Cancer care involves many different healthcare professionals, and miscommunication can impact the quality of care people receive. Clinical guidelines recommend multidisciplinary team (MDT) meetings to facilitate communication between healthcare professionals.1 2 The effectiveness of such meetings is influenced by clinician workload, attendance rates, logistical factors and funding.2 The Belgian government runs a funding scheme to encourage the use of MDT meetings in cancer care: healthcare professionals can claim reimbursement for attending or organising MDT meetings and hospitals can claim additional funding for oncology nurses, psychologists, dietitians and data managers based on the number of MDT meetings held per year.1 This funding approach has increased the number of MDT meetings held per year and the proportion of people with cancer discussed in MDT meetings. It also improved the comprehensiveness of the Belgian Cancer Registry and facilitated knowledge exchange between healthcare professionals.1 3



Cancer care involves many different healthcare professionals, ranging from oncologists, surgeons and general practitioners (GPs) to social workers, dietitians and psychologists.1 Effective multidisciplinary work requires communication between all healthcare professionals involved, as miscommunication can have a negative impact on the quality of cancer care delivered to patients.1 2 Multidisciplinary team (MDT) meetings can improve communication between healthcare professionals involved in cancer care.2 These meetings use a collaborative and evidence-based decision-making process to coordinate the cancer care pathway for individual patients.1 3 MDT meetings can increase clinicians’ job satisfaction4 and improve patients’ survival rates, quality of life, satisfaction with care and access to clinical trials.2 5-7

Despite MDT meetings being recommended as best practice in clinical guidelines and by scientific and patient advocacy organisations, their implementation in practice varies and is influenced by clinician workload, attendance rates, logistical factors (e.g. administrative support and data sharing) and healthcare funding.2 Additional challenges include ensuring balanced input from all attendees and representing patients’ interests in meetings.8-10


The Belgian government introduced a new funding scheme in 2002 to tackle funding-related barriers to MDT meetings and encourage the nationwide adoption of the MDT approach. Healthcare professionals can claim reimbursement for organising or attending up to three MDT meetings per cancer patient per year through the National Institute for Health and Disability Insurance (RIZIV-INAMI). For reimbursement, MDT meetings must be:

  • requested by a treating clinician (e.g. oncologist or GP)
  • physically attended by four to six specialists from different disciplines, with at least one specialist in surgical oncology, medical oncology, radiotherapy or haematology-oncology.1

GPs or healthcare professionals from other hospitals can attend as external specialists. One attending healthcare professional acts as the meeting coordinator, noting what is discussed and sending a written report to all attendees, the requesting clinician, the patient’s GP and the patient’s sickness fund. Reimbursement is available for up to four attendees.1

Based on the number of MDT meetings completed per year, hospitals can also claim additional funding from RIZIV-INAMI for oncology nurses, dietitians, psychologists, social workers and data managers. For example, a medium-sized hospital may conduct 500 MDT meetings per year, generating funding for approximately 6.5 full-time equivalents, such as 2 full-time oncology nurses, 2 full-time psychologists, 1 full-time social worker, 1 full-time dietitian and a part-time data manager.1


What has it achieved?

The funding approach for MDT meetings led to:1

  • an increase in the number of MDT meetings held per year, from 28,350 (2003) to 104,530 (2012)
  • an increase in proportion of people with cancer discussed in MDT meetings, from 50% (2004) to 82% (2011).

In 2012, hospitals were able to claim additional funding for 1,070 full-time equivalents, including:1

  • 330 oncology nurses
  • 330 onco-psychologists
  • 165 social workers
  • 163 dietitians
  • 82 data managers.

The total cost of the initiative was €16.6 million in 2012 – approximately €160 per patient.1

The increase in MDT meetings facilitated knowledge exchange between different healthcare professionals. For example, urologists involved in MDT meetings for prostate cancer became more knowledgeable about radiation therapy.3 The funding provided for data managers may also have contributed to improved comprehensiveness of the Belgian Cancer Registry, from 71% of cases reported in 2004 to 86% of cases reported in 2011.1

Next steps

GPs are a valuable source of medical information for MDT meetings, particularly when they have a long-standing relationship with the patient. However, GPs made up less than 1% of MDT meeting attendees in 2011.1 Future efforts will focus on increasing communication between hospitals and local GPs to generate awareness of MDT meetings. One of the requirements for MDT meeting reimbursement is physical attendance. Video- and telephone-based conference calls are being considered to improve MDT meeting attendance rates, especially for GPs and external specialists.1

While the number of MDT meetings increased, the impact of MDT meetings on patient care and outcomes still needs to be investigated.1 The funding scheme primarily rewards the quantity of MDT meetings held, and the quality of MDT meetings remains a topic of interest.10


Further information

  • The RIZIV-INAMI webpage on MDT meeting reimbursement (available only in Dutch and French)
  • A policy statement on multidisciplinary care by the European Partnership Action Against Cancer (EPAAC)
  • A report by the Belgian Health Care Knowledge Centre on multidisciplinary team meetings in oncology
  • An article on multidisciplinary care for prostate cancer in Belgium


  1. Vrijens F, Kohn L, Dubois C, et al. 2015. Ten years of multidisciplinary team meetings in oncology - current situation and perspectives. Brussels: Belgian Health Care Knowledge Centre (KCE)
  2. Borras JM, Albreht T, Audisio R, et al. 2014. Policy statement on multidisciplinary cancer care. Eur J Cancer 50(3): 475-80
  3. Van Belle S. 2008. How to implement the multidisciplinary approach in prostate cancer management: the Belgian model. BJU Int 101(s2): 2-4
  4. Field KM, Rosenthal MA, Dimou J, et al. 2010. Communication in and clinician satisfaction with multidisciplinary team meetings in neuro-oncology. J Clin Neurosci 17(9): 1130-35
  5. Lordan JT, Karanjia ND, Quiney N, et al. 2009. A 10-year study of outcome following hepatic resection for colorectal liver metastases – The effect of evaluation in a multidisciplinary team setting. Eur J Surg Oncol (EJSO) 35(3): 302-06
  6. Davies AR, Deans DAC, Penman I, et al. 2006. The multidisciplinary team meeting improves staging accuracy and treatment selection for gastro-esophageal cancer. Dis Esophagus 19(6): 496-503
  7. Rummans TA, Clark MM, Sloan JA, et al. 2006. Impacting quality of life for patients with advanced cancer with a structured multidisciplinary intervention: a randomized controlled trial. J Clin Oncol 24(4): 635-42
  8. Fleissig A, Jenkins V, Catt S, et al. 2006. Multidisciplinary teams in cancer care: are they effective in the UK? Lancet Oncol 7(11): 935-43
  9. Lamb BW, Sevdalis N, Arora S, et al. 2011. Teamwork and team decision-making at multidisciplinary cancer conferences: barriers, facilitators, and opportunities for improvement. World J Surg 35(9): 1970-76
  10. Horlait M, Baes S, Dhaene S, et al. 2019. How multidisciplinary are multidisciplinary team meetings in cancer care? An observational study in oncology departments in Flanders, Belgium. J Multidiscip Healthc 12: 159-67