Case MDT Professional Opinion, Data and Governance Rules.

1. Status and purpose

1.1 These Rules apply to every Case MDT submission, live or asynchronous professional discussion, panel contribution, governance review, Case MDT Opinion and Case MDT Discussion Summary. They supplement the Terms and form part of the contract for each Case MDT.

1.2 Case MDT is a genuine confidential multidisciplinary professional discussion between appropriately qualified healthcare professionals. It may produce a non-binding collective professional opinion based on the limited, effectively anonymised information supplied. It is not an emergency service, patient referral, assumption of care, prescription, treatment authorisation, guarantee of outcome or substitute for examination and patient care. Unless a separate signed agreement expressly establishes a different regulated service, it is not a formal clinical second-opinion service.

1.3 The submitting clinician remains the treating or responsible professional and retains sole and continuing responsibility for the patient, including assessment, investigations, diagnosis, consent, treatment, documentation, referral, follow-up, local governance and compliance with professional and legal requirements.

2. Eligibility and professional scope

2.1 Only an appropriately qualified, registered where required, insured or indemnified and authorised healthcare professional acting wholly or mainly for purposes connected with their professional practice may submit a clinical case.

2.2 The submitter must work within professional competence and must not use Case MDT to bypass local MDT, referral, safeguarding, indemnity, employer, regulator, prescribing, product or emergency requirements.

2.3 Each participant remains personally accountable under their applicable professional standards for their own conduct and advice. Participation does not make a panel member part of the treating team or transfer patient responsibility.

2.4 We may decline a case outside the panel's expertise, submitted for an improper purpose, lacking sufficient anonymised information or creating disproportionate legal, clinical, ethical, data or reputational risk.

3. Mandatory case-specific Professional Acknowledgement

3.1 Before every case is submitted or discussed, the submitting clinician must electronically sign the current Professional Acknowledgement. General membership acceptance, a prior case acknowledgement or payment does not replace it.

3.2 The acknowledgement must state:

I confirm that I am an appropriately qualified and, where required, registered healthcare professional acting in my professional capacity. I remain the treating or responsible clinician and retain sole and continuing responsibility for the patient and every clinical decision. I understand that Case MDT is a limited multidisciplinary professional discussion which may produce a non-binding collective opinion; it is not a referral, assumption of care, prescription, treatment authorisation, guarantee, formal clinical second opinion or substitute for my own examination, judgement and local governance. I may accept, reject or depart from any opinion, and I will independently assess its relevance, verify material information and not use it as the sole basis for a clinical decision. I understand that the panel has not examined the patient or reviewed the complete clinical record and cannot guarantee that supplied information is complete, accurate or current. I confirm that all submitted material is effectively anonymised, lawfully used and authorised. I will not represent any output as IAMRegen or MSK Regen authorisation, approval, guarantee or transfer of responsibility. I maintain appropriate professional indemnity or insurance and accept the Case MDT Rules and applicable liability provisions. I expressly request Case MDT discussion on this basis.

3.3 The electronic record must capture the applicable Terms and Rules version, user identity, professional registration where applicable, case reference, acknowledgement wording, date, time and affirmative action. The acknowledgement must be available in durable form.

4. No emergency use

Case MDT is not continuously monitored. A case involving urgent deterioration, immediate risk, safeguarding or time-critical treatment must be managed through appropriate local clinical and emergency systems.

5. Mandatory anonymisation standard

5.1 Only information rendered effectively anonymous so the patient is not reasonably identifiable to IAMRegen, panel members or other recipients may be submitted through the standard Service.

5.2 Pseudonymisation is not enough. Replacing a name with initials, a study number or a code while retaining a key does not make the data anonymous for data-protection purposes.

5.3 The submitter must remove or sufficiently generalise:

• name, initials, signature, voice and contact details;
• NHS, hospital, clinic, insurance, study and device identifiers;
• full date of birth, exact address, full postcode and precise geolocation;
• exact admission, operation, imaging or unusual event dates where not essential;
• face, distinctive tattoos, labels and recognisable backgrounds;
• DICOM headers, image overlays, EXIF data, filenames and hidden document metadata;
• names or identifiers of relatives, clinicians and institutions where unnecessary; and
• rare or highly specific combinations of age, occupation, location, condition, event and dates that could enable identification.

5.4 Use age bands, relative time intervals and clinically sufficient general descriptions wherever possible.

6. Mandatory anonymisation confirmation

Before upload, the submitter must separately confirm that:

• all direct identifiers have been removed;
• image, DICOM and document metadata have been inspected and removed;
• indirect identifiers and rare combinations have been sufficiently generalised;
• the case can reasonably be discussed without re-identification;
• the material contains no data about another person without lawful authority;
• the case does not involve an emergency or safeguarding matter requiring another route;
• the submitter is authorised by their organisation and professional rules to use the material; and
• the information is accurate, relevant and proportionate to the professional question.

7. Exceptional identifiable-data pathway

7.1 If effective anonymisation is impossible, the case must not be uploaded or emailed through the standard Service.

7.2 An exceptional pathway exists only after MSK Regen gives written approval and the parties complete, as applicable:

• a controller-role assessment and data-sharing or processing agreement;
• a DPIA and security review;
• an Article 6 lawful basis and Article 9 condition;
• patient information and valid consent where required;
• institutional, ethics, sponsor and professional approvals; and
• a documented retention, access, transfer and incident plan.

7.3 Payment, membership or urgency does not create approval.

8. Information quality and submitter responsibility

8.1 The submitter confirms that the submission is lawful, materially accurate to the best of their knowledge, within scope, effectively anonymised and free of unauthorised third-party rights.

8.2 The submitter is responsible for selecting and describing the information supplied. IAMRegen and participants do not examine the patient, verify the complete record or warrant that the information is complete, accurate or current.

9. Access and confidentiality

9.1 Access is limited to authorised administrators, panel members and technical providers who need it for the Service.

9.2 All participants must preserve confidentiality, use information only for the authorised discussion, avoid external searching intended to identify the patient and not download or retain material unless authorised.

9.3 Live discussions must use an approved platform. Private recording, screen capture and artificial-intelligence transcription are prohibited unless IAMRegen expressly enables and discloses them.

10. Panel conflicts and professional conduct

10.1 A panel member must disclose a conflict, prior clinical involvement or information that could identify the patient. IAMRegen may recuse, replace or restrict that member.

10.2 Panel members provide professional observations in good faith based on limited information. They must distinguish evidence, uncertainty, opinion, differing professional views and regulatory variation, and must not promote a product because of an undisclosed interest.

10.3 A participant must not contact the patient, assume care, solicit work from the patient or submitter, or use the case outside the authorised purpose.

11. Case MDT Opinion and Discussion Summary

11.1 Where included, IAMRegen may issue a Case MDT Discussion Summary recording the material question, information presented, evidence, uncertainty, risks, professional observations, differing views and a non-binding Case MDT Opinion.

11.2 Every output must display prominently:

NON-BINDING PROFESSIONAL OPINION

This document records a limited multidisciplinary professional discussion based only on the effectively anonymised information supplied. It is not a referral, assumption of patient care, prescription, treatment authorisation, guarantee or formal clinical second opinion. The submitting clinician may accept, reject or depart from it and remains solely and continuously responsible for the patient, independent verification, consent, decisions, documentation, referral and follow-up. It must not be used as the sole basis for a clinical decision or represented as approval by IAMRegen, the Science Board or MSK Regen.

11.3 The Science Board or another appointed reviewer may review the output for process compliance and whether it faithfully records the material discussion. Any reviewed output must state:

Reviewed under the IAMRegen Case MDT governance process as a faithful record. This review does not constitute Science Board approval of patient-specific treatment, a guarantee of clinical accuracy or an assumption of patient care.

11.4 The submitter must interpret the output within applicable law, professional standards, local resources and the patient's individual circumstances. The output must not be supplied to a patient, court, regulator or third party as an IAMRegen medico-legal report, formal clinical second opinion or treatment approval without express written permission.

12. Responsibility, reliance and liability

12.1 The submitter may accept, reject or depart from any Case MDT Opinion. They must independently assess its relevance, verify material information and not rely on it as the sole basis for a clinical decision.

12.2 Subject to sections 30 and 31 of the Terms and to the fullest extent permitted by law, MSK Regen, IAMRegen, the Science Board and participants do not accept responsibility for the submitter's independent decision to adopt, reject or modify a Case MDT Opinion, or for treatment or patient outcomes arising from that decision.

12.3 Nothing excludes responsibility that cannot lawfully be excluded. Each regulated professional remains responsible to their regulator for their own conduct and advice.

12.4 The Business User indemnity in section 32 of the Terms applies, including to prohibited patient data and any misrepresentation of a Case MDT output as authorisation, approval, guarantee, formal second opinion or transfer of responsibility.

13. Intellectual property and permitted learning use

13.1 The submitter retains rights in their pre-existing material and grants MSK Regen the licence needed to administer the discussion and create the Case MDT Opinion and Discussion Summary.

13.2 MSK Regen owns the Association-created summary, format, moderation record and compiled output, subject to the submitter's pre-existing rights.

13.3 Genuinely anonymised and aggregated learning points may be used internally for training, quality improvement, safety and service development.

13.4 External teaching, publication, research, promotion or artificial-intelligence training involving a recognisable case requires a new assessment and all necessary consent, ethics, permissions and licences. No participant may publish a case independently merely because it was discussed.

14. Retention and deletion

The case-specific acknowledgement, administrative records and final Case MDT Opinion and Discussion Summary are normally retained for 6 years for governance and dispute purposes. Working copies are removed when no longer needed. Genuinely anonymised learning material may be retained longer.

If prohibited identifiable information is discovered, we may quarantine access, preserve only what is necessary for incident management, notify relevant parties and securely delete the material when lawful.

15. Security and incident reporting

15.1 A participant who notices an identifier, disclosure, misdirected message, unauthorised recording or security concern must stop accessing or sharing it and notify [email protected] immediately.

15.2 Participants must cooperate with containment, deletion, investigation and legally required notifications.

15.3 Ordinary email must not be used to submit a case or case attachment.

16. Cross-border access

Cases may be discussed by professionals in different countries only through approved arrangements. Effective anonymisation is the primary safeguard. No participant may transfer or disclose material outside the authorised group.

17. Fees, scheduling and cancellation

Case MDT Fees reserve administrative and panel time. Specific scheduling and cancellation rules are shown before booking. Statutory rights and the Terms apply.

18. Enforcement

Breach may lead to rejection, deletion, loss of Case MDT access, suspension, professional or institutional notification where lawful, regulatory reporting and other remedies under the Terms.