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Do you know how long the wait is for cancer treatment? The answer might shock you

Cancer_time
The targets for diagnosing and treating cancer within a specific timeframe reflect the minimum expected for patients

How long would you be willing to wait for urgent cancer treatment? A few weeks, a month? How about 62 days. This is the current maximum time people are supposed to wait between having an urgent referral for cancer to actually receiving treatment in England, and that’s if you’re one of the lucky ones. But sadly increasing numbers of people are having to wait even longer than that.

Cancer waiting times are now among the worst on record in the UK. The targets for diagnosing and treating cancer within a specific timeframe reflect the minimum expected for patients. On Oct 1 last year, the NHS streamlined 10 existing standards into three cancer waiting time standards for England.

However, statistics recently released for December 2023 show that none of the targets were met. In fact, across England, Scotland, Wales and Northern Ireland, targets haven’t been met for many years.

Why are there constant delays – and, crucially, what can you do if your diagnosis or treatment is delayed?

Why are waiting lists so long?

The charity Cancer Research UK says today’s cancer waiting lists “represent a long-term failure to plan and invest in the NHS workforce and key facilities and equipment”. NHS Scotland says: “Staffing issues combined with a high number of referrals continue to limit capacity and impact on performance.”

There is also the question of soaring demand. As the population grows and ages, the number of new cancer cases is increasing. NHS figures published in January showed that almost three million people in England were tested for cancer in 2022, a 133 per cent increase in the decade since 2013. Cancer Research UK says that by 2040, the number of new cases is expected to increase by around a quarter. That means around half a million new cases diagnosed each year.

The current unrest in the NHS isn’t helping. New figures show that more than 7,000 cancer operations have been delayed since March as a result of junior doctors’ strikes. This is a 27 per cent reduction in cancer surgeries over the period.

Diagnosing cancer early and receiving timely treatment is key to improving outcomes,” says Minesh Patel, the head of policy at Macmillan Cancer Support. “However, sadly, thousands of people are facing alarmingly long waits for cancer tests and treatment, turning lives upside down. NHS professionals are stretched to breaking point. We have repeatedly called on the UK government to provide dedicated funding and support to bring down waits for cancer care and treatment. But we are yet to see real action.”

What can I do if I’m on a long waiting list, and how can I complain?

Waiting to be diagnosed or to start cancer treatment is highly stressful. Although nine out of 10 people referred for suspected cancer will not be diagnosed with the disease, waiting can occasionally be deadly. One study estimated that a four-week delay to cancer surgery led to a 6-8 per cent increased risk of dying.

However, NHS waiting lists are not like bus queues, and doctors can prioritise people with more advanced and aggressive cancers. Cancer Research UK says that in most cases, a few weeks’ delay will likely make little difference to your prognosis.

The Patients Association says: “The service you are waiting for should provide realistic timescales of when you’ll be seen and what to expect while you wait. If this isn’t happening, you have every right to ask that it does.

“It may also be worthwhile to discuss with your GP whether you could get treatment sooner if you visit another hospital. Patients in England have the right to use My Planned Care which advises on how long waits are at different hospitals. If you use the NHS’s Find A Hospital  online service, you can compare waiting times.”

The last option is to consider private tests or scans if you can afford it.

All NHS patients have the right to complain. The charity Healthwatch.co.uk can help people make a complaint more effectively. It states that in the first instance, you speak directly to the service itself, such as the specific clinic you have been referred to, and see if you can resolve the issue. If you are waiting to be seen at a hospital, the first contact should be with the Patient Advice and Liaison Service (PALS) team. You should find their contact details on your hospital’s website. You can contact the Parliamentary Health Service Ombudsman if you are still unhappy. In England, this is through their website, or you can call the helpline on 0345 015 4033.

The Patients Association’s website  has advice about making a complaint wherever you are in the UK. Tips include who to complain to, the information you should include in your complaint, including your name and date of birth, your NHS number if you have it, and details of what has already happened, such as your GP appointment, with dates and times, and what outcome you want, such as to be seen within a certain time frame. It says complaints should always be polite in tone. The charity’s free helpline is available from 9.30am to 5pm, Monday to Friday, at 0800 345 7115, or you can contact them via email at helpline@patients-association.org.uk.

For help, support and advice, you can visit Macmillan’s website or call 0808 808 00 00.

Cancer Research UK offers a nurse helpline on 0808 800 4040.


Cancer waiting times: Guidance for 2024

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England


The 28-day Faster Diagnosis Standard (FDS)

The standard: People with an urgent referral should have cancer ruled out or receive a diagnosis within 28 days.

NHS target: 75 per cent of patients should be diagnosed or given the all-clear within this timeframe.

Who does it apply to? People who have been urgently referred: by a GP for suspected cancer;  following an abnormal cancer screening result; or by a GP for breast symptoms (where cancer is not suspected).

Current performance: 74.2 per cent.

The 62-day referral to treatment standard

The standard: People with cancer should begin treatment within two months (62 days) of an urgent referral.

NHS target: 85 per cent of people should be treated by this deadline. However, the NHS recently announced that it aims for 70 per cent of patients to begin treatment within two months of their urgent referral by March 2024.

Who does it apply to? People with cancer who have been urgently referred: by a GP for suspected cancer; following an abnormal cancer screening result; by a consultant who suspects cancer following other investigations (also known as ‘upgrades’).

Current performance: 65.9 per cent

The 31-day decision to treat to treatment standard

The standard: People with cancer should begin treatment within a month (31 days) of a decision being made to treat their cancer.

NHS target: 96 per cent.

Who does it apply to? Anyone who has been diagnosed with cancer, including people who have cancer which has returned.

Current performance: 91.1 per cent.

Outside England

The Faster Diagnosis Standard only applies to England. But while Scotland, Wales and Northern Ireland have different targets, these are also being missed.


Wales

The latest figures were released by the Welsh Government in January 2024 and cover November 2023.

The 62-day referral to treatment standard

The standard: All urgent and non-urgent cancer referrals have one target time. This is for eligible patients to be diagnosed and start treatment by 62 days from when cancer is first suspected. The clock could start ticking from a GP referral, an abnormal screening result or a hospital admission.

NHS target: 75 per cent of patients to either be told they do not have cancer or start cancer treatment within 62 days.

Current performance: 53.5 per cent.


Scotland 

The most recent figures on cancer waiting times from Public Health Scotland were issued in December 2023. They cover patients who had started their first treatment by the quarter ending Sept 30 2023 and only apply patients with one of the following cancers: breast, colorectal, head and neck, lung, lymphoma, ovarian, melanoma, upper gastro-intestinal (hepato-pancreato-biliary and oesophago-gastric), urological (prostate, bladder, other) or cervical.

The 62-day referral to treatment standard

The standard: People should wait no longer than 62 days from an urgent suspected cancer hospital referral to their first treatment.

NHS target: 95 per cent.

Current performance: 72 per cent.

The 31-day decision to treat to treatment standard

The standard: Patients should wait no longer than 31 days from the decision to treat them to their first cancer treatment.

NHS target: 95 per cent.

Current performance: 94.9 per cent.


Northern Ireland

The latest statistics for cancer waiting times in Northern Ireland were published in January this year, covering the quarter ending September 2023.

The 62-day referral to treatment standard

The standard: People should wait no longer than 62 days from an urgent suspected cancer hospital referral to treatment.

NHS target: 95 per cent.

Current performance: 33.6 per cent.

The 31-day decision to treat to treatment standard

The standard: Patients should wait no longer than 31 days from the agreement of a treatment plan to their first cancer treatment.

NHS target: 98 per cent.

Current performance: 89.1 per cent.

The 14-day urgent breast cancer referral standard

The standard: Patients with suspected breast cancer should be seen by a breast cancer specialist within 14 days of the hospital receiving an urgent referral.

NHS target: 100 per cent.

Current performance: 52.9 per cent. A drop from 70.2 per cent in the previous quarter.