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RESULTSOF UPPER GI MDT QUESTIONNAIRE. Sukhbir Ubhi National Clinical Lead for Upper GI Cancer Services Collaborative \'Improvement Partnership\'. Aims. Obtain a “snapshot” view of the structure and function of Upper GI MDTs Identify organisational issues with MDTs

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resultsof upper gi mdt questionnaire

RESULTSOF UPPER GIMDT QUESTIONNAIRE

Sukhbir Ubhi

National Clinical Lead for Upper GI

Cancer Services Collaborative \'Improvement Partnership\'

slide2
Aims
  • Obtain a “snapshot” view of the structure and function of Upper GI MDTs
  • Identify organisational issues with MDTs
  • Assess the use of “mapping” to identify problem areas
  • Identify bottlenecks
responses
Responses
  • 57 Replies received
  • 51 Upper GI MDTs are fully up and running
  • 6 Upper GI MDTs are partially up and running
major organisational problems with mdts
Major Organisational Problems With MDTS?

32 replied that they had major organisational

problems including:

  • No MDT co-ordinators
  • No timetabled activity
  • Limited or No dedicated accommodation or equipment
  • Audit/data collection
  • Obtaining notes/X-ray
mapping exercise for upper gi patient journey
Mapping Exercise For Upper GI Patient Journey
  • 27out of 57 have already processed mapped with a 50% success rate
  • 5 are currently being planned
  • Difficulties encountered:

- Complex pathway

- Poor documentation/feedback of findings

- Lack of action following process mapping

- Hidden issues not "teased" out

- No CSC person in post

- No allocated time

bottlenecks
"Bottlenecks"
  • Primary Care
    • Referral pathway
    • Patients not going to GP with symptoms
    • Poor support for patients
    • GP not recognising alarm symptoms
bottlenecks1
"Bottlenecks"
  • Radiology/Endoscopy
    • Booking
    • Capacity
    • CT Waiting Times
    • CT Staging
    • Access to PET scanning
bottlenecks2
"Bottlenecks"
  • Delays to first diagnostic test due to referrals to Gastroenterology, A&E or Care of the Elderly
  • Chemotherapy/Radiotherapy start dates
  • Histology reporting
  • Access to palliative care
  • Insufficient time for surgery
  • Bed availability HDU/POCCU/ITU
  • No Upper GI nurse specialist
summary
Summary
  • Major Organisational issues with most MDTs
  • Variable attendance of “key” personnel at MDTs
  • Bottlenecks at every stage of the patient journey
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