"Lack of Communication"

I am writing to provide feedback regarding a recent oncology appointment, which was deeply distressing and ultimately unproductive due to a lack of coordinated communication following MDT discussions.

I want to emphasise that this feedback is not directed at individual clinicians. All staff I encountered were professional and courteous. My concern relates to system-level communication between specialties and how MDT decisions are made and communicated to patients, particularly those from remote and regional areas.

I travelled 3600km to this appointment with the clear expectation that treatment would be commencing, based on prior advice from urology that adjuvant immunotherapy was planned after a diagnosis of stage 3 kidney cancer and removal of my left kidney and one of two tumours. Importantly, the presence of another tumour was not new information. This had been known and documented throughout my care and prior to this appointment.

Despite this, I attended the oncology appointment at SCGH only to be told that immunotherapy could not proceed because of the other tumour. Oncology advised that the tumour should be removed, while urology at RPH would not proceed with surgery until genetic testing is completed. All reasonable medical plans. However, as a result, I was left with:

Conflicting advice between oncology and urology

No agreed or actionable treatment plan

No clear explanation of what had been resolved or deferred at the MDT

Significant distress and uncertainty

A long and unnecessary trip that could have been avoided

Given that all relevant clinical information was already available, it is concerning that these fundamental issues were not resolved prior to my appointment. MDT meetings exist to ensure coordinated, patient-centred decision-making. In this instance, it was evident that immunotherapy eligibility, timing of surgery, and the impact of genetic testing had not been aligned before I was asked to travel and attend.

For patients from remote and regional areas, each appointment carries substantial personal, financial, and emotional cost. Clear, unified communication following MDT discussions is essential to avoid unnecessary travel and prevent avoidable distress.

I believe there is a need for:

Clear and unified treatment plans following MDT meetings

Resolution of inter-specialty disagreements before patients are booked to attend appointments

Greater consideration of the impact of uncertainty on remote patients

Improved communication when plans change or cannot proceed

I provide this feedback in the hope that MDT communication and coordination can be improved for future patients, particularly those living outside metropolitan areas who rely on these systems functioning effectively.

Thank you for taking the time to consider this feedback.