Patients Waiting Too Long to Start Cancer Treatment, Data Suggests

Patients Waiting Too Long to Start Cancer Treatment, Data Suggests

The pressures on the NHS are revealed as Sian Norris and the Byline Intelligence Team analyse the latest data on cancer testing and screening

When it comes to diagnosing the health of the National Health Service, cancer is a good place to start. One in two of us will get cancer in our lifetimes, and the disease kills around 167,000 of us every year – although thanks to pioneering medical science and dedicated healthcare staff, more and more of us are surviving a diagnosis too, 

As we go into winter, the NHS is already under real pressure. More than seven million people are currently on the NHS waiting list, the average waiting time is 13.8 weeks, while waiting times for Category One ambulance calls was nine minutes in July this year. 

Facing a twin threat of flu and Coronavirus, the health service is braced for another hard winter – while under-inflation pay offers and a workforce crisis has led to nurses voting for strike action. 

As part of our ongoing series looking at the National Health Crisis, the Byline Times has examined the data on cancer waiting times and screening, to understand the current situation facing cancer patients in the NHS and what it tells us about the service’s own health. 

---

Waiting Times

According to the NHS Confederation, cancer waits of over 62 days have doubled from their pre-pandemic levels, and have “ticked upwards having seen a rising trend since the shock at the start of the pandemic”. It notes that part of this trend is due to increased demand after the worst days of the lockdowns, with urgent GP referrals increasing over 2021/2022.

One of the key measures for cancer treatment is the number of patients being seen within 14 days of a referral. Back in 2010, 95% of patients were seen within a two week period, this number dropped to 90% in 2019. 

In quarter one 2022/23, 80.1% patients were seen by specialists after an urgent referral for suspected cancer were seen within 14 days of referral. This was a positive increase compared to 78.9% in quarter 2021/22, but a decrease from 85.9% in the same period the previous year. 

When it comes to starting treatment, in quarter one 2022/23 92.1% of patients began a first definitive treatment for cancer within 31 days of diagnosis. This was a small decrease compared to 92.3% in quarter four 2021-22, but a more significant drop from 94.7% in quarter one 2021/22. In August this year, 92% patients began treatment within a month of referral.

While this gives us an overall picture, when you dig into data around specific cancers, the figures become more concerning. 

In 2009/10, a target was introduced that symptomatic breast cancer patients should wait no more than two weeks to see a specialist. Back then, 92% of patients were seen within the target – a figure that has dropped to 55.3% in quarter four 2021/2022. This increased to 67.1% in quarter one of 2022/2023 – an improvement, but still way down on the target.

Even before the pandemic, the NHS was struggling to meet the target: in quarter two 2019, fewer than 80% of symptomatic breast cancer patients saw a specialist within two weeks of a referral. 

As the Government sets out in its elective recovery delivery plan, it aims to have 75% of patients – who have been urgently referred by their GP for suspected cancer – diagnosed or have cancer ruled out within 28 days by March 2024. 

---

Screening Rates

One of the reasons we have better survival rates for cancer than ever before is the way in which medical science has advanced screening technology. Getting checked for cancer symptoms is a surefire way to save lives. 

There are three national cancer screening programmes in England: bowel, cervical and breast. And here’s some good news: bowel cancer screening rates are above target. According to NHS data, bowel cancer screening performance has remained above the acceptable threshold of 52% since 1 April 2017, while in the most recent data set for the year 2020-21, out of 64 screening services, all of them met the acceptable threshold and 59 met the achievable threshold of 60%.

Cervical cancer screening is more of a mixed picture. The acceptable screening rate is 80%, however rates have remained below since April 2017 – peaking at 70.9% in quarter four 2019/2020. Rates dipped to their lowest in quarter three 2020/2021, to 68.1% before recovering slightly to 68.9%.

There are numerous reasons why women avoid cervical cancer screening, including historic experiences of sexual assault, as well as feeling embarrassed or uncomfortable about the procedure. 

The NHS provides regional data into cervical screening, which shows that in 2022/2023, the lowest rates of cervical screening for women aged 25-49 were in the North West and the Midlands. South Asian women are statistically less likely to go for cervical and breast cancer screening. 

The pressures on the NHS come after a decade of real-terms underfunding – although funding was increased during the pandemic. The annual increases to Government spending on health fell to less than 1% under 2010’s Coalition Government, before creeping up to just under 2% before 2019 – compared to 6% annual increases under Labour. 

It also comes after various scandals related to the outsourcing of cancer screening services to private providers. In 2018, Capita came under heavy criticism when hundreds of women did not receive vital information concerning cervical cancer screenings. The same year, the beleaguered company also failed to send letters inviting women to breast cancer screenings. 

A Department of Health and Social Care spokesperson told Byline Times: “We are working at pace to improve outcomes for cancer patients across England, including by improving referral rates – during August, 92% of people started cancer treatment within a month of referral.

We have also opened over 80 community diagnostics centres so far, which have delivered over two million additional scans, tests and checks”.