Our survey of MDT coordinators, with the number and the geographical distribution of the responses, gives a nationally representative picture of MDT coordinators in UK. This is the second study of its kind, following a 2006 survey of the colorectal MDT coordinators
Nearly half of the of the MDT coordinators felt that their job plan does not reflect what they actually do. MDT coordinators feel that they neither contribute to the MDT discussion nor their opinions carry weight in treatment decisions. Regarding leadership of MDT meetings, they thought that MDT meetings are mostly chaired by surgeons. MDT coordinators reported that there is not always a decision for each cancer case discussed at the MDT meeting and reasons for such are variable but lack of investigation results and non attendance of a key member were the commonest.
Respondents appear to have received some relevant training and have access to equipment and facilities appropriate for the job. A learning need analysis form a focus group study identified a need for an educational programme for MDT coordinators
. The UK Association of Cancer Registries (UKACR) produced a manual named the MDT coordinator pack, which is the available resource for training, besides what is locally arranged at each hospital. Recently a plan was put in place by the National Cancer Intelligence Network (NCIN) in collaboration with the UKACR, National Action Cancer Team (NCAT), Cancer Networks and the National Cancer MDT Coordinators Forum to produce an e-learning training programme aimed primarily at the MDT coordinators. This has led to the development of a tool Understanding Cancer: Oncology Training for NHS and Public Health non-clinical staff which was launched in April 2012
. It can be said that sharing the result of this survey had a role in achieving the above. Although beyond the scope of this study, future research needs to investigate the training needs of MDT coordinators across different tumour types and to put into consideration the effects of case mix and inter compatibility of IT systems on training needs for organisational skills. There is evidence that the majority of domains of MDT working are common across major tumour types, but areas such as the clinical decision-making process have been found to vary and may need to be tailored to particular tumour types
Comparing the results of our survey which was conducted in 2010 to the 2006 survey of the Colorectal cancer MDT coordinators
 shows a marked improvement in the job related training received by the MDT coordinators and their equivalents for example compared to the 2006 survey, the percentage of MDT coordinators who had training has increased from 22% to 57.7% in Data system and IT, from 17.8% to 31.7% in general oncology and from 8.9% to 32.1% in anatomy/ physiology. We anticipate this educational resource will further enhance training for the MDT coordinators. An audit in a few years time would answer the question as to whether the training has improved for these MDT core members. Further, although MDT coordinators appear to not have a direct role in clinical decision-making, it seems that their work supports the decision-making of the clinical members of the MDT and without it decisions could not be made. These findings support our own previous research
, as well as work carried out by others, including the National Cancer Action Team, and the ICCC of the Royal Colleges that recognises the role of the MDT coordinator, as well as the need to strengthen the position by improving resources and training available to MDT coordinators nationally
[11, 16, 17]. This view has been reflected in the establishment of the National Team for the Cancer MDT coordinators (formally known as the Taskforce), Forum, and the Annual Conference, along with development of national job descriptions and training programmes
. Barriers to reach a clear decision at the MDT meetings are variable. Lack of Radiological and Pathological results at the time of the discussion followed by non attendance of MDT key members were the most common causes from the coordinators’ views in reaching a final decision. To a lesser extent they thought that unavailability or non-consideration of patients’ status and co-morbidities were other factors in the way of reaching such decisions. Similar results were observed in other studies where similar factors were blamed for not reaching a decision at the MDT meeting
Certain limitations must be applied to our findings. There is no available statistical data on the total number of the MDT coordinators; however the majority of the 1500 MDTs in the UK are supported by a coordinator or an equivalent. Data on the educational background of coordinators was not gathered and may therefore be a confounder with regards to the level of training already undertaken as participants may have trained elsewhere prior to their work as MDT coordinators. The method used to recruit the survey sample involved snowballing so it is not possible to calculate the response rate. This means it is not possible to estimate the representativeness of responses. Furthermore, although the survey software records a unique identifier for each respondent, it is impossible to verify that each response is from a separate individual and therefore guarantee the integrity of the dataset. However, the sampling was successful in representing respondents across MDTs and different tumour types throughout the UK, and we have no reason to believe that respondents filed multiple surveys.