'My cancer spread while I waited months for surgery': The cost of England's cancer wait times

Alan, a 70-year-old man, was diagnosed with lung cancer after a nodule was discovered in his lung in June last year. He was scheduled for surgery within weeks, but due to delays, the surgery took place almost five months later. During this time, his cancer had spread, making the surgery more complicated. Alan expressed his frustration and anger over the lack of timely treatment.

Alan's situation is not unique; each month in England, thousands of cancer patients fail to receive treatment within the target timeframe. The government's National Cancer Plan and the NHS Planning Guidance aimed for 80% of patients to start treatment within 62 days of an urgent GP referral by March 2027, with the target reaching 85% by the same date. However, performance has worsened since the announcement; currently, only 69.9% of patients begin treatment within the 62-day timeframe, down from 71.9% previously.

Prof Pat Price, a prominent clinical oncologist in the UK, claims that the government's targets are now unattainable due to a lack of plan and accountability. She attributes the failures to the absence of a new independent cancer board and the complete loss of momentum. According to Radiotherapy UK analysis, over 3,000 additional patients need to start treatment each month to meet the March 2027 target - an increase of nearly 15% from current numbers.

Every month a cancer patient waits for treatment, their chances of survival decrease by around 10%. In Alan's case, the cancer had already spread to his lymph nodes and the nodule had grown significantly by the time he underwent surgery. Despite the operation, he now suffers from debilitating pain and cannot engage in activities he once enjoyed.

To achieve the government's goal, roughly 54,000 more patients need to start treatment within 62 days before 2029. Salisbury District Hospital, one of the trusts making progress on its waiting list, still struggles to meet targets. Staff attribute this to a lack of a comprehensive solution and emphasize the need for consistent appointment reminders, working IT systems, recruiting the right personnel, ensuring full surgical lists, and expanding capacity.

The Salisbury trust's pathologist, Lee Phillips, faces significant challenges due to the overwhelming number of biopsies from various hospital services. He calls for more staff and equipment to manage the demand. Radiotherapy, another bottleneck, requires patients to travel to nearby hospitals for daily sessions. Missed appointments, whether due to late letters, illness, transportation problems, or anxiety, also strain the system.

Cancer managers in trusts like Salisbury report that their efforts to reduce missed appointments have been effective. However, trusts with the sharpest declines in performance, such as Buckinghamshire Healthcare, University Hospitals Dorset, Milton Keynes University Hospital, East Cheshire, and Torbay and South Devon, cite rising demand, workforce shortages, and diagnostic bottlenecks as contributing factors.

Some mention industrial action and staff sickness, while others highlight the reliance on external diagnostic providers or major changes to their systems.

Addressing these issues and meeting the ambitions of the National Cancer Plan for England requires urgency and visible progress, according to Steve Haines of Macmillan Cancer Support. He emphasizes the need for a National Cancer Board to oversee improvements in waiting times and treatment. The Department of Health and Social Care acknowledges the challenges and concedes that there is work to be done.