What is the positive change that has emerged through new collaborations or partnerships during Covid-19 that your project is going to embed?

Input from several specialists, together with good communication with, and involvement of, patients are fundamental to the delivery of high-quality cancer care. Prior to the Covid pandemic, building on the Calman-Hine report (1995) NHS England had set out guidance for multidisciplinary team (MDT) streamlining diagnostic and treatment decision making during face-to-face meetings.  The pandemic has, opportunistically, resulted in streamlining of some of the processes of the MDTs. A good example is that virtual MDT sometimes allowing more decision-makers to attend than was possible with a physical meeting and associated travelling. However, it is not a like for like translation.

Our resource pack will help MDTs on how  to move a face-to-face meeting to an online meeting without comprising on outcomes, by addressing issues such as re-training of meeting chairs, thinking through the agenda to optimise attention spans, maintaining eye contacts and other virtual conferencing etiquettes to encourage participations.

What does your project aim to achieve?

The project aims to

1. Learn from up to 3 cancer MDTs on their experience of virtual meetings so far, specifically what elements of team working we want to continue beyond the pandemic, and potentially what tasks are best left for physical meetings for now and the future
2. Identify key enablers of effective virtual MDT working, quantify the time gains and how do we ‘spend’ the gains
3. Use Plan-Do-Study-Act principles to work with staff on how best to incorporate elements of effective virtual workings amongst team members
4. Share our improvement journey with other cancer MDTs to inform service configuration and resource requirements in London and elsewhere

This work will compliment parallel workstreams looking at different aspects of cancer care and outcomes from diagnosis to treatment that have been impacted by the pandemic, from route to diagnosis, diagnostic pathway and treatment to recurrence and survival.

How will the project be delivered?

From our conversations with teams since the start of the pandemic, it was evident virtual clinical decision-making requires team members to interact differently.  Building on our work on MDT improvement led by Prof Muntzer Mughal, the project will examine a number of factors the new ways of working virtually by Cancer MDT members:

1. Retrieve quantitative data from the MDT records on attendance, reflective of expertise available to the clinical decision making process, and efficiency using  analyse on time spent per case, and number of people involved in each discussion as metrics.
2. Conduct interviews and collate reflection of attendees to identify how teams can:
   (a) accommodate for reduced attention spans;
   (b) be savvy with technology to suit different styles of working
   (c) prepare before meeting
   (d) be clear on roles and responsibilities in virtual meetings

At the end of project, our findings will form a bitesize training package for Cancer MDTs.

How is your project going to share learning?

In addition to involving our clinicians and operational leads and commissioning colleagues in North Central London Cancer Alliance through our existing governance structure, the learning from the project will be shared with the Q community and the wider Health Service through:

• Discussion on twitter (#virtualMDT)
• National Cancer Programme Share and Learn webinars
• Working with UCLPartners, our Academic Health Science Network, to share learning through blogs, workshops and webinars
• Project update on Q Exchange page
• Share progress and learnings at activities organised by Q Exchange
• Sharing our bitesize training package on our website and FutureNHS Cancer Alliances Workspace
• Presentation at conferences