Table I.

“Old” MDT meetings vs “New” MDT meetings

Decision-making forum	Decision-making forum
No official chair; RC’s responsibility to manage the meeting and discussion	Independent chair (not the RC, not part of the patient’s current care team, nursing/clinical background); 2 chairs for the 4 teams
All service users discussed weekly (up to 18 service users per RC)	Each service user discussed fortnightly (up to 9 service users per RC)
Lengthy meetings; attendance fluctuated between and in each meeting; little time for SUs discussed towards the end Unpredictable meeting times which took place on ward; “ward on hold” (waiting for the team to arrive)	Shorter meetings; consistent attendance; more set time for each SU (approx. 30 min) Fixed meeting times in a set room on the ward or a suitable office meeting room within the clinic (outside the ward)
Not all disciplines involved/contributing Minutes less structured	All disciplines must participate by producing a summary prior to the meeting (Care Review Form) More accountability (transparency?) – minutes recorded for each meeting (including an “action plan” box and care review summary for each service user); attendance and summaries audited
Informal, no predetermined structure, no action log	Formal, structured, minutes and action log, better time management; summary form
Less opportunity for SUs to attend; not invited to attend; SU rarely attended	All SUs asked to attend; SU more likely to attend now
No systematic risk formulation Decisions based on unsystematic assessment of current presentation (stable)	Active risk formulation; more drive on index offence and psychology work Evidence based – considering risk, previous risk, current presentation
RC on leave – no meeting	Meeting takes place regardless (although no “legal” or key decisions made if RC not present)