NSW public genetic services participate in an increasing number of multidisciplinary team (MDT) meetings and multidisciplinary clinics (MDCs). This collaborative model is becoming the gold standard of care.
MDT meetings and MDCs help ensure patients with suspected, complex or rare genetic conditions receive a faster genomic diagnosis and benefit from collective expertise.
Multidisciplinary care can take place in various ways, across different services. Examples include:
- local discussions in paediatric, neurology, cardiology or other specialty areas
- joint meetings across local health districts or specialty health networks
- statewide MDT meeting for complex cases, e.g. ocular genomics, paediatric cancer or complex prenatal cases.
Straightforward cases may be managed locally, without a full MDT.
Service level agreements between LHDs or SHNs help ensure equitable access to genomic care for people in rural, regional and remote areas.
Embedding genomic care into mainstream care
The NSW Health Genomic Strategy (2017) shows NSW Health’s long-term plan to integrate genomics into the NSW health system.1 To do this, non-genetic health workers need training in genomics, and MDT meetings are a key way to support this shift.
Genetic testing is becoming more common in areas like paediatrics, cancer and heart disease, with many covered by Medicare. These tests often need input from clinical genetics, and MDT meetings can help with both the genetic advice and to bring that expertise into routine care.
In 2022, the NSW Ministry of Health reviewed genomic mainstreaming across the state. The review found that:
- supporting MDT meetings is a key way to make genomic healthcare more consistent, effective and fair
- MDT meetings improve access, education and collaboration.
Methods used to develop the principles
The guiding principles in this resource aim to support non-genetic clinicians and healthcare services involved in multidisciplinary care to review, improve and standardise processes. They are based on an evidence review and experiential evidence looking at real-world insights from existing MDTs and MDCs with genetic input in NSW.
The principles also draw on a 2012 guide from New Zealand’s Ministry of Health on best practice for multidisciplinary cancer care.2
Multidisciplinary care survey
In 2023, we surveyed NSW genetic services to understand how multidisciplinary care is currently delivered. We received 67 responses—26 from MDCs and 41 from MDT meetings. Key themes from this survey, along with findings from a literature review and consultation report, helped shape these principles.
Acknowledgements
Agency for Clinical Innovation, Clinical Genetics Network, Executive Committee
Dr Alan Ma, Clinical Geneticist, The Children’s Hospital at Westmead, Sydney Children’s Hospitals Network
Prof Robyn Jamieson, Clinical Geneticist and Head, Western Sydney Genetics Program, The Children’s Hospital at Westmead, Sydney Children’s Hospitals Network
Glossary
Multidisciplinary team
A multidisciplinary team (MDT) includes multiple health professionals from different disciplines who work together to care for the person being treated.
Multidisciplinary team meeting
MDT meetings are either in person, via videoconference or a hybrid of both, and involve health professionals with expertise in a range of different specialities discussing a person’s treatment, care or potential diagnosis(es).2
Multidisciplinary clinic
Multidisciplinary clinics (MDCs) include the person receiving care, unlike traditional MDT meetings which are clinician-only. The person may see several specialists in one visit, either one after the other or simultaneously.2 Care is coordinated across multiple disciplines, making the experience more streamlined and collaborative. An MDT meeting is usually held either before or after these clinics.
References
- NSW Ministry of Health. NSW Health Genomics Strategy. Sydney: NSW Government; 2017.
- New Zealand Ministry of Health. Guidance for Implementing High-Quality Multidisciplinary Meetings: Achieving best practice cancer care. Wellington: Ministry of Health; 2012.