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More than 7,000 cancer operations delayed by junior doctors’ strikes

Junior doctors on the picket line outside the Royal London Hospital, London, on Jan 4
Junior doctors on the picket line outside the Royal London Hospital, London, on Jan 4 - ANDY RAIN/EPA-EFE/Shutterstock

More than 7,000 cancer operations have been delayed as a result of junior doctors’ strikes, leaked NHS figures show.

The data show that during walkouts the total amount of cancer operations has fallen by 27 per cent, even among the most deadly and time-sensitive cases.

The NHS is bracing for a tenth round of strikes by junior doctors starting on Saturday, with five days of walkouts planned after talks with the Health Secretary broke down.

Health officials are pleading with the British Medical Association (BMA) to agree exemptions to protect cancer patients from further action, and have shared evidence of the potentially lethal impact of strikes so far.

The union has so far refused to agree to exclude any such services from the walkouts.

Since strikes by medics began last March, health officials and the union have been at loggerheads about the dangers being posed to patients - especially in the case of fast-spreading disease.

NHS England has now carried out analysis showing there has been a 27 per cent reduction in cancer surgery - equivalent to 7,000 operations - during junior doctor walkouts.

The analysis found that the scale of reduction appears to be replicated even for time-sensitive cancers including lung, upper gastrointestinal and head and neck.

Delays for such patients increase the risk of tumour growth and spread.

The analysis has found that even when periods of industrial action ended, cancer patients typically faced a further delay of one to two weeks for surgery, amid a backlog of people requiring operations.

Every four-week delay in starting cancer treatment increases the risk by around 10 per cent, with the highest risks among patients with bowel cancer and head and neck disease, research shows.

A memo from Dame Cally Palmer, NHS England’s national cancer director, and Prof Peter Johnson, clinical director for cancer, sent to medical directors of England’s cancer networks on Monday states: “NHSE analysis suggests that, despite the efforts by colleagues across the country to maintain services wherever possible, there has been a 27 per cent reduction in cancer surgery during periods of industrial action by junior doctors [equivalent to more than 7,000 fewer cancer operations since March 2023] and that this scale of reduction has been replicated even for time-sensitive cancers”.

Officials said hospitals have taken two weeks to catch up with activity lost on strike days.

“Similar patterns are observed with faster-progressing cancers, where even short delays with treatment could adversely impact outcomes,” it notes.

Every NHS cancer centre will now be asked to provide health chiefs with details of how many urgent cancer operations for fast-progressing cancers are planned, for each day of the strike, and how this compares with normal performance.

Health officials hope such evidence will put further pressure on the BMA to agree mitigations to allow urgent cancer surgery to go ahead.

‘Life-saving services’

Dame Cally told The Telegraph: “The NHS is working incredibly hard to maintain provision of urgent cancer surgery on strike days, but it is right to say that we are growing increasingly concerned about the risk of harm to patients.

“That’s why we are in active discussions with the BMA to agree to safety mitigations for patients, and people should continue to come forward, either for checks or their appointment, unless told otherwise.”

Michelle Mitchell, Cancer Research UK’s chief executive, said: “We urge all parties to work together to quickly reach an agreement and ensure that people affected by cancer don’t miss out on life-saving services. If this can’t be reached, hospitals must ensure that risk to cancer patients’ disease progression is the overriding concern when protecting critical services.”

Caroline Johnson, a Tory MP and doctor, said: “Doctors contemplating further strike action should consider whether they can live with knowing they are leaving cancer patients to wait in order to get themselves more money.”

The MP, a member of the Commons Health Select Committee, said ministers should use minimum service level legislation to protect patients from clinically significant delays.

Official figures show more than 1.3 million hospital appointments and operations cancelled in England so far as a result of all NHS strikes.

Junior doctors are demanding a pay rise of 35 per cent, which they say is required to restore pay to previous levels in real terms, saying they would accept over several years.

On Monday, Dr Emma Runswick, deputy chairman of the British Medical Association Council said strikes could continue for years, past the next general election.

She told the BBC’s Political Thinking with Nick Robinson podcast: “The dispute we have now is not going to end with a change of government. It’s going to end with progress on pay for doctors.”

Junior doctors received an average pay rise of 8.8 per cent this year, with those in their first year of training receiving a 10.3 per cent increase.

Talks between the Government and the union broke down earlier this month when the BMA announced the five-day strike from February 24 to 28th.

Prof Philip Banfield, BMA council chairman said: “We take any concerns around patient safety incredibly seriously.

“Throughout industrial action we’ve maintained discussions with NHS England, stressing that Trusts should be planning services on and around strike days carefully and prioritising people with the most urgent needs – including patients needing urgent cancer surgery.

“We have been more than willing to work with NHS England on this, yet we know some hospitals are still scheduling non-urgent operations on and around strike days, which affects the ability to reschedule urgent surgery.

“Discussions around these recent specific concerns raised by NHS England are ongoing,” he said, adding that trusts could have been given more notice of strikes if the Government had agreed to hold negotiations while strikes were called.