Purpose, Structure, and Governance of the Multidisciplinary Team
Purpose and function
An MDT exists to bring together the disciplines needed to make one coherent plan for a patient, rather than a series of parallel plans. Its purposes are coordination, shared decision-making, continuity, and accountability for a single documented plan. Distinguish the MDT from a case conference (information sharing) and from a ward round (medical decision-making): the MDT is a governed decision forum.
Structure
Typical structural elements include a chair, a coordinator, named core members, an agreed quorum, a standing agenda, a minute-taker, and a defined output (the plan and action log). Core membership should reflect the decisions the team is authorised to make; extended members attend for specific cases. Structure follows function, so every element should be traceable to the terms of reference.
Governance
Governance covers terms of reference, reporting lines, delegated authority, confidentiality, conflict-of-interest declarations, escalation routes, and review of the team's own performance. Accountability does not dissolve into the group: the team recommends or agrees a plan, but named clinicians remain accountable for the care they deliver. Quorum is a control, so decisions taken without required disciplines should be recorded as provisional pending ratification.
Traps
Questions often test whether you think the chair is the decision-maker (usually a facilitator), whether consensus means unanimity (it does not), and whether 'the MDT decided' removes individual accountability (it does not). Another trap is treating a well-attended meeting as good governance without checking terms of reference, quorum, and documented outputs.
Rule of thumb
If it is not in the terms of reference or the action log, it did not happen. Match every meeting element to a stated purpose and every decision to a named owner.