Recurring concern
Unreliable governance and accountability of multidisciplinary team decisions
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Request correctionFirst reported 26 May 2017•Latest report 22 Dec 2025
What this concern includes
Includes failures of governance and accountability controls specifically dedicated to multidisciplinary team decisions, including safeguards against inappropriate unilateral override, clear allocation of decision ownership and leadership, defined thresholds for MDT consideration or escalation, and mechanisms to review or challenge departures from MDT decisions. Includes the anchor and comparable failures concerning absent ownership or unclear discussion thresholds.
Not included
- Excludes generic failures of multidisciplinary meeting attendance, discussion quality or patient participation where decision governance and accountability are not the shared unsafe condition; these belong to a broader meeting-operation concern.
- Excludes failures to implement or follow an MDT recommendation after the decision has been reliably made where decision governance itself is not deficient.
- Excludes generic clinical governance, senior oversight or individual clinical decision-making failures that do not concern governance of a multidisciplinary team decision.
- Excludes referral completion, information relay or record-keeping failures unless they directly undermine the governance, ownership or authorised review of an MDT decision.
- Reports
- 9
- Individual concerns
- 10
- Date range
- 2017–2025
- Stated actions
- 3
Distinct published reports
A report can raise multiple concerns
First to latest report issue date
Described in published responses
Reports over time
Reports over time
Reports about this concern issued each year.
* 2026 is projected from reports observed to 7 Sep 2026.
Most frequent recipients
Most frequent recipients
Reports about this concern sent to each recipient.
Concerns and responses across reports
Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.
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Concerns raised1
Absence of a clear multidisciplinary protocol for CT scan requests
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
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Concerns raised1
Lack of evidence that SPOE referral for MDT consideration is embedded in team practice
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
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Action
Implement Home Treatment Team referral and discharge processes requiring onward-referral outcomes and care pathways to be discussed before discharge.
Stated by Pennine Care NHS Foundation Trust
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Concerns raised1
Unclear regularity and thresholds for MDT discussions
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
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Position
Discussing every patient weekly in multidisciplinary meetings is not feasible because of high caseloads, so risk-based thresholds and prioritisation apply.
Stated by Berkshire Healthcare NHS Foundation Trust
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Concerns raised2
Insufficiently robust safeguards against overriding MDT decisions
Failure to establish how a senior clinician was able to override an MDT decision
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
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Action
Establish mandatory multidisciplinary governance for specialist-service funding decisions, changes, recording, challenge and escalation.
Stated by Herefordshire and Worcestershire Health and Care NHS Trust
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
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Position
The revised MDT funding decision process is considered sufficient to prevent clinicians from unilaterally overriding specialist referral decisions.
Stated by Herefordshire and Worcestershire Health and Care NHS Trust
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Concerns raised1
Reliance on a Care Coordinator to make clinical decisions about MDT referral
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
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Concerns raised1
Unclear escalation of absconding incidents to MDT review
This report raised 7 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
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Action
Inform the multidisciplinary team or make referrals after absconding incidents and conduct six-weekly or more frequent monitoring visits with placement review where needed.
Stated by PENTRE LODGE CARE HOME LIMITED
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Concerns raised1
Failure to discuss disputed acute dietetic referrals at a multidisciplinary team meeting
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
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Concerns raised1
Failure of multidisciplinary team members to challenge incorrect clinical decisions
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
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Concerns raised1
Lack of individual ownership and leadership for MDT decisions
This report raised 8 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
Data last updated 7 September 2026