The authors conducted descriptive analysis of 1500 cases discussed from 02/09/2015 onwards at the renal cancer SMDT meeting, which is a weekly meeting with 15 core and 18 extended members. In this meeting cases from 11 referring hospital trusts are usually discussed. The estimated average cost of the meeting was calculated as the number of hours members required to prepare and attend the meeting, using the mid-point of pay band attributable to the attendees (NHS pay scales 2015). The cost per meeting, per case, and per patient was calculated. The annual cost extrapolated.
One thousand five hundred discussions took place over 34 meetings (02/09/2015 to 20/04/2016) and represented a cohort of 933 patients: 61.7% male (n=576); mean age 63.8 (IQR 24; range 14-96). One hospital trust referred the majority of patients (n=538, 57.7%). Most patients were referred by urology (n=720, 77.3%). Just above a quarter of discussions (n=399, 26.6%) represented new referrals. Each patient had their case discussed a mean of 1.6 times (range 1-7), with a majority of patients being discussed once (n=563, 60.3%). Only 100 discussions (6.7%) were deferred to subsequent meetings due to incomplete clinical details or unavailability of imaging scans or path reports. 11.1% (n=166) of cases were discharged from care. The estimated average cost of the meeting was: £130,875 per year, £2,517 per meeting, £57 per case discussed, and £92 per patient.
In conclusion, an average of 44 cases was discussed per meeting. One discussion was usually sufficient to decide management, deferral of cases was uncommon and, given the low discharge rate, one can infer that referrals to the meeting were appropriate. In a high volume center, the cost per case was modest and represented good value in providing a focused decision making structure for renal cancer patients.
Presented by: Joana B Neves
Affiliation: Royal Free London NHS Foundation Trust, London, United Kingdom
Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre.Twitter: @GoldbergHanan at the 37th Congress of Société Internationale d’Urologie - October 19-22, 2017- Lisbon, Portugal