The colorectal multidisciplinary team meeting (MDT) takes place every Friday at 2pm via MS Teams. The meeting makes recommendations regarding the management of patients with lower GI malignant disease. This is predominantly patients with colon or rectal adenocarcinoma but patients with anal squamous cell cancer, small bowel malignancy or appendiceal tumours may also be discussed. The meeting provides sub-specialty support and advice to patients from across NHS Highland (Raigmore, Belford and Caithness) and NHS Western Isles. The meeting includes representation from the following services:
- Colorectal Surgery
- GI Oncology
- Pathology
- Radiology
- Clinical Nurse Specialists
Meeting Chair
The meeting is chaired on a rotational basis between five named colorectal consultant surgeons:
- Colin Richards :colin.richards@nhs.scot
- Raymond Oliphant: raymond.oliphant@nhs.scot
- Thanesan Ramalingam: thanesan.ramalingam@nhs.scot
- Michael Walker: michael.walker@nhs.scot
- Angharad Jones: angharad.jones@nhs.scot
Adding patients to the MDT
Patients are added to the MDT via a dedicated online form, available via Formstream. Only certain clinicians have access to this form and the ability to add patients for discussion. If a patient is unknown to the department and requires an MDT discussion, the details should be sent via secure NHS email to one of the above named colorectal surgeons. It is strongly encouraged that the clinician who has current responsibility for the patients care attend the meeting to provide background information on the patients fitness or personal wishes. However, the meeting Chair will present the case and the document an outcome (see below).
For those clinicians with access to the Colorectal MDT form on Formstream, please choose a date (MDT is every Friday afternoon at 2pm) when all the relevant biopsies, imaging and endoscopy results will be available. Discussing patients with outstanding results usually causes unnecessary re-discussion and increases workload. This is particularly relevant to patients with a new diagnosis of rectal cancer where an MRI is required to complete staging prior to MDT discussion.
When completing Formstream it is important to be as thorough as possible, including all relevant patient details e.g. co-morbidity or assessment of frailty in conjunction with endoscopic, radiology and histological results. When a clinician has completed Formstream, it is important to remember to then press “Save Draft” and not “Verify”. If the form is verified, it becomes locked to future editing and a copy is automatically uploaded onto Trakcare/PMS. The only way to unlock a form in this scenario is to contact the hospital IT department.
The deadline for adding patients for MDT discussion is 6pm on Tuesday on the week of the meeting. This is designed to give adequate time to the meeting Chair, radiologist, pathologist and oncologist to report and consider each case. Adding additional patients after this deadline has passed is discouraged and will only be possible with the express agreement of the meeting Chair. Normally, this is only given in cases where a time-critical decision is required.
A list of confirmed MDT cases, along with an invite to join the MS Teams meeting is emailed out each week to the MDT group members by Shirley Caddle (shirley.caddle2@nhs.scot).
MDT outcome
The MDT outcomes will be signed off at the end of the meeting by the Chair and a copy of the Formstream outcome document will be automatically uploaded onto Trakcare/PMS. The Chair will only communicate directly with the referrer in selected circumstances e.g. by prior agreement with referring clinician.