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Cancer Multidisciplinary co-ordinator team workforce model: user guide October 2017
We support providers to give patients
safe, high quality, compassionate care
within local health systems that are
financially sustainable.
1 | > Contents
Contents
1. Introduction ................................................................................ 2
Completing the model ........................................................................................... 2
2. Tips for successful completion ................................................... 4
3. Overview of the model ............................................................... 5
4. The tabs ..................................................................................... 6
Team data tab ....................................................................................................... 6
Data from workload tracker tab ............................................................................. 6
Summary of workload tracker tab .......................................................................... 8
Data tab ................................................................................................................. 9
Run chart tab ....................................................................................................... 10
MDT staffing calculator tab .................................................................................. 10
5. Reviewing the models .............................................................. 15
2 | > Cancer: multidisciplinary team workforce model: user guide
1. Introduction
We developed the cancer multidisciplinary team (MDT) workforce model to allow
staff groups such as MDT co-ordinators (MDTC) to calculate the number of staff
needed to adequately deal with their workload.
In conjunction with the staff workload tracker (SWT) tool1 this model allows teams
to identify how much time is needed for both fixed duties such as attending MDT
meetings and variable duties such as preparing for that MDT.
Using the model teams and their leaders can identify the time needed for these
duties and so compile a model of the total number of staff needed.
This model is a starting point for conversations about the delivery of key roles or for
organisations planning service change because it provides a better understanding
of the time each staff member needs to complete their work, reducing dependence
on anecdotal evidence.
All our tools are available, free of charge, from our Improvement Hub.2
Completing the model
Completing the model requires two stages of data collection. The information team
can complete one and the staff members of the MDTC team need to complete the
SWT tool.
We recommend operational managers work with colleagues from the selected staff
group to agree which key activities populate the SWT tool and which actions fall
within each of the activity categories.
A model will need to be completed for each cancer site. This is because each site
may take different times to track patients and prepare and outcome MDT meetings.
Agreeing the standard set of activities for the SWT tool will ensure consistency
across the team.
1 https://improvement.nhs.uk/resources/staff-workload-tracker-tool/
2 https://improvement.nhs.uk/improvement-hub/elective-care/
3 | > Cancer: multidisciplinary team workforce model: user guide
Complete a copy of the SWT tool for each member of staff once you have agreed
the activity list.
This user guide will take you through the steps to complete the model successfully.
It is primarily for those new to the model. The model is Excel based and to operate
correctly requires as a minimum Excel 2007.
4 | > Cancer: multidisciplinary team workforce model: user guide
2. Tips for successful completion
Each member of your team must do two weeks of data collection using the bespoke
MDTC staff workload tracker (SWT) tool3 before completing this model.
You need your team to have recorded the number of patients on the MDT and the
number of patients tracked in the weeks they complete the SWT tool. See the SWT
user guide for more information.4
You need to complete a model for each cancer site, so if you have a staff member
who works with more than one site, they need to attach their activities to a cancer
site when using the SWT.
This is important because there may be significant differences between specialties
that you need to know about to plan for future growth adequately.
When completing the SWT tool it is important that the staff member is working their
normal week, ie they don’t have any leave. Recording as ‘normal’ a week as
possible will give more accurate results. For example, if a team works 20 hours they
need to record 2 weeks when they work their 20 hours.
Throughout this model when you need to copy and paste, please use the paste
special function and select values. (See Section 4 ‘The tabs’ for how to do this.)
3 https://improvement.nhs.uk/resources/staff-workload-tracker-tool/
4 https://improvement.nhs.uk/resources/staff-workload-tracker-tool/
5 | > Cancer: multidisciplinary team workforce model: user guide
3. Overview of the model
The model consists of nine tabs:
1. Notes tab
2. Team data tab
3. Data from workload tracker tab
4. Summary of workload tracker tab
5. Data tab
6. MDT staffing calculator tab
7. Run chart tab
8. FAQs tab
9. Assumptions tab.
Data needs to be entered into tabs 2, 3, 5 and 6. All these tabs need to be
completed for the model to work.
Mandatory cells are highlighted in yellow.
The notes tab gives an overview of the model so this user guide starts with the
second tab, the team data tab.
6 | > Cancer: multidisciplinary team workforce model: user guide
4. The tabs
Team data tab
Complete this tab with:
• organisation name
• cancer site or specialty
• number of MDT co-ordinators (whole time equivalent (WTE))
• number of cancer trackers (WTE).
Data from workload tracker tab
After successfully completing the SWT tool twice (one for each week) for each
member of staff you need to copy and paste the summary tables from the summary
tab on the SWT tool into the boxes on this tab.
7 | > Cancer: multidisciplinary team workforce model: user guide
Use paste special – values to do this: select the table you want to copy, right click
and choose copy.
Then select the box on the ‘data from the workload tracker’ tab that you want to
paste into.
Right click and choose paste special which will open another box, choose the box
with numbers 123 on as below.
8 | > Cancer: multidisciplinary team workforce model: user guide
This will then copy the number from the summary table and not the formulas.
You need to copy and paste two tables for each staff member for the specialty you
are completing the model for; ie if there are two members of staff, you need to copy
four tables (as shown below).
Summary of workload tracker tab
This tab does not include any data entry, it displays the average amount of total
time the team spends on the 12 activities from the SWT tool.
Paste special
Paste Values
9 | > Cancer: multidisciplinary team workforce model: user guide
Data tab
The data tab is used to understand variability within the key tasks for this staff
group.
You ideally need 52 weeks of data for:
• MDT list size
• the patient tracking list (PTL) size for the specialty,
The MDT list size is used to understand how many patients you need to be able to
prep and outcome for each week.
The PTL size is used to understand how many patient you need to be able to track
each week.
Some providers are unable to get some or all of this data retrospectively. If so, you
need to start doing manual counts over at least a 12-week period. If possible,
request your business informatics department to start producing this data so that in
future iterations of the model you can get a full history.
Enter your data in the rows identified on this tab.
Once the data is entered the model will calculate the 65t and 85th percentile.
These percentiles help assess what number of patients (demand) you should set
your capacity against.
Demand and capacity theory suggests you need to set your capacity higher than
the average so that you do not build up a backlog over time. The lower you set the
capacity the more weeks a year demand will exceed capacity, whereas the higher
10 | > Cancer: multidisciplinary team workforce model: user guide
you set the capacity the more weeks a year capacity will exceed demand which in
extremis may leave staff with no work to do.
The correct level will have to be tested but given that patients cannot be left off the
MDT and ideally all patients should be tracked at least weekly most providers have
decided to use the 85th percentile to set their capacity against.
Run chart tab
This tab shows a run chart of all the data items entered on the data tab. It displays
the variability in the numbers for each data set.
MDT staffing calculator tab
This tab enables you to collate all the data input into the model to calculate the
requisite team size for each specialty.
There are three sections that will be autocompleted if the previous tabs have been
populated correctly.
The table on the right-hand side of the tab is populated from tab 4, Summary data.
11 | > Cancer: multidisciplinary team workforce model: user guide
.
The data for the bottom 9 categories is drawn from into the table on the bottom left
titled ‘Other duties’. The times have been converted from hours and minutes into
minutes.
The table at the top displays the 65th and 85th percentiles for:
• MDT list size
• PTL size
12 | > Cancer: multidisciplinary team workforce model: user guide
When first opening the tab check the data has fed through correctly. If there is an
issue, check you have correctly entered the data on the preceeding tabs.
The first step is to add in the MDT size and PTL size from each of the two weeks
of data capture using the SWT tool to the bottom table on the right-hand side.
Once complete the table at the top titled ‘Variable duties’ will autocomplete with the
times it takes to prep and outcome an MDT and to track a patient for that cancer
site.
The next step is todecide on what number of patients per week you are going to
use to calculate the time needed to:
• prep the MDT
• outcome the MDT
• track a patient.
To do this, choose a number from the table on the right which displays the 65th and
85th percentiles of demand.
13 | > Cancer: multidisciplinary team workforce model: user guide
However, you can use any number here as long as you understand why you are
choosing it.
For instance you may want to use the 85th percentile but you don’t track patients
until they reach seven days, so you might reduce the 85th percentile figure by an
average number of weekly 2ww referrals. Or you might want to raise the figure to
allow for a percentage of patients to be tracked twice in the week.
The numbers in the table are a guide but you need to use your knowledge of your
service to select the most accurate figure.
If you change any figures please record this in the assumptions tab so that
any future iterations can use the same methodology.
It is important to be as accurate as possible with these figures but especially the
tracking figure (both the time it takes and the demand figure). For most people the
numbers being tracked will be larger than the other tasks and so the impact of
getting this figure wrong is magnified. You may need to test this figure if the outputs
of the model do not make sense.
Finally, you need to review the bottom table. Are there missing tasks? ie tasks that
the team should have completed but didn’t. Are there tasks you know were only half
completed during the weeks of the SWT tool exercise?
14 | > Cancer: multidisciplinary team workforce model: user guide
In the example below, no time was used to perform the audit task so you might
want to add in the time you think should be dedicated to audits each week to
complete this task adequately.
Once you are happy that the data reflects the requirements on your team the model
is complete and a figure is calculated at the bottom which indicates the size of team
required (inclusive and exclusive of annual leave cover).
15 | > Cancer: multidisciplinary team workforce model: user guide
5. Reviewing the models
We recommend:
• keeping a note of the actions included in the activity categories and the
associated assumptions or exclusions, to inform future versions of the
model– you can use a blank tab in the model for this
• adding any assumptions and alterations made around increasing or
decreasing times to the assumptions tab
• reviewing the model every year or more frequently if the service
experiences a change in demand.
© NHS Improvement October 2017 Publication code: IG 21/17
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