Behind the headlines: cancer care delays

In November 2022, a BBC analysis revealed a sharp rise in long waits for cancer therapy in the past four years.

Dr Kathryn Scott, Chief Executive at Yorkshire Cancer Research, explores the situation in Yorkshire, what this means for people with cancer and what can be done to tackle the problem.

Back in 2009, a number of standards were set to help ensure the NHS provides timely care for people with cancer, regardless of where they live.

These include making sure people see a specialist for further tests within two weeks of being urgently referred to hospital with suspected cancer symptoms and that those diagnosed with cancer receive treatment within 31 days of doctors setting a treatment plan.

The 62 day wait target requires that at least 85% of people with cancer start their treatment within two months of being urgently referred to hospital with symptoms by their GP.

Every day counts when it comes to cancer. It is essential people receive treatment as quickly as possible.

But it’s been a long time since the NHS was able to meet this target, and the pandemic has only made the situation worse.

The 62 day wait target has not been met in Yorkshire since 2013/14 – but there has been a significant increase in delays as a result of the pandemic.

In September 2022, just 61% of people in the region received their first treatment within 62 days. This is the lowest percentage ever seen since data recording began in 2009.

In numbers, this means that 553 people waited longer than they should for cancer treatment in September alone. And in the past year, 5,754 people experienced delays – nearly double the number during the same time in 2017/18.

11 of the 12 NHS Trusts in Yorkshire are not meeting the target, and less than half of patients in Leeds, Hull and Sheffield received treatment within 62 days in September (47.6%, 49.7% and 48.8% respectively).

More people than ever before are being diagnosed with cancer, putting huge pressure on limited resources.

In 2021/22 the number of people in Yorkshire being seen by a specialist following a referral with cancer symptoms increased by 45,800 compared to the previous year.

The number of cancers being diagnosed dropped significantly during 2020 due to the pandemic, so an increase was expected during 2021/22 as people started coming forward with symptoms again.

But this figure is still 21,400 higher than before the pandemic, and the numbers continue to increase year on year.

The large number of people being referred with suspected cancer is now causing a ‘bottleneck’, with more people than ever before needing diagnostic tests in a system that is already overwhelmed.

The vast majority (93%) of those coming forward with symptoms will not have cancer. But for those who do have cancer, this is having a knock-on effect and causing increasing delays between their initial referral with suspected cancer, receiving a diagnosis and getting their first treatment.

Doctors and nurses are working hard to tackle the backlog. But the fact is that the NHS doesn’t have the staff or resources needed to deal with the volume of suspected cancer cases and those diagnosed with cancer quickly.

A survey carried out in 2016 found that some people with cancer noticed their general health and cancer symptoms getting worse while waiting for treatment. 6 in 10 patients also reported experiencing anxiety, depression or fear while waiting for treatment.

And the delays are also putting lives at risk.

Early diagnosis is key to saving lives. There are usually more treatment options available, and the likelihood of survival is greater.

So it’s vital that measures are taken to ensure everyone receives a timely diagnosis, the treatment they deserve and the very best chance of survival.

Along with other cancer charities, we are calling for more investment in the NHS workforce and equipment to improve diagnosis, treatment and care.

We are asking the government to:

1. Deliver on its manifesto pledge to plan for the cancer workforce by providing funding to train and employ more cancer staff to fill current vacancies and ensure that the workforce has the capacity to meet increasing demand, innovate and drive lifesaving research. Around £200m additional investment in Health Education England is needed over the 3 years to grow the key cancer professions by 45% by 2029.
2. Create a Cancer Nurse Fund of £124 million to train the next generation of Cancer Nurse Specialists, helping to deliver on the NHS Long-Term Plan promise for every patient to get a named cancer nurse.
3. Substantially invest to refresh and expand diagnostic equipment and radically reform how diagnostic services are delivered, including rolling out Community Diagnostic Hubs and investing £1.3 billion in capital funding to improve CT, MRI and PET-CT equipment.
4. Drive earlier and faster diagnosis by reforming and maximising the benefits of national cancer screening programmes.

Behind the cancer waiting times statistics are families across Yorkshire who are not only facing the impact of a cancer diagnosis, but also experiencing the consequences of a lack of direction from the government.

A ‘perfect storm’ is now brewing in the world of cancer treatment. With cancer screening, GP appointments, diagnostic tests and treatment significantly affected by the Covid-19 pandemic, it’s now more important than ever that the Government provides a clear plan for the future.

In February 2022, the government announced its intention to develop a 10-Year Cancer Plan that would ‘start a war on cancer’. But we are yet to see a date set for publication.

We are urging the government to take action, before more families lose loved ones.