The rise of spinal mdts in private patient practice
Mr Tom Ember is a Consultant Orthopaedic and Spinal Surgeon specialising in the treatment of adult and paediatric spinal conditions. He established and chairs HCA Healthcare UK’s London Bridge Hospital spinal multidisciplinary meeting, promoting a multidisciplinary team environment throughout his practice.
HCA UK has been pioneering within the independent sector in establishing specialist MDTs. The spinal MDT includes spinal clinical nurse specialists and physiotherapists, as well as consultants specialising in orthopaedic spinal surgery, neurosurgery, radiology, pain management, orthotics and, when required, oncology, rheumatology and neurology.
Members of the consultant team submit the cases they wish to discuss during the week prior to the meeting online. For an MDT to be effective and accurate, the Chair will ensure that the patient’s case history has been provided, is comprehensive with imaging up to date.
How an MDT shares their opinion with the patient
The discussions and consensus view are summarised by the Chair and this forms the basis for the patient output document. A traffic light system is used to summarise the meeting:
Green represents a normal variance of opinion in which a consensus has been reached, that the agreement on the proposed treatment is reasonable and has a high chance of success with a low risk of complication.
Amber represents some variance of opinion with some members of the team disagreeing with the proposed treatment plan. It is important that the referring consultant discusses the alternative treatment options, benefits and relative risks of the different treatments with their patient.
Red represents a general view among the whole group that the proposed treatment is not reasonable and would represent outlying activity as the risks are too high and the chances of a good result are low. These cases occur very rarely.
Key factors for MDT success
For MDTs to be successful, "participation is key," stresses Mr Ember. "It is important that members of the team attend the meeting, even if they do not have cases of their own to present as their opinions on colleagues’ cases are important.
Members of the team are to attend with an open mind and a desire to hear alternative opinions and points of view. Attending high quality MDTs makes us all better doctors."
Patients are always very positive when they learn about the MDT process. "If I am planning to operate on a patient, I explain to them that their case history and imaging will be discussed among a group of specialists and I will therefore be able to provide them with multiple "second opinions" and a consensus view with regards to the best treatment for their problem. Patients invariably find this reassuring and are always keen to see the results of the meeting.
"An MDT should be an enjoyable and fulfilling meeting for colleagues who share the same interests and passions. When done well, the MDT benefits the patient, the consultant and the hospital where treatment has been taking place" closes Tom.
At HCA UK, our healthcare professionals come together to determine a patient’s treatment plan and improve the quality of care. They are integral in consistently ensuring patient safety and driving best-in-class care.
Meet the specialist
Mr Tom Ember
Mr Ember specialises in the treatment of adult and paediatric spinal conditions and his expertise includes degenerative disc disease (including lower back pain and sciatica), spinal tumours and spinal deformity (scoliosis and kyphosis). Treatments extend from spinal injection therapy (caudal epidural, nerve root blocks and facet joint blocks) to surgery.
He contributes to spinal surgery publications and teaches about spinal conditions. His current NHS appointments are at Guy's and St Thomas' NHS Foundation Trust and Great Ormond Street Hospital for Sick Children. He is based at the London Bridge Hospital for HCA Healthcare UK.