The crisis in NHS cancer care is at a “watershed moment” and must be tackled with the same urgency as the search for a Covid vaccine, experts have said.
Writing in the Lancet Oncology journal, clinicians from Imperial College London, the Institute of Cancer Policy at King’s College, Radiotherapy UK, and Check4Cancer said delays to treating cancer patients must be tackled now, adding: “The UK public and the NHS should not tolerate the normalisation of delayed cancer care.”
The team pointed to a “survival gap” compared with many other countries, adding: “Although all NHS backlogs are important, the cancer backlog is the most time-sensitive and the most deadly. The NHS and frontline staff need the same urgency and leadership, combined with the authority to work through obstructive bureaucracy, that was given to the Covid-19 Vaccine Taskforce.”
Latest NHS figures show a decline in the number of people starting their first cancer treatment within two months. Only 60.3% of the 14,425 cancer patients urgently referred by their GP in October had waited less than two months by the time they started treatment.
This was the second-lowest percentage on record and below the 85% target. The medics said that when it comes to curing cancer, a four-week delay in treatment “increases mortality by between 6% and 13% for solid cancers, with further increases if the delay is longer”.
They added: “The complex cancer pathways were fragile and failing in the UK before their breakdown during the Covid-19 pandemic.
"The 2021 Joint All-Party Parliamentary Group Cancer Summit Report highlighted multiple causes for their failure, including a deteriorating workforce crisis, a lack of short-term and long-term planning to address the workforce shortage, insufficient diagnostic (radiology and pathology) and treatment capacity, and an outdated information technology infrastructure.”
The team argued that introducing more targets could distort priorities and “so many targets have been missed that targets become a less meaningful tool for change”. A new NHS workforce plan should “lead to major improvements in cancer care” but “short-term action is needed to save lives now”.
They added: “To immediately improve cancer survival, the UK needs to deliver cancer treatment within the recommended timeframe.
"No research breakthroughs are needed, just an effective, efficient pathway to diagnose and treat patients with cancer.”
To achieve this, the NHS must retain current staff and “give them the tools and support they need to do their jobs”.
The authors said: “Inefficient practices have emerged: secretarial support suspended so consultants are less productive than they should be, obsolete IT slowing everyday work, workflow tools not being purchased, and antiquated equipment, such as radiotherapy machines, so out of date they take twice as long as modern machines to treat patients less well than is possible.”
The team said there needs to be major investment in radiotherapy, which is in danger of collapse, despite the fact that it is needed by at least 53% of UK patients with cancer. It is involved in 40% of cancer cures.
Oncologist and founder of the #CatchUpWithCancer campaign Professor Pat Price, one of the authors, said: “This is a watershed moment for UK cancer services – the biggest cancer crisis ever – we can’t accept the normalisation of record-breaking cancer treatment waiting times.”
Cancer Research UK’s chief executive, Michelle Mitchell, said: “UK cancer survival lags behind other similar countries and some cancer waiting times targets have not been met since at least 2015. It’s frustrating to see, month after month, yet more unacceptable figures – because behind this data are real people who deserve better.
“Long delays can cause anxiety and distress for those who are waiting for tests and treatment. And early diagnosis of cancer can mean the difference between treatment working or not. NHS staff are working harder than ever to diagnose and treat the record number of people being referred, but demand has outstripped capacity and chronic workforce shortages are threatening the recovery of cancer services.”
An NHS spokesman said: “While fewer people came forward during the early months of the pandemic, over 780,000 people in England have started treatment for cancer since March 2020 – 94% within a month – and over 250,000 had radiotherapy as a subsequent treatment, while record numbers of people are getting checked thanks to our biggest ever national cancer awareness campaign and record numbers of GP appointments.
“The NHS is investing billions to expand diagnostic and treatment services to meet increased demand, as well as rolling out new initiatives including straight to test services, cancer symptom hotlines and mobile lung scanning trucks, which have already diagnosed over a thousand cancers earlier when they are easier to treat.”
Labour’s shadow health secretary Wes Streeting said: “Thousands of cancer patients are waiting longer than is safe, with seriously worrying consequences for their chances of survival and their peace of mind while they wait.”
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