlining in a urology cancer service.

Materials and methods

An SoC framework was developed by the cancer lead in line with national guidance. Using this, the Urology MDT at Dartford and Gravesham NHS Trust (DGT) introduced a pre-MDT triage model. Each week, a consultant urologist, clinical nurse specialist, and MDT coordinator reviewed referrals and allocated them for either full MDT discussion or protocolised management. Data were collected over 50 weeks, including meeting duration, case numbers, plan changes, and a clinician survey.

Results

Average MDT duration reduced from 158 to 135 min (p < 0.001), allowing more focused discussion of complex cases. Of 50 MDT members invited, 25 responded to the survey (50%): 79% were confident that SoC-aligned cases received appropriate management without full discussion, 84% supported ongoing streamlining, and most reported time savings. Suggested improvements included artificial intelligence (AI) decision-support and clearer timelines. Overall, streamlining improved both the operational efficiency and clinician satisfaction.

Conclusion

The initiative enhanced MDT efficiency, maintained oversight, and strengthened clinician confidence in protocolised care pathways. Challenges remain, including reliance on a single consultant for triage and occasional gaps in the availability of radiology or histopathology reports, which may affect sustainability. Overall, these findings support wider adoption of pre-MDT streamlining in cancer services.