Multidisciplinary teams improve survival rates
Survival rates for women who have undergone surgery for breast cancer are improved if decisions are made as part of a healthcare team rather an individual doctor, according to a new study.
The research from NHS Greater Glasgow and Clyde, published in the BMJ, shows decision-making by teams made up of surgeons, cancer physicians and nurses is likely to improve survival following surgery for breast cancer.
The health board said that before the introduction of multi-disciplinary care in 1995, breast cancer mortality was 11 per cent higher than in the surrounding west of Scotland health board areas.
Eileen Kesso, project manager, carried out the study and found survival was 18 per cent higher in patients managed in Glasgow when decisions about their care were made by a group rather than an individual doctor.
She said: "Multidisciplinary teams (MDTs) were introduced in Greater Glasgow Health Board in the mid-1990s, several years before the rest of the UK.
"They marked a new development in the delivery of cancer services but until now there has not been any strong evidence that they made any difference to patients' survival."
The study, carried out at the West of Scotland Cancer Surveillance Unit, compared breast cancer survival in the greater Glasgow area to the rest of the west of Scotland.
It found survival was poorer in Glasgow in the early 1990s but after team decision-making through MDTs were introduced in 1995, survival was nearly 20 per cent higher in Glasgow compared with other areas.
The teams, comprising a range of specialists, use evidence-based guidelines, audit their performance and meet regularly to discuss how patients should be treated.
The study found survival from breast cancer improved in all areas throughout the 1990s but it improved even more in Glasgow after team decision-making was introduced.
Chief Medical Officer Sir Harry Burns is co-author of the report and as director of public health in Glasgow in the 1990s he was involved in establishing MDTs.
Sir Harry said: "We looked at the way the surgeon with the best survival in Glasgow worked in a team with his clinical and nursing colleagues, and modelled care for the whole health board on his approach.
"We are pleased these findings confirm our belief that this is the best way to deliver breast cancer care.
"I'm also pleased to report that this is the way in which all breast cancer care is now delivered in Scotland and other parts of the UK."
But Sarah Woolnough, Cancer Research UK's director of policy, said the Government needed to make sure all patients received the best possible care.
"This study highlights how properly delivered cancer care can really improve things for patients. Multidisciplinary teams were brought in as the 'gold standard' of cancer care in the 1990s and have helped the UK begin to catch up with the best in Europe in terms of cancer outcomes," she said.
"But we know that not all hospitals are offering the same standard of multidisciplinary care to all patients, so we need to make sure best practice is shared around the NHS."
She also highlighted the impact of the forthcoming changes to the NHS in England.
"We need to keep monitoring things, to ensure that the imminent NHS restructure is seen as an opportunity to reinforce this way of caring for patients in all regions," she added.
Copyright Press Association 2012
- Kesson, E.M., Allardice, G.M., George, W.D., Burns, H.J.G. & Morrison, D.S. (2012). Effects of multidisciplinary team working on breast cancer survival: retrospective, comparative, interventional cohort study of 13 722 women, BMJ, 344 (apr26 1) e2718. DOI: 10.1136/bmj.e2718