Cancer treatment targets missed, thousands left waiting

Three new NHS standards reveal how well services are performing. Yet all have been missed and some targets not met for nine years.

The most critical is the 62-day referral to treatment target, latest data for which shows only 65.2% received a diagnosis and started their first treatment within two months of an urgent referral. The target is 85% and has not been met since 2015.

Cancer Research UK claims that if the target had been consistently met since the general election in 2019, around 124,000 additional patients would have started treatment on time.

The charity calculates that between now and the expected autumn election around 48,000 patients would have been waiting longer than they should against the target.

Overall, analysis suggests some 175,000 patients across just over four years have waited longer than they should.

Michelle Mitchell, the charity’s chief executive, said: “The cancer crisis is urgent and it’s real. Over the past few years, pressure on NHS cancer services has been mounting.

“Testing for cancer, diagnosing it and starting treatment quickly saves people from stress and anxiety. Not only this, but cancer that’s diagnosed and treated at an early stage, when it isn’t too large and hasn’t spread, is more likely to be treated successfully. Prompt diagnosis and treatment underpin this.”

December 2023 was the first month data on cancer waiting times was reflected in new and updated NHS targets streamlining 10 standards into three targets.

The 62-day target relates to referrals made by a GP for suspected cancer, after screening or by a consultant who suspects cancer following other investigations, known as “upgrades”.

CRUK analysis shows that at the end of January 2020, nearly 15,300 patients were waiting more than 62-days to start treatment, or to have cancer ruled out, following referral.

By the end of August 2023, that number had jumped to 23,800. In the same month, patients in some parts of England were around 2.7 times more likely to wait longer than 62-days for treatment than those in other areas.

The two week wait target, stating people with suspected cancer should see a specialist within 14-days of being urgently referred by their GP or screening programme, has been replaced with the faster diagnosis standard [FDS].

It was axed and replaced at a time when performance against it is among the worst on record – and the target not met since May 2020.

The FDS, which states 75% of patients should be diagnosed, or have cancer ruled out, within 28 days of an urgent referral, was 71.9% in November.

This applies to patients who have been urgently referred by a GP for suspected cancer, following an abnormal screening result, or by a GP for breast symptoms (where cancer is not suspected).

The target has never been met since its introduction in October 2021.

And just 90.1% of people started treatment within 31-days of doctors deciding a treatment plan. The target is 96%. The decision to treat standard applies to anyone who has been diagnosed with the disease, including patients who have had cancer which has returned.

The data is specific to England. Scotland, Wales and Northern Ireland have their own cancer waiting times targets.

Ms Mitchell said: “Every month, cancer wait time targets in England are missed. Thousands of cancer patients across the country face a more anxious and uncertain time as a result. Despite the best efforts of NHS staff, many people are waiting longer than they should to be diagnosed and treated. The last time all targets for cancer waiting times were met was as far back as 2015.”

“It’s vital the Government delivers additional investment in NHS staff and diagnostic equipment, coupled with reform to cancer services. Without this, targets will continue to be missed, and patients will not receive the level of care that they deserve.”

Oncologist and former NHS cancer consultant Karol Sikora said: “Not long ago, Britain was a world-leader across all aspects of cancer care – diagnosis, treatment and research. Now? We are the sick man of Europe. Thousands and thousands of patients experiencing horrific delays just to get diagnosed, with our survival rates reflecting this.”

“While countless patients endure torturous delays, three advanced cancer facilities remain unused in Reading, Newport and Northumberland. I can honestly say these centres are among the very best I have seen anywhere in the world, yet our establishment is happy for them to remain empty? It is a national scandal.”

Daily Express columnist Prof Sikora, 75, added: “Throughout my half a century in medicine, I have never been so disappointed. This network has the capacity to help 20,000 patients a year, with some of the most advanced equipment known to man – including proton beam therapy, a state-of-the-art treatment that can drastically reduce side-effects and significantly improve the quality of life for patients.”

“Charities, politicians and commentators will all bemoan the state of UK cancer care, yet almost nobody has lifted a finger to help open these centres. Here is a ready-made solution that could deliver results for patients almost overnight. Why on earth aren’t we grabbing it with both hands?”

The Department of Health and Social Care said: “Cutting waiting lists is one of the Government’s top five priorities.”

The NHS is seeing and treating record numbers of people for cancer and more people are being diagnosed at an earlier stage than ever before.

“This is thanks in part to the government’s investment in 150 new Community Diagnostic Centres and as a result, cancer survival is the highest it’s ever been. We know there is more to do – our Major Conditions Strategy will set out how we will improve cancer prevention, diagnosis and treatment.”

An NHS spokesman said: “The NHS is seeing and treating record numbers of people for cancer, with 30% more people being treated last year than in 2015/16 and almost 3 million people receiving potentially lifesaving cancer checks in the last 12-months, ensuring more people have been diagnosed at an early stage.”

“While this record level of demand has led to some people waiting longer, NHS staff are working hard to prioritise and treat the longest waiters and most urgent cases, and over 90% of patients have been able start their treatment within a month of diagnosis in 2023/24.”

Heartbroken Amy Gray, who lost her mother to a rare type of bladder cancer in 2021, said missed waiting time targets are no surprise.

Jayne, 64, a headteacher from East Leicestershire, was first diagnosed in 2005.

She was receiving treatment during the pandemic, but Amy said blaming staff and equipment shortages on Covid is an “easy get-out”.

Amy, 37, said: “For my mum and I, the issues of understaffing and lack of equipment were confounded by the pandemic but not caused by it – they’re symptoms of years of chronic underfunding and under-resourcing.”

Amy, 37, said: “For my mum and I, the issues of understaffing and lack of equipment were confounded by the pandemic but not caused by it – they’re symptoms of years of chronic underfunding and under-resourcing.”

Three years after her mother’s death, Amy said “I feel exceptionally frustrated waiting times remain an issue. I remember the anxiety caused by the long and uncomfortable two-hour waits in corridors for planned chemotherapy treatments, the repeated lack of beds in oncology when Mum needed to be admitted, and the last-minute delays to getting scans. All these issues were a source of huge stress to us as a family.”

“Patients deserve the best possible care, and it’s not acceptable when hospitals are squeezed to the point they are no longer able to provide this. I certainly wanted better for my Mum.

“Should I ever require long-term hospital treatment, I want better for myself and everyone else that is already going through one of the hardest, most scary times of their life.”

Amy, who is engaged, added: “I want to be inspired by my political leaders and confident they have the highest-level aspirations when it comes to our nation’s healthcare.”

“Rhetoric is not enough – there needs to be meaningful action.”