NHS cancer performance drops to worst ever level for 8 targets

NHS cancer crisis sees waiting times hit longest on record: Health service performed worse than EVER on eight of its nine speed targets in January

  • Only a quarter of suspected cancer patients in England were seen by a specialist within a 2 week NHS target 
  • NHS operational guidelines say 93 per cent of these patients should be seen within a fortnight of a GP referral
  • The figure for January is the worst performance for this cancer care metric lowest since NHS records began
  •  In total NHS cancer care performance dropped to lowest ever levels in 8 out of 9 the health service’s targets

Cancer diagnosis and treatment times in England have reached record lows with the NHS in England recording its worst ever performance in eight out of nine of its performance targets in January.

It comes just a month after after Sajid Javid declared a ‘national war on cancer’ in a bid to improve Britain’s survival rate for the disease.

Now official data shows one in four suspected cancer patients did not get to see a consultant within two weeks of an urgent referral from their GP, a total of 50,723 patients. 

The NHS’s operational standard is for 93 per cent of patients in this situation to see a specialist who can help determine if they have cancer and therefore what the next steps might be within the fortnight timeframe.

January’s performance of just 75 per cent of patients seen by this benchmark is the lowest ever recorded since the NHS started collecting data in October 2019.

Additionally, only 61.8 per cent of patients diagnosed with cancer had started treatment within two months of their original referral in January, likewise a record low.

In human terms this means 5,161 people with cancer in England were still waiting to start treatment. 

The NHS operational standard is for 85 per cent of cancer patients to start treatment within two months of their referral and while January’s figure is a record worst for the health service has struggled with this standard for years. 

Rapid diagnosis and treatment for cancer, in the form of chemotherapy, surgery and the like, is a key factor in improving survival outcomes for patients with the disease.

The two worst ever records for referrals for suspected cancer patients and starting treatment within two months for those found to have the disease were joined by six other record lows for NHS cancer performance targets.  

Mr Javid has said that he would set out a 10-year cancer plan later this year as part of a ‘war on cancer’.

NHS England has also recently released consultation on proposed new cancer targets which would see the two week target for suspected cancer patients to see a specialist scrapped in favour of a diagnostic standard where should be diagnosed in 28 days — or have the disease ruled out.

In further signs of the mammoth backlog of care facing patients in England, the latest data also revealed  NHS waiting lists for routine operations hit yet another record high of 6.1million.

Data from NHS England shows one in nine people in the country were waiting for routine treatment — such as joint replacement and cataract surgery — or diagnostic tests as of the end of January

NHS England’s two week target for suspected cancer patients to see a specialist could be scrapped under new plans. 

It could be replaced with a new ‘faster diagnostics standard’, where patients who have been urgently referred should be diagnosed in 28 days — or have the disease ruled out. 

Health chiefs said the current two-week goal sets no expectation of when patients should be given the all-clear or told they have cancer.  

The NHS said the proposals, which comes just a month after Sajid Javid declared a ‘national war on cancer’ in a bid to improve Britain’s survival rate for the disease, are based on recommendations of an independent taskforce. 

Cancer Research UK claimed it should lead to improvements in diagnosis times but called for a plan to boost the workforce. 

However, Breast Cancer Now admitted it was disappointed that NHS England had watered down the ambitions of the Independent Cancer Taskforce (ICT) report. 

‘The ICT recommended the ambition should be for 95 per cent of people to be diagnosed with cancer, or have cancer ruled out within 28 days of urgent referral by 2020,’ said Baroness Delyth Morgan, of Breast Cancer Now. 

‘We’re deeply concerned NHS England has significantly lowered its ambition for rapid diagnosis by setting the target for the new Faster Diagnosis Standard (FDS) at 75 per cent by March 2024.’ 

Other new proposed cancer targets include for patients who receive a cancer diagnosis to start treatment within nine weeks from the date of their initial referral, dubbed a 62-day referral to treatment standard.

Patients must start first treatment within a month of a decision to treat them, the guidelines say. 

The latest NHS cancer treatment statistics recorded the worst ever level of cancer referrals.

Some 202,816 urgent cancer referrals were made by GPs in England in January but only 75 per cent had their first consultant appointment within two weeks, the lowest percentage in records going back to October 2009.

Some 202,816 urgent cancer referrals were made by GPs in England in January but only 75 per cent had their first consultant appointment within two weeks, the lowest percentage in records going back to October 2009. 

NHS targets state more than 90 per cent of patients given an urgent referral should be seen within a fortnight.

The target is set to be axed under NHS plans, it was revealed this week.    

Macmillan Cancer Support director of advocacy, Eve Byrne, said yet another round of ‘worst-ever- records was ‘deeply troubling’ for cancer patients in England. 

She added that any new Government measures or targets to improving cancer care in England will fail without a plan to increase the workforce.   

The poor performance data comes as NHS England currently runs a consolation on ditching the two week target for suspected cancer patients to see a specialist.

It will instead be replaced with a new ‘faster diagnostics standard’, where 75 per cent patients who have been urgently referred should be diagnosed in 28 days — or have the disease ruled out by March 2024.  

Today’s data shows the NHS England, which already records this data, only managed to have 63.8 per cent of suspected cancer patients were diagnosed or had cancer ruled out within 28 days in January. 

Data on this metric only goes back to April 2021 so there are no comparable figures for January 2021, but this is the lowest percentage so far. 

Other cancer metrics also fared poorly with an NHS performance target for breast cancer also recording a worst ever low. 

Less than half of the 10,000 suspected breast cancer patients (49.4 per cent)  in England were seen by consultant within two weeks of a GP referral.  

The NHS standard is to have 93 per cent of such patients seen within a fortnight. 

A target to have cancer patients start treatment for their disease within a month of a decision to undergo treatment also declined in January.

Only 89.6 per cent of the about 25,000 patients in this group commenced their cancer treatment within in that timeframe, the lowest ever proportionally. 

The NHS standard is to have 96 per cent of these patients starting treatment within a month.

This cancer care performance is further broken down into three targets depending on the type of treatment a patient undergoes. 

These are anti-cancer drugs (chemotherapy), radiotherapy where cancer is hit by radiation, and surgery where cancerous tissue is removed.

In January, all three failed to meet their NHS standard, and in fact recorded record lows.

Surgery had the biggest gap between standard and reality,  with only 79 per cent of patients, 1,000 people, not getting an operation for their cancer within a month. The NHS’s standard is 94 per cent.

The NHS aims for 98 per cent of anti-cancer drug patients and 94 per cent of radiotherapy patients to be treated within a month but only managed to commence treatment for 96.6 and 91.5 per cent, respectively,  within this time frame.

A two month target to get cancer patients who were identified through a national screening service, such as the home bowel cancer screening sent to the over 60s, to start treatment also failed to be met.

NHS data shows only 65.4 per cent of patients managed to meet this deadline, the target is 90 per cent. 

However this wasn’t a record low, with only 13.3 per cent of patients meeting the target in June 2020 during the Covid pandemic.  

NHS England has defended its January performance, saying it had delivered 280,000 more diagnostic tests and checks in the month compared to the same time in 2021 despite ongoing staffing pressures.    

The NHS’s national medical director, Professor Stephen Powis said staff were determined to address the Covid backlogs that had ‘inevitably built up’ during the pandemic. But he added that it could not happen ‘overnight’.   

Other NHS data shows an additional 30,000 people were on the list for routine operations such as hip and knee replacements and cataract surgery in January compared to December.

The 6.1m toll is 2m higher than when the pandemic hit, when NHS elective care was effectively frozen for months. 

Mr Javid has come under increasing pressure to get a handle on the crisis, with charities warning that millions of Brits are living in pain while waiting for their surgeries.    

The number of people waiting over a year to start treatment increased to 311,528 in January, up from around only 1,400 before Covid hit. 

The Government and NHS England have vowed to eliminate all waits of more than a year by March 2025 as part of their pandemic recovery plan. The health service will get an extra £12billion a year from April, funded by the 1.25 per cent hike to national insurance.

Almost 24,000 have been waiting at least two years for treatment, up from 20,065 in December, and over nine times the 2,608 who were waiting in April 2021. 

These patients will be contacted by the end of the month to be offered alternative appointments in places where queues aren’t as long or in private hospitals. Their transport and accommodation fees will be covered.  

Health charities slammed today’s figures, with some warning that it demonstrates the pressure the health service is under as Covid hospitalisation numbers begin to creep up again.  

The Royal College of Surgeons’ vice president, Tim Mitchell, said: ‘If someone is left waiting years for a planned hip or knee operation, for example, it’s not surprising they will now be struggling to walk or work.’ 

Charity Versus Arthritis also slammed the data, saying it represented thousands of people living in agony while waiting in limbo for procedures. 

‘Behind today’s waiting times statistics are people with arthritis living in agony and distress, slipping further away from a life free from pain, being able to work, and having some semblance of independence,’ the charity’s head of policy and public affairs Tracey Loftis said. 

Labour’s shadow health and social care secretary said the situation patients faced was ‘unacceptable’. 

‘Record numbers of patients are forced to wait unacceptable lengths of time, including 24,000 who have been waiting for treatment since before the pandemic began,’ Wes Streeting said. 

As well as record long waiting lists, January also saw the lowest ever level of cancer referrals made within two weeks and A&E performance dived again.  

A&E performance also hit a record low in February, with only 73.3 per cent of patients seen within the four-hour target. 

Queues for routine operations are expected to peak in 2024 at around 10.7million in the most pessimistic scenario, modelling from the NHS shows. It is because the health service expects many patients who missed operations to now come forward for care

Other estimates showed up to 200,000 people could still be on waiting lists for more than a year by 2025 under the most pessimistic scenario. This was despite Health Secretary Sajid Javid saying year-long waits would end by this date

This is down from 74.3 per cent in January and 83.9 per cent in February last year, and equals the lowest percentage since records began in November 2010. 

NHS will PAY for a taxi and hotel to send long haulers for surgery at less busy or private hospitals in other parts of country 

The NHS will pay for patients in England stuck on waiting lists to be sent to less busy hospitals in other parts of the country under radical new plans.

They will be offered appointments in places where queues aren’t as long or referred to private hospitals with their transport and accommodation fees covered.

Health Secretary Sajid Javid unveiled the move as part of a series of reforms to slash the record queues for routine operations that have amassed during the pandemic. 

Mr Javid said the NHS will be soon be ‘proactively’ contacting all patients who have been waiting for two years or more by the end of this month to discuss alternative places to get their care.

The offer will be expanded to everyone who has waited more than 18 months by the end of this year, with a view to offering it wider in the future.  

Patients will be offered treatments in parts of the country where queues aren’t as long at other NHS trusts, or referred to private facilities for taxpayer-funded care.  

Speaking at the Royal College of Physicians in London this week, Mr Javid said: ‘It could be the trust next door, it could be a trust that’s further away and if it is your transport costs, accommodation, and other incidental costs will be covered.  

‘It could be independent sector, this is something the very best systems are already doing but I want it to become standard.’ 

Mr Javid also said that the Government cannot keep throwing money at the NHS without reforming it, and highlighted the health service’s budget is the same size as the GDP of Greece.

Despite his libertarian background, Mr Javid also shot down the suggestion that the US’ healthcare system was more free than the UK’s. He said it was ‘not freedom for the millions of people who can’t afford it’.

The target, to get 95 per cent of patients admitted, treated or discharged within four hours has not been met since 2015.    

Data released yesterday also showed 16,404 people had to wait more than 12 hours in A&E departments in England in February.

The figure is a slight improvement from 16,558 in January, which was the highest for any calendar month since records began in August 2010.

In total, 114,910 people waited at least four hours from the decision to admit to admission in February, again a slight improvement from an all-time high of 122,427 in January.   

Official NHS modelling estimates the backlog could peak at 10.7million in March 2024, with 200,000 people in England waiting more than a year by 2025. 

Waiting lists for routine treatment were high before Covid but have increased meteorically due to the disruption the pandemic caused to healthcare and by people’s conditions worsening not wanting to put pressure on NHS resources.

The British Heart Foundation described today’s figures as a ‘ticking time bomb’ for patients.

Dr Sonya Babu-Narayan, the charity’s associate medical director, said: ‘The vast and mounting backlog of cardiac care is a ticking time bomb, which the health secretary recognised earlier this week.

‘Cardiac care can’t wait – significant delays could lead to more avoidable heart attacks, disabling heart failure, or even premature deaths.’

The number of people waiting for cardiac care in England grew to 293,500 by the end of January, about 4,000 of which had been waiting over a year, and 100 for over two years. 

Elective cardiac care can include planned heart surgery such as fitting stents or balloons to open narrow or blocked arteries. 

Soaring waiting lists and record low treatment targets comes just a month after Mr Javid unveiled the £12billion-a-year NHS Covid recovery plan.  

It includes a raft of measures including building 100 community diagnostic centres, and new surgical hubs.

But reaction to the plan has been muted, with the headline promise to scrap one-year waiting lists not coming into effect until 2025.

The revised July 2022 deadline to scrap two-year queues was four months later than was previously promised by the Government, critics also said.

It comes as experts have asked NHS England for proof that new A&E measures — set to replace the four-hour waiting times target — will improve patient care.

The Royal College of Emergency Medicine (RCEM), Nuffield Trust and King’s Fund have all expressed concern that data from pilot studies in 14 NHS trusts has not been made public.

A new target of average wait times for A&E patients is set to replace the four-hour target a change backed by several NHS groups.

Under the new measures, patients would be seen within 15 minutes of arriving at A&E for an initial assessment and hospitals would be monitored based on the average time people spend in the department.  

UK’s daily Covid cases jump by another 50 PER CENT in a week as hospitalisations and deaths creep up 

Britain’s Covid resurgence continued today, according to official data that showed cases, hospitalisations and deaths all rose again.

Another 67,159 positive tests were logged across the UK yesterday, up 52.6 per cent on last Wednesday.

Deaths within 28 days of a confirmed coronavirus test also increased to 123, up 66.2 per cent on the 74 recorded last week.

And hospital admissions increased to 1,192 on March 5, the latest date UK-wide data is available for, marking a 14.6 per cent rise on the previous week.

It was the third time in a row all three metrics increased week-on-week, after cases started to rise last Wednesday.

Experts believe it is a combination of all restrictions being lifted in England on Freedom Day at the end of February and the rise of a more infectious version of Omicron — although experts insist it is not more deadly than its parent strain.

Hospitalisations are rising in every region of England and are now at record levels in the South West of England, which has typically been hit less hard than other parts of the country.

But NHS data suggests a significant share of Covid hospital patients are not primarily ill with the virus and test positive after admission for something else.

In terms of ambulance performance, the average time for people waiting for an ambulance for life threatening emergencies in February was eight minutes and 51 seconds.

This is up from eight minutes and 31 seconds in January but below record the nine minutes and 20 seconds recorded in October 2021, the longest average response time since current records began in August 2017.   

Ambulance response times for less urgent emergency calls which cover incidents like burns, epilepsy and strokes rose to 42 minutes and seven seconds in February.   

This is up from 38 minutes and four seconds in January.     

The number of people admitted for routine treatment in England in January was 226,856 – up 63 per cent from a year earlier (139,378), although this reflects lower-than-usual figures for January 2021, due to Covid disruption. 

In January 2020, the last data before before the pandemic hit, the figure was 303,466.

Another worrying statistic was the number people in England been waiting more than six weeks for a key diagnostic test in January.

Data shows 435,000 people were waiting for one of 15 standard tests – which include an MRI scan, non-obstetric ultrasound or gastroscopy.

The equivalent number waiting for more than six weeks in January 2021 was 377,651 while in January 2020 there were just 46,319.

The elective recovery plan sets the ambition that 95 per cent of patients needing a diagnostic test receive it within six weeks by March 2025.

The Nuffield Trust said the collection of worsening NHS performance data was ‘sobering’.

Nuffield Trust deputy director of research Sarah Scobie also said the figures came as the country saw a rise in hospital admissions for Covid which could hobble any the NHS as it tried to deal with the treatment backlog. 

‘A renewed wave of the virus just as health and social care services are struggling to get back on their feet could be perilous for any hopes of recovery,’ she said. 

The latest data shows Covid hospital admissions increased to 1,192 on March 5 marking a 14.6 per cent rise on the previous week.

While not all Covid hospital admissions are there primarily for treatment for the virus, any patients with Covid have to be isolated away from other patients creating extra strain on NHS resources. 

Source: Read Full Article