King’s Fund warns England’s cancer plan may miss 2029 targets without MDT overhaul

England’s National Cancer Plan risks missing its 2029 waiting time targets and its ambition to modernise cancer care unless the NHS changes how it works, particularly by overhauling multidisciplinary team (MDT) meetings and creating space for staff to adopt innovation, a new report from The King’s Fund has warned.

The analysis, among the first detailed examinations since the plan was published in February, explores what “innovation readiness” looks like in practice. After a roundtable with clinicians, policymakers, researchers and patient advocates, the think tank concludes that the NHS is not yet harnessing the full potential of innovation in cancer care.

Rising demand and significant workforce shortages mean clinical teams often lack the time to test and embed new diagnostic and treatment approaches, limiting efforts to modernise care pathways and improve outcomes. The King’s Fund also questions whether measures currently under way will, on their own, free up the time and capacity clinicians need to engage meaningfully with innovation, particularly as workloads continue to rise.

Urgent reform of MDT meetings is identified as a central solution. The report says growing patient volumes have caused MDT sessions to balloon in length and complexity, leaving existing models unsustainable. One radiologist described spending hours preparing imaging for MDT discussions, only to present it again during weekly meetings that can run for three hours.

While MDT working is widely valued for bringing together different clinical perspectives, the report argues it must be better targeted to deliver maximum benefit for patients. To that end, The King’s Fund recommends introducing a standardised, triage‑based MDT model.

It says such an approach could reduce workload, release specialist time for diagnosis and reporting, and support pathway improvements, while maintaining safety and quality of care. The think tank says this model should be considered as part of the government’s ongoing review of MDT working, led by the Royal College of Radiologists.

The College has committed to issuing new national guidance in spring 2027, which the report notes is an opportunity to embed reforms that support innovation, efficiency and better use of specialist expertise. Niamh Buckingham, a policy adviser at The King’s Fund, said the plan’s ambitions are bold and, if realised, would save and improve thousands of lives.

She added that meeting tight ministerial timeframes will require the NHS to move quickly to embrace the innovations needed to bring cancer care into the 21st century. Historic blockers to adopting innovation remain, she said, with staff lacking the “headspace” to engage with new developments amid workforce pressures and rising patient numbers.

Reforming MDT meetings, she argued, would help create the capacity needed for testing and adopting new ways of working and building the skills required for modernised care. The report’s central message is that without targeted changes to MDT processes and steps to relieve workforce pressures, the NHS will struggle to capitalise on advances in cancer care and to deliver on the plan’s timelines.

Further detail is expected when new MDT guidance is issued in 2027.