The National Cancer Plan for England risks falling short of its 2029 waiting time targets and ambition to modernise cancer care unless the NHS urgently reforms Multi‑Disciplinary Team working, according to a new report by The King’s Fund.
The analysis is among the first detailed examinations of how England can deliver on the Cancer Plan’s aims since its publication in February, and warns that without changes to how MDTs operate, the NHS will struggle to harness innovation and improve outcomes for people with cancer.
The report follows a roundtable convened by The King’s Fund, bringing together clinicians, policy makers, researchers and patient advocates to explore what “innovation readiness” looks like in practice.
Participants focused on how national ambitions, particularly around early diagnosis, modernised services and better outcomes, can be translated into meaningful change for patients on the ground.
Embracing innovation is a central theme of the National Cancer Plan, with commitments to modernise cancer services, maximise scientific advances and narrow the gap between England’s cancer outcomes and those of the best‑performing countries internationally.
One of the report’s key conclusions is that the NHS is not harnessing the full potential of innovation in cancer care, largely due to limited workforce capacity.
Clinical staff often lack the time and headspace needed to adopt, test and refine new approaches, amid rising demand and significant workforce shortages.
The report highlights:
- A national shortfall of consultant radiologists, with all departments relying on outsourcing or insourcing to meet demand
- A projected 39% shortfall in radiologists by 2029 if current trends continue
- An expected 19% shortfall in oncology consultants over the same period
These pressures, the report argues, reduce the NHS’s ability to modernise pathways and adopt new diagnostic and treatment innovations.
However, The King’s Fund says it remains unclear whether this strategy alone will free up the time and capacity clinicians need to engage meaningfully with innovation, particularly while workload continues to rise.
Urgent reform of MDT meetings is identified as a central solution in the report.
The King’s Fund heard that rising patient volumes have caused MDT meetings to balloon in length and complexity, making existing models unsustainable.
One radiologist described spending hours preparing images for MDT discussions, only to “re‑show” them during three‑hour‑long MDT meetings each week. While MDT working is widely valued for bringing together different clinical perspectives, the report stresses it must be better targeted to deliver maximum benefit for patients.
The report recommends introducing a standardised MDT triage model, where:
- Clinically complex or uncertain cases are discussed in streamlined MDT meetings
- Routine cases proceed with full MDT oversight, but without requiring discussion of every individual patient
This approach could significantly reduce workload, release specialist time for diagnosis and reporting, and support pathway improvement – all while maintaining safety and quality of care.
The King’s Fund says this triage‑based MDT model should be considered as part of the government’s ongoing review of MDT working, being led by the Royal College of Radiologists. The College has committed to issuing new national guidance in spring 2027, offering an opportunity to embed reforms that support innovation, efficiency and better use of specialist expertise.
Policy Adviser at The King’s Fund, Niamh Buckingham, said:
“The National Cancer Plan for England sets out a series of bold ambitions and if realised they would undoubtedly save and improve the lives of thousands of people. Making these aims achievable, especially within the tight timeframes ministers have set out, will require the NHS to move rapidly to embrace the innovations needed to bring cancer care into the 21st century.
“From our analysis, the historic blockers to harnessing innovation remain in place. One of the biggest constraints is the lack of headspace among staff to properly engage with new developments due to wider workforce pressures and a significant increase in patient numbers. If staff can only think of moving from one case to the next there is never the time available to them that would allow for the testing and adoption of new ways of working and building the skills needed for delivering modernised care.
“A way to rectify this would be through the urgent reform of MDT meetings. MDT working that brings together different clinical professionals can be incredibly valuable, but it must be targeted where it can do most good for patients. The present set up of discussing every case in their current format has become unsustainable. Instead, system leaders should look to adopt a streamlined model, with MDT oversight of all patients and dedicated time in MDT meetings of cases where discussion is required. This approach needs to be considered by the government’s ongoing review of MDT working.
“By significantly freeing up clinical and diagnostic capacity in this way, cancer staff can turn attention to the spread and scale of innovations needed to meet the National Cancer Plan's targets and, crucially, deliver improvements in patient outcomes.”
The report concludes that without reform to MDT working and action to address workforce pressures, the NHS will struggle to:
- Meet 2029 cancer waiting time targets
- Modernise services at pace
- Fully benefit from technological and scientific advances
The King’s Fund argues that smarter, more targeted MDT models could act as a catalyst for progress – helping ensure cancer services are fit for the future and capable of delivering the improvements patients expect.
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