Why is it important?
People’s needs are often complex, spanning multiple domains—medical, surgical, social, and emotional. If we don’t provide a properly holistic response to these patients, they won’t get the best possible care, or the best possible outcomes.
Where different practitioners are involved in someone’s care, or their options for support aren’t straightforward, MDT meetings can make sure support is coordinated in the right way.
Through structured conversations, these meetings help practitioners make the best decisions for new patients and people with complex needs. For this process to work, all members of the IBD team need to be involved – and additional input sought where appropriate. Protected time should be allocated and funded to enable attendance at MDT meetings.
The IBD team should have regular timetabled meetings, preferably weekly, to discuss appropriate IBD patients.
These might be part of an established meeting, such as a gastrointestinal/surgical meeting, but the outcome of the discussions should be formally recorded and discussed with the patients concerned.
A named IBD MDT co-ordinator should organise and keep a record of each meeting. These records should include the names of all attendees and the patients being discussed, and any agreed actions, including who will take them and when. A responsible person for each case should also be noted. The records need to be securely stored and referred to at subsequent meetings to ensure actions are completed and updated.
It is also important to communicate the actions and responsible person to the primary care team. Patients should also receive relevant feedback (e.g. written and/or verbal) from meetings held by their MDT.
MDT discussions should include:
- Newly diagnosed patients
- Patients with complex needs
- Patients with perianal Crohn's Disease
- Patients with aggressive Crohn's Disease at high risk of needing a further resection
- Patients with Ulcerative Colitis who may require surgery
- Patients with refractory IBD
- New patients with fistulas unable to achieve sustained steroid-free remission
- Patients identified to start biologics or small molecule therapy
- Patients with growth failure and diagnosis at a very young age
- Patients experiencing extra-intestinal manifestations (EIMs)
- Discussions about holistic support, considering other services and approaches (e.g., emotional, social and physical factors, or adjustments needed to support engagement in care)