Performance and cost of a Renal Cancer Specialist Multidisciplinary Team Meeting: Results from 1500 discussions

OBJECTIVES: To report on the performance and cost of a surgeon-led renal cancer specialist multidisciplinary team meeting at a high-volume centre. MATERIALS AND METHODS: Retrospective analysis of 1500 consecutive cases discussed from 2 September 2015 onwards. Performance was assessed as the number of cases where a clinical recommendation was made. The cost per meeting, discussion and patient were calculated using the mid-point of pay band attributable to the attendees (National Health Service pay scales 2015). RESULTS: Over 34 meetings, 1500 discussions occurred (933 patients: 61.7% male; mean age 63.8). Above a one-quarter of discussions (n = 399, 26.6%) were new referrals. Each patient’s case was discussed a mean of 1.6 times, the majority being discussed once (n = 563, 60.3%). In 93.3% of discussions, a clinical recommendation was made. Only 100 discussions (6.7%) were deferred due to incomplete clinical information. A total of 11.1% (n = 166) cases were discharged. The average costs were: £141,901 per year, £2729 per meeting, £62 per case discussed and £99 per patient. CONCLUSION: One discussion was usually sufficient to decide management; deferral was uncommon; and, given the low discharge rate, referrals seemed appropriate. The cost per patient was modest, and represented good value in providing a focused and shared clinical decision-making pathway for renal cancer patients.