Experts agree radical changes to speed up patient-centred cancer treatment decisions

In a review of cancer multidisciplinary team (MDT) working published today, 10th November 2026, experts have identified opportunities to improve NHS cancer care through more effective collaborative working, and will now develop a practical toolkit to bring about a radical shift in cancer MDT working across the UK.

The government’s National Cancer Plan for England committed to modernising cancer care and recognised the need to reform cancer MDT working to ensure patients receive the right expertise, at the right time, through the most appropriate mechanism, without unnecessary delays to their care pathway. To realise this ambition, the government asked the Royal College of Radiologists (RCR) to lead a review of cancer MDT working, which the RCR has conducted in partnership with Macmillan Cancer Support.

The RCR identified that while multidisciplinary working is essential to provide high-quality cancer care, the current model is broken. Resource-intensive formal MDT meetings are often inefficient and not delivering timely care for patients.

The RCR engaged with patients and professionals from across the UK to build consensus on what needs to change. These included clinicians working in fields such as radiology, oncology, surgery, nursing and pathology, the essential non-clinical staff who coordinate and administrate MDT working, representatives from the healthcare industry, and patients with lived experience of cancer care.

Through this extensive engagement, the review identified opportunities to improve MDT working. It found that MDT meetings should focus on patients whose cases would most benefit from multidisciplinary input, such as those with rare and less common cancers. Meanwhile, patients with more routine cases should not have to wait until a weekly meeting to receive treatment recommendations.

• The right discussion at the right time. Speed up patient pathways by allowing routine cases to progress without discussion at a formal MDT meeting. Improve treatment quality and reduce variation by focusing specialist MDT capacity on patients with more complex cases and rarer cancers.

• No decision about me without me: strengthening patient-centred recommendations. Improve treatment quality by ensuring that the patient’s preferences and wider psychosocial factors are considered when developing treatment recommendations. This reduces the risk of patients receiving recommendations that don’t work for them and therefore helps to speed up treatment.

• Putting the ‘T’ back into MDT. Increase treatment quality and consistency by improving team efficiency through clearer leadership expectations, purposeful involvement and better-supported MDT teams.

• Designing technology around MDT needs: enabling a digitally supported MDT model. Speed up patient pathways and reduce variation in care by defining clear expectations for MDT technology, enabling critical patient information and specialist expertise to move across providers, specialist MDTs, and regional networks.

Numerous attempts have been made to streamline MDT working in the past, but unfortunately, change has not stuck.

So, the RCR and Macmillan Cancer Support will now focus on turning these opportunities for improvement into practical, sustainable action to permanently transform cancer MDT working in the UK. Over the coming months, they will lead dedicated workstreams, stakeholder engagement and local testing to develop a practical toolkit of resources that will genuinely support healthcare providers to implement and sustain safer, more efficient and patient-centred cancer MDT working for the long term.

The MDT Improvement Toolkit will be published in spring 2027.

Dr Nicky Thorp, Vice-President for Clinical Oncology at the RCR, said:

Good multidisciplinary working is the cornerstone of high-quality cancer care. This review is a vital step towards faster, more effective and patient-centred cancer care. We must re-orient MDT working around a simple principle: every patient should receive the right expertise, at the right time, through the most appropriate mechanism, without unnecessary delays.

Changing the way we have been working for 30 years will take time and commitment. That is why we will now develop a practical toolkit to empower cancer services to turn these recommendations into lasting change.

Dr Anthony Cunliffe, National Lead Medical Adviser at Macmillan Cancer Support, said:

MDTs are intended to ensure that people with cancer receive appropriate, personalised treatment advice to help them make informed decisions.

However, specialists say the current structure of MDT meetings does not always ensure robust multidisciplinary input into the patient cases that need it most. At the same time, they use up hours of specialists’ time that could be better spent supporting high-quality shared decision-making conversations with patients.

We need significant, sustainable change driven by the people working in MDTs, and by people with lived experience of cancer care who understand that case complexity involves more than scan and biopsy results.

Hayley Rixon, Chair of the Royal College of Nursing’s Cancer Forum, said:

Modernising oncology MDTs is about ensuring they are used where they add the greatest value. By focusing collective expertise on the patients who need it most, we can improve patient experience, support our workforce and build more sustainable cancer services for the future.

Jo Williams, who has lived experience of cancer care, said:

Traditionally, most MDT meetings have focused on diagnostic and clinical factors, and the patient is not privy to a discussion that will impact the rest of their lives. With greater national strategic focus on patient-centred care, the healthcare system must look to broaden the perspective to a more holistic approach, including social factors and things in life that matter to us.

Our lives are in the MDT professionals’ hands; let’s make sure they have the right information at the right time to develop the right treatment plan for us.

Professor Helen Winter, Clinical Director at the Somerset, Wiltshire, Avon and Gloucestershire (SWAG) Cancer Alliance, said:

Behind every cancer diagnosis is a person and a family who cannot wait. Every decision matters. Our MDT reform sets a bold, patient-centred direction: decisions at the right time, guided by clinical urgency and what matters most to patients, enabling timely treatment and access to world-class outcomes and research.

Working nationally with the RCR and Macmillan Cancer Support, and with colleagues from across the UK, we are turning the ambitions of the National Cancer Plan into action and empowering our teams to focus their expertise where it makes the greatest difference, improving outcomes and giving patients and families greater confidence and hope.

Dr Hilary Williams, Clinical Vice President for Professional Development at the Royal College of Physicians, said:

17% of patients diagnosed with cancer first present as emergencies. While those numbers are reducing, these patients so often get lost in multiple MDT pathways. This can delay the vital lifesaving treatments they need, and can compromise our ability to provide good, supportive care. In cases where time really matters, the current MDT process has sometimes stopped us from making the right, patient-focused decisions.

This important review is the first step towards every patient with cancer getting the care they need, when they need it.

Professor Sarah Coupland, President-Elect of the Royal College of Pathologists, said:

Patients benefit when multidisciplinary expertise reaches them promptly and in the right form, and MDT reform is key to making that happen. Pathologists currently spend considerable time in MDT meetings, so better-designed processes would also help clinicians work more efficiently. Digital pathology and better IT infrastructure would also increase the efficiency of MDT working.

• Media contact: [email protected] 02038054065

• The Royal College of Radiologists (RCR) is the leading professional membership body for clinical radiologists and clinical oncologists

• Clinical radiologists are specialist doctors who use imaging to diagnose, monitor and treat diseases and injuries 

• Clinical oncologists are specialist doctors who manage cancer and prescribe drug-based treatments and radiotherapy 

• The RCR review of cancer multidisciplinary team (MDT) working, conducted in partnership with Macmillan Cancer Support, is endorsed by the Royal College of Physicians (RCP), the Royal College of Pathologists (RCPath), and the Royal College of Surgeons of England (RCSEng).

• In September 2025, the RCR and other expert bodies called for the National Cancer Plan for England to overhaul MDT working. The government accepted this call and asked the RCR to lead this work.