6th European Conference - Academic Conferences

Shada Alsalamah et al.
Figure 1: Part of breast cancer treatment conceptual model
4. Results
Although the investigation is still under way, the following results have been found.
First, according to the National Institute for Healthcare and Clinical Excellence (NICE) (2002), breast
cancer diagnosis and treatment is a co-operative activity that involves a range of professionals, both
within and outside the breast cancer unit. We found that there are at least 16 healthcare professionals
involved in the treatment of a patient in this process in Wales. Although each plays a well-defined but
different role, they are increasingly working in teams (Commission for Health Improvement and Audit
Commission, 2001). Annually, each MDT diagnoses and treats 100 new breast cancer patients
(NICE, 2002). The provision of a high quality service requires close co-operation between specialists
from several disciplines and it is essential that care is provided by a breast cancer MDT in a specialist
breast unit (Cancer Services Expert Group, 2008). In addition, there are at least two professionals for
each role in the core breast care team (NICE, 2002). The different MDT members’ roles can be
categorised into three different groups:
Primary care personnel: GP, district nurse, and practice nurse.
Principal specialist personnel (core breast cancer team): breast cancer nurse specialists, clinical
and medical oncologists, radiologists, pathologists, and surgeons.
Affiliated personnel: liaison psychiatrist and/or clinical psychologist, palliative care specialists and
teams, physiotherapists and occupational therapists, surgeons experienced in breast
reconstruction, clinical genetics, pharmacists, and haematologists.
Second, there are at least seven HISs holding information about the patient with each having its own
patient health record. This record stores sensitive and confidential personal and medical information.
Although the HISs collectively adopt and adapt national guidelines, each applies its own and different
policies and guidelines locally. These meet local needs and circumstances (Cancer Services Expert
Group, 2008). The seven HISs found in this scenario and the different types of medical records they
might contain are listed in Table1 in appendix A.
Finally, a crucial feature of the breast cancer MDT is its composition, the way it works, and the
coordinated care it offers. This team functions in the context of a cancer unit or centre, which may
consist of one or more sites using shared facilities (NICE, 2002). NICE (2002) and the Commission
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