COVID-19 multidisciplinary working group

Editor – We write in support of the process outlined by Satta et al in their recent commentary which explored the methods for creating an expert multidisciplinary team (MDT) to support decision making and governance around therapeutic options during the COVID-19 pandemic.¹

Within our own organisation, a large district general hospital, we established a similar COVID-19 oversight group (COG) by mid-April 2020, drawing in multiple experts, like those reported by Satta et al. We developed the trust-wide guidelines for managing COVID-19 and maximised the delivery of clinical trials, overseeing study outcomes with early implementation of efficacious treatments through this group.

During the COVID-19 pandemic, up to 10 May 2021, our organisation recruited 5,431 participants into research studies of which 6% (n=333) were recruited to interventional trials including RECOVERY (n=222) and REMAP-CAP (n=15).^2,3

The COG was also able to review, through weekly virtual meetings, the outcomes from various research studies and interim position statements released from the department of health. Various novel therapeutic agents were implemented into updated guidelines within 7 days of release of the interim position statements with effective transition into standard care within this time period.^2–4

In order to evaluate the impact of the COG guidelines, we undertook a trust-wide audit of randomly selected COVID-19 patients admitted between 01 May 2020 and 30 Nov 2020. The majority of patients received appropriate therapeutic interventions during the audit time periods: dexamethasone (93%) and remdesivir (84%). Tocilizumab guidance was received in January 2021 and a further audit suggested that 86% of our patients received this treatment appropriately.

We agree with the authors and feel confident that the establishment of a local MDT has enabled our organisation to provide rapid access to therapeutic interventions in COVID-19 with high levels of concordance with local guidelines. Although NHS organisations have a wide degree of heterogeneity, we believe that the effective implementation of a local COVID-19 MDT group could have beneficial impact across the wider healthcare system.