Decision making through multidisciplinary teams offers an opportunity to improve perioperative care for high-risk surgical patients. While multidisciplinary team decision making is commonplace in the NHS, involvement of perioperative physicians including anaesthetists and intensivists in this process is not well established. This article presents an exemplar of anaesthetic and intensivist involvement in a joint perioperative upper gastrointestinal cancer multidisciplinary team meeting at the Royal Surrey County Hospital in Guildford, UK. It is hoped that this model example and critical analysis will assist others who are interested in improving perioperative shared decision making in their units.