Abstract
Risk management is essential to patient safety in NHS multidisciplinary teams (MDTs). COVID-19 transformed established practices at speed, yet a coherent account of how MDT risk management evolved across pre-pandemic, lockdown, and post-pandemic periods remains lacking. This systematic review synthesized 21 studies identified through several database using PRISMA 2020 guidance. Narrative synthesis informed by reflexive thematic analysis generated 248 codes collapsed into four themes. Pre-pandemic MDT risk management relied on face-to-face consensus routines but contained latent vulnerabilities. Lockdown forced rapid reconfiguration including virtual meetings and altered governance, generating new risk logics while creating inequitable outcomes and moral distress. Post-pandemic practice institutionalized hybrid models, system-level governance, and continuous review cycles. Cross-cutting lessons emphasize risk management as collective sensemaking requiring clear governance, balanced standardization, and attention to equity and workforce wellbeing.