Multidisciplinary Diagnostic Centres (MDCs)

Wave 2 of the ACE Programme comprises five projects piloting Multidisciplinary Diagnostic Centre (MDC) based pathways.

Wave 2 of the ACE Programme comprises five projects piloting Multidisciplinary Diagnostic Centre (MDC) based pathways. This pathway is for patients with non-specific but concerning symptoms that could be indicative of several cancers, where a clear referral route does not currently exist. Wave 2 delivers recommendation 21 of the Independent Cancer Taskforce report to explore new pathway models that speed up diagnosis.

What is a MDC?

The MDC concept has been implemented in Denmark where a patient can undergo several diagnostic tests in one location, at the same time, leading to a faster diagnosis. A MDC doesn’t have to be a new ‘centre’, but can be set up within an existing hospital or community setting and would supplement cancer-specific diagnostic pathways.

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Why pilot MDCs?

Patients who display symptoms, or a combination of ‘non-specific’ symptoms that indicate several different cancers, currently don't have an effective referral pathway. As a result, they go back and forth between primary and secondary care, present to emergency services or fall through the gap – which leads to delays to diagnosis and subsequently poor outcomes.

MDCs could potentially be an effective way to support patients with non-specific symptoms who tend to present late, and support GPs who are unsure of the appropriate referral pathway.

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The pilots

There are currently 5 MDC pilot projects across England, these are situated in Airedale, London, Oxford, Leeds and Greater Manchester.

These sites are testing how feasible this referral route will be for the NHS in England and are assessing the clinical and economical effectiveness of this model to see if it can:

  • shift from late to earlier cancer diagnosis at stages 1 and 2
  • reduce the number of emergency presentation diagnoses
  • improve patient experience.
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The ACE Programme

Find out how the ACE Programme aims to reduce system delays and improve early diagnosis of cancer.

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Resources

The ACE Programme has developed resources to support local development and implementation of MDC-based pathways:

MDC results paper

Patients with non-specific symptoms often experience longer times to diagnosis and poorer clinical outcomes than those with site-specific symptoms. This paper reports initial results from five multidisciplinary diagnostic centre (MDC) projects in England, piloting rapid referral for patients with non-specific symptoms.

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Qualitative evaluation summary of ACE implementation

An approach to building the local case for MDCs

The following article sets out a potential approach to planning and developing MDCs. It may be helpful to local commissioners and policy makers interested in implementing MDC-based pathways in their areas.

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An approach to understanding pathway costs

MDC core data items and metrics

This document lists the data items to be collected as part of the MDC evaluation. Similar data items should be recorded whenever possible for the MDC and comparator groups.

A data item called ‘Control pathway or MDC case’ has been added to be used as a filter – the comparators are referred as ‘control’ or ‘control pathway’ across the document.

A full data items list is available on request, please email aceteam@cancer.org.uk.

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MDC patient experience survey report

MDC design principles

ACE has identified three emerging ‘models’ as well as a set of overarching MDC design principles that are shared by all 5 projects. These models are not intended to reflect any specific ACE project pathway, but instead provide generic information on distinct potential approaches.

Each ‘model’ includes the approach, diagnostics and leadership required. The design principles should be read in conjunction with the MDC resource pack.

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Early project learning leaflet

This material is based on feedback from the five ACE projects and describes the key learning points from their early experiences. The information focuses specifically on aspects of planning and development for a cancer diagnostic pathway for non-specific but concerning symptoms.

The five areas covered in this leaflet are: timing, essentials to developing MDC plans, working with primary care, key data elements and operational challenges.

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Evidence suggests that MDCs are having a positive impact on the time to diagnosis, by providing a rapid referral pathway for patients with non-specific but concerning symptoms.

The ACE Programme, MDC interim report, 2018

To find out more about the ACE Programme, visit Cancer Research UK.