Quality statement 2: Multidisciplinary teams for sarcoma

Quality statement

Adults, children and young people with bone sarcoma and adults with soft tissue sarcoma have their care plan confirmed by a sarcoma multidisciplinary team (MDT) and treatment delivered by services designated by the sarcoma advisory group.

Rationale

A sarcoma MDT should confirm care plans for adults, children and young people with bone sarcoma and adults with soft tissue sarcoma, although they might not deliver all of their care. Treatment may be provided by other services if agreed by the sarcoma MDT and sarcoma advisory group. Children with soft tissue sarcoma, for example children with rhabdomyosarcoma, would usually be managed by paediatric oncology MDTs.

Quality measures

Structure

a) Evidence of written protocols and local arrangements for adults, children and young people with bone sarcoma and adults with soft tissue sarcoma to have their care plan confirmed by a sarcoma MDT and treatment delivered by services designated by the sarcoma advisory group.

Data source: Local data collection.

b) Evidence of written protocols and pathways agreed between sarcoma MDTs and site‑specific cancer MDTs clarifying the circumstances in which patient care should be transferred from one team to the other.

Data source: Local data collection. National Cancer Peer Review Manual for cancer services: sarcoma measures, measure 14‑2L–112.

Process

a) Proportion of adults, children and young people with bone sarcomas who have their care plan confirmed by a sarcoma MDT and treatment delivered by services designated by the sarcoma advisory group.

Numerator – the number in the denominator who have their care plan confirmed by a sarcoma MDT and treatment delivered by services designated by the sarcoma advisory group.

Denominator – the number of adults, children and young people with bone sarcomas.

Data source: Local data collection. National Cancer Intelligence Network Cancer outcomes and services dataset.

b) Proportion of adults with soft tissue sarcomas who have their care plan confirmed by a sarcoma MDT and treatment delivered by services designated by the sarcoma advisory group.

Numerator – the number in the denominator who have their care plan confirmed by a sarcoma MDT and treatment delivered by services designated by the sarcoma advisory group.

Denominator – the number of adults with soft tissue sarcomas.

Data source: Local data collection. National Cancer Intelligence Network Cancer outcomes and services dataset.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (such as hospitals, sarcoma MDTs and cancer MDTs) ensure that adults, children and young people with bone sarcomas and adults with soft tissue sarcomas have their care plan confirmed by a sarcoma MDT and treatment delivered by services designated by the sarcoma advisory group. Site‑specific cancer MDTs that are not specifically for sarcoma should liaise with sarcoma MDTs when people with sarcoma are referred to them.

Healthcare professionals ensure that adults, children and young people with bone sarcomas and adults with soft tissue sarcomas have their care plan confirmed by a sarcoma MDT and treatment delivered by services designated by the sarcoma advisory group.

Commissioners (such as NHS England and clinical commissioning groups) ensure that adults, children and young people with bone sarcomas and adults with soft tissue sarcomas receive a care plan that is confirmed by a sarcoma MDT and treatment that is delivered by services designated by the sarcoma advisory group.

What the quality statement means for patients, service users and carers

Adults with soft tissue or bone sarcoma (a rare type of cancer that develops in a bone or in soft tissue such as muscle or fat) and children and young people with bone sarcoma are cared for with the help of a sarcoma multidisciplinary team (a specialist team of healthcare professionals who have training and experience in caring for people with sarcoma) who will advise on their care plan. Children with soft tissue sarcoma are usually cared for by a team that specialises in children's cancers (a paediatric oncology multidisciplinary team).

Source guidance

  • Sarcoma (2006) NICE cancer service guidance, Section 5: Improving treatment: sarcoma multidisciplinary teams (pages 54 and 56)

Definitions of terms used in this quality statement

Sarcoma multidisciplinary team (MDT)

The core membership of a sarcoma MDT is defined in the National Cancer Peer Review Manual for cancer services: sarcoma measures.

Sarcoma MDTs can also have extended team members, some of whom may work as part of the core team. Extended team members can work at sites distant from the sarcoma MDT. Extended team members should participate in sarcoma MDT meetings when appropriate. Extended team roles include:

  • specialist sarcoma physiotherapist

  • specialised allied health professionals (such as therapy radiographers, occupational therapists, prosthetists, orthotists, dietitians, social workers, counsellors or psychologists)

  • paediatric oncologist (specifically for MDTs that treat children and young people with bone and/or soft tissue sarcoma)

  • specialist nurse(s) (including palliative care nurses and appropriately trained ward staff)

  • designated medical or clinical oncologist from a linked cancer centre

  • affiliated diagnostic service clinicians

  • other professionals including orthopaedic, thoracic, plastic, head and neck, gynaecological, gastrointestinal and vascular surgeons.

[Adapted from Sarcoma (NICE cancer service guidance), Section 5: Improving treatment: sarcoma multidisciplinary teams and National Cancer Peer Review Manual for cancer services: sarcoma measures]

Equality and diversity considerations

When referring people to a sarcoma MDT, potential difficulties in access such as age, travelling distance, disability or financial barriers should be taken into account.